1. Communicating Environmental Factors in Breast Cancer to the Public Charles K. Atkin, Kami J. Silk, & Sandi W. Smith Department of Communicatin Michigan State University

2. Project Funding This research was made possible by the Breast Cancer and the Environment Research Centers grant number 1-U01-ES12800 from the National Institute of Environmental Health Sciences (NIEHS), and the National Cancer Institute (NCI), NIH, DHHS. The contents of this presentation are solely the responsibility of the presenter and do not necessarily represent the official views of the NIEHS or NCI, NIH.

3. Overview Introduce Breast Cancer & Environment Research Centers (BCERC) Define transdisciplinary research Present the precautionary principle as source of tension Identify challenges associated with transdisciplinary model in the breast cancer context

4. BCERC The National Institute of Environmental Health Sciences (NIEHS) and the National Cancer Institute (NCI) established the BCERC Network in 2003 Four BCERC centers across the United States –Michigan State University –Fox Chase Cancer Center –University of Cincinnati –University of California, San Francisco

5. BCERC Each Center has three cores –Epidemiology* –Biology –Communication Outreach and Translation Core MSU’s Communication Department is part of the COTC *MSU does not have an epidemiology core

6. BCERC Organizational Model UC MSU UCSF UP COTC BIO EPI Steering Committee Working Group BIO EPI COTC EPI BIO COTC BIOCOTC

7. BCERC COTC The overall goal for the COTC is to develop public health messages for: young girls and women who are at high risk for breast cancer about the role(s) of specific environmental stressors in breast cancer and how to reduce exposures to these stressors

8. “Transdisciplinary” Defined Involves broadly constituted teams of researchers that work across disciplines (and community members) in the development of the research questions to be addressed. By definition, the research problem is beyond the scope of any individual discipline. Prominent interest in translating scientific knowledge into practical applications to benefit the public (Source: Institute of Medicine)

9. Trans-Challenges and Solutions Challenges Integration Time Advocates and researchers have different goals Advocates as Volunteers Evaluation Funding (Source: BCERC members) Solutions Conference calls/meetings Input sought across projects Committee structure Shared authorship and collaboration on writing projects An assumption of “synergy” Funding grants longer than 5 years

10. Advocates as Partners Pivotal role in BCERC Volunteers Survivors Different goals than researchers Supporters of the precautionary principle

11. …“when an activity raises threats of harm to human health or the environment, precautionary measures should be taken even if some cause and effect relationships are not fully established by science Wingspread Statement on the Precautionary Principle, 1998 Advocates strongly adhere to it Potential conflict btw researchers & advocates Implications for communicating risks Precautionary Principle

12. Message Considerations When is it time to share risks from emerging science? How do we use the emotional context of breast cancer to influence risk reduction activities? If puberty is a critical window of susceptibility for later risk of breast cancer, how do we communicate risks for young girls?

13. Range of Studies at MSU Memorable messages Health literacy/readability focus Media & website content analyses Focus Group research with moms and daughters Qualitative and quantitative testing of risk messages for mothers

14. Sample Messages

15. Some Recommendations Need for more prevention messages –Precautionary principle Use of family and friends as sources –Especially mothers to daughters Improvement of television, newspaper, and website content about breast cancer is necessary –Increased talk of prevention –Increased discussion of environmental factors –Use clear and understandable language

16. Some Recommendations Mothers Clarify risk factors and provide information on how to accurately assess relative risks Encourage discussion with daughters, especially because they perceive schools are not informing girls on the issue Need an efficacy component to messages Incorporate their specific concerns Daughters Increase salience and self-efficacy Fear appeals inappropriate Link healthy lifestyle factors to other positive health outcomes

17. Some Recommendations Use both physicians and researchers as credible sources in messages Test messages for readability levels Include website links in messages for further information seeking People see science as “truth”; communicate that science is uncertain and emerging Collaborate with a range of people to create and disseminate messages

18. BCERC Information www.bcerc.org MSU Research & References www.bcerc.msu.edu www.bcerc.org www.bcerc.msu.edu Thank You