1. Unsafe Environmental Contaminants and Breast Cancer: Website Advisories, Media News Coverage, and Women’s Risk Perceptions Charles Atkin, Sandi Smith, Pam Whitten, Kami Silk & Lauren Hamel Michigan State University

2. BC Content Emphasis: Similar for Web & Traditional Media Treatment > Detection> Prevention Treatment > Detection> Prevention Within prevention: Collective > Individual Within prevention: Collective > Individual Within individual: Genetics > Environment Within individual: Genetics > Environment

3. Environmental Safety Info on 157 BC Websites

4. Coders* evaluated sites based on key healthcom prevention theories Theory of Planned Behavior (Azjen) Theory of Planned Behavior (Azjen) Attitudes, norms, & perceived behavior control Attitudes, norms, & perceived behavior control Extended Parallel Processing Model (Witte) Extended Parallel Processing Model (Witte) Perceived threat, self efficacy, response efficacy Perceived threat, self efficacy, response efficacy Transtheoretical Model (Prochaska) Transtheoretical Model (Prochaska) Stages of change Stages of change

5. There’s some contamination content… Does the website have a section to inform users about anything in the environment that increases a person's chances of getting breast cancer? Does the website have a section to inform users about anything in the environment that increases a person's chances of getting breast cancer? 31% of all BC websites 31% of all BC websites

6. # Exposures to BC Messages (past year) 9 TV public service spots 9 TV public service spots 8 Magazine stories 8 Magazine stories 8 TV newscast stories 8 TV newscast stories 7 Newspaper news/feature items 7 Newspaper news/feature items 4 TV talk shows/dramas 4 TV talk shows/dramas 90% saw stories in traditional media 20% searched internet Statewide survey N=250 females (2004)

7. Channels for learning useful BC info 68% TV newscasts 68% Women’s magazines 67% Newspaper articles 65% Pamphlets 63% TV PSAs 60% TV talk shows National survey N=250 females (2007)

8. Secondary channels… 43% Newsmagazines 43% Newsmagazines 30% Internet websites 30% Internet websites 29% TV dramas 29% TV dramas

9. Credibility of BC Info Channels (0-10 scale) 7 Newspapers 7 Newspapers 6 Newsmagazines 6 Newsmagazines 6 TV newscasts 6 TV newscasts 5 Health websites 5 Health websites Statewide survey N=250 females (2004)

10. Who seeks BC info? TRADITIONAL MEDIA: Broad cross section INTERNET: Concerned women, Activists -- Web traffic primarily driven by diagnosis -- Web traffic primarily driven by diagnosis -- Activists focus on organized action -- Activists focus on organized action

11. Most-visited BC websites breastcancer.org breastcancer.org komen.org komen.org cancer.gov cancer.gov (webmd & acs) (webmd & acs) Lower rank for contaminant-oriented sites: silentspring.org silentspring.org envirocancer.cornell.edu envirocancer.cornell.edu

12. Breastcancer.org Antiperspirants Do Not Increase BC Risk Background and study design: The rumor that using underarm deodorant or antiperspirant can cause breast cancer has circulated for years on the Internet…. Background and study design: The rumor that using underarm deodorant or antiperspirant can cause breast cancer has circulated for years on the Internet…. Take-home message: Hopefully, this study will help to calm women's fears about antiperspirant and deodorant use and breast cancer…. Take-home message: Hopefully, this study will help to calm women's fears about antiperspirant and deodorant use and breast cancer….

13. toxicbust.com

14. Credibility of BC Sources (0-10 scale) 10 American Cancer Society 10 American Cancer Society 9 Federal agencies 9 Federal agencies 9 Medical centers 9 Medical centers 9 Komen Foundation 9 Komen Foundation 8 Universities 8 Universities

15. Women’s Perceptions of BC Risk Factors (0-10 scale) Women’s Perceptions of BC Risk Factors (0-10 scale) 9 Smoking cigarettes 9 Smoking cigarettes 9 Genetics / Family history 9 Genetics / Family history 7 Hormone Replacement Therapy 7 Hormone Replacement Therapy 7 Secondhand smoke 7 Secondhand smoke 6 High-fat foods in childhood 6 High-fat foods in childhood 6 Obesity in childhood 6 Obesity in childhood 4 4 Chemicals / Pesticides 

16. Weak relationships between BC website visits and… …level of concern about contaminants …encouraging daughter to avoid pesticides …encouraging daughter to avoid household chemicals National survey N=250 females (2007)

17. Implications… Need “better” BC websites: Need “better” BC websites: esp. Enhance in line with healthcom theory esp. Enhance in line with healthcom theory Need to organize content according to distinct motivations of audience segments Need to organize content according to distinct motivations of audience segments Need to use traditional media to drive the majority to websites (esp. enhanced sites) Need to use traditional media to drive the majority to websites (esp. enhanced sites)