Research Notes: The Angelina Effect

The second most popular Pop Health post of 2013 was "Angelina Jolie's 'Medical Choice' Dominates the Internet" (May 14, 2013).  In that post, I highlighted several public health implications of her op-ed that were being discussed in the media coverage-

(1) Angelina as a "champion" for breast cancer prevention: would her celebrity status help or hurt the cause?
(2) Legal and policy issues with BRCA genetic testing.
(3) Health communication (specifically regarding risk perception).
(4) Reviewing the evidence base for recommending BRCA testing or preventative mastectomies.

When celebrity health stories such as this are publicized, I always keep my eyes peeled to see if any evaluation research or subsequent stories follow.  So I was thrilled to see a peer-reviewed paper released last week that examined the impact of her op-ed.  Authors of "The Angelina Effect: Immediate Reach, Grasp, and Impact of Going Public", conducted a survey which asked participants to report their understanding, reactions, perceptions, and subsequent activities related to the story.  The researchers were especially interested in the public's ability to distinguish the genetic context of Angelina's risk of Breast Cancer from the lower risk that characterizes the vast majority of women who do not carry a BRCA mutation.

Some key findings:

• Approximately 75% of sampled adults were aware of Angelina's choice to undergo a double mastectomy to reduce her risk of developing Breast Cancer.

• Of those aware of her story, only 3.4% indicated that they had read her op-ed originally posted in the New York Times.  Instead, most became aware of the story through the national/local news (61.2%) or entertainment news (21.5%).

• Among respondents that correctly reported Angelina's risk of developing Breast Cancer, fewer than 10% had the information necessary to interpret her risk relative to a woman unaffected by the BRCA gene mutation.

• The majority of respondents (80%) did not report any health-related actions (e.g., speaking with a doctor or genetic counselor) in the 3 weeks between the op-ed's publication and survey completion.

The authors' conclusions have important implications for those of us that lead health communication efforts- especially those efforts that intersect with the popular media:

"While celebrities can bring heightened awareness to health issues, there is a need for these messages to be accompanied by more purposeful communication efforts to assist the public in understanding and using the complex diagnostic and treatment information that these stories convey."

What Do You Think?

• Are you surprised that Angelina's op-ed did not result in significant knowledge or behavior change among readers?
• Should we retire "awareness" as a public health goal since it often does not lead to knowledge or behavior change?
• Since most respondents were not able to distinguish Angelina's cancer risk from women who do not carry the BRCA gene mutation, could the op-ed do more harm than good?
• This survey was conducted within 3 weeks of the op-ed publication; are there questions you would like to see asked in a longer-term follow-up survey?