Center of Excellence in Cancer Communication Research at the University of Pennsylvania

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Overview: The primary mission of the Penn CECCR is to study the complex public information environment around cancer and how that affects behavioral choices people make relevant to cancer. The center's research focuses on the interaction of public communication and clinical services, as they both affect cancer-related outcomes. Drawing from a broad range of disciplinary backgrounds, the Penn CECCR seeks new knowledge about cancer communication and develops and tests interventions to enhance cancer-related behavior. Penn CECCR participated in the first iteration of CECCR; for more information about their first set of projects, see the CECCR Archive.

Primary research and goals: This center is conducting two primary projects aimed at understanding the interaction of public communication and clinical services as they affect cancer-related decisions and outcomes, with the following goals:

  1. To improve procedures for developing promising messages for cancer communication interventions through the Message Core.
  2. To foster innovative, transdisciplinary developmental projects in cancer communication research that support Penn CECCR's mission.
  3. To train physician and non-physician researchers for careers in cancer communication.

Key partnerships and collaborations: Penn CECCR brings together scholars from the University of Pennsylvania from the Annenberg School for Communication, Abramson Cancer Center, School of Medicine, the Wharton School, the School of Nursing, and the School of Arts and Sciences. Penn CECCR has also collaborated with researchers from institutions such as Fox Chase Cancer Center, UCSF, and the University of Illinois, Chicago.

Photo of Dr. Robert C. HornikPrincipal investigator: Dr. Robert C. Hornik is the Wilbur Schramm Professor of Communication and Health Policy at the Annenberg School for Communication, University of Pennsylvania, and a member of the Health Communication Group of the Annenberg Public Policy Center. In those roles, he has led efforts to design and evaluate large-scale public health communication and education programs. Some major projects for which Dr. Hornik has been principal investigator include U.S. Agency for International Development (USAID)-sponsored evaluations of national AIDS education programs in four developing countries (AIDSCOM), and of communication for child survival programs in 10 developing countries (HEALTHCOM), and CDC-sponsored research on determinants of immunization status in Philadelphia. He has completed direction of two evaluations of domestic violence prevention projects: the Philadelphia: Let's Stop Domestic Violence program and the It's Your Business domestic violence radio serial. He is currently co-principal investigator and scientific director for the NIDA-funded evaluation of the National Anti-drug Media Campaign.

Some of Dr. Hornik's publications include "Public Health Education and Communication as Policy Instruments for Bringing about Changes in Behavior," "Alternative Models of Behavior Change," and "Channel Effectiveness in Development Communication Programs" as well as the books Development Communication: Information, Agriculture and Nutrition in the Third World (Longman, 1989), Towards Reform of Program Evaluation (co-authored, Jossey-Bass, 1980), and Educational Reform with Television: The El Salvador Experience (co-authored, Stanford, 1976.)

He is editor of Public Health Communication: Evidence for Behavior Change (Lawrence Erlbaum Associates, 2001), which presents the essential evidence that public health communication in a variety of forms has influenced important health behavior and outcomes. Dr. Hornik received his Ph.D. from Stanford University.

Contact information:
Robert C. Hornik


Photo of Co-investigator Katrina Armstrong, M.D.
Katrina Armstrong, M.D.
Photo of Co-investigator Joseph Cappella, Ph.D.
Joseph Cappella, Ph.D.
Photo of Co-investigator Caryn Lerman, Ph.D.
Caryn Lerman, Ph.D.
Photo of Co-investigator J. Sanford Schwartz, Ph.D.
J. Sanford Schwartz, Ph.D.

Primary projects

  1. Patient-clinician information exchange (PCIE)
    1. Lead researchers: Dr. Robert Hornik, Ph.D.; Dr. Katrina Armstrong, M.D.
    2. Overview: PCIE focuses on patient-clinician information exchange after cancer diagnosis. The observational study investigates whether PCIE in the context of use of other information sources is associated with and predictive of treatment choices and other health management decisions, behaviors, and outcomes. The study also investigates antecedents of PCIE. The sample includes 2,013 breast, prostate and colorectal cancer patients drawn from the Pennsylvania Cancer Registry (64 percent response rate) who were followed for up to 3 years after diagnosis. For eligible patients, questionnaire and PCR information were merged with Medicare claims information.
    3. Implications for cancer prevention and control: This research will elucidate the pathways that lead to PCIE and allow us to determine the facets of PCIE that lead to particular medical outcomes. By extension, this research will allow the CECCR at Penn to determine what types of PCIE lead to more desirable medical and psychological outcomes (e.g., more effective treatments) and what variables predict engagement in desirable patient-clinician communication.
    4. Selected works published as a result from CECCR II funding:
      1. Lewis, N., Gray, S.W., Freres, D. R, & Hornik, R. (2010). Examining cross-source engagement with cancer-related information and its impact on doctor-patient relations. Health Communication, 24(8), 723-734.
      2. Martinez, L., Schwartz, J.S., Freres, D., Fraze, T., & Hornik, R. (2009). Patient-clinician information engagement increases treatment decision satisfaction among cancer patients through feeling of being informed. Patient Education and Counseling, 77(3), 384-390.
      3. Nagler, R.H., Romantan, A., Kelly, B.J., Stevens, R.S., Gray, S.W., Hull, S.J., Ramirez, A.S., & Hornik, R.C. (2010). How do cancer patients navigate the public information environment? Understanding patterns and motivations for movement among information sources. Journal of Cancer Education, 25(3), 360-370.
      4. Nagler, R., Gray, S., Romantan, A., Kelly, B., DeMichele, A., Armstrong, K., Schwartz, S., & Hornik, R. (2010). Differences in information seeking among breast, prostate, and colorectal cancer patients: Results from a population-based survey. Patient Education and Counseling, 81, S54-S62.
      5. Tan, A., Bourgoin, A, Gray, S. Armstrong, K., & Hornik, R. (in press). How does patient-clinician information engagement influence self-reported cancer-related problems? Findings from a longitudinal analysis. Cancer.
      6. Wakefield, M. Loken, V., & Hornik, R. (2010). Use of mass media campaigns to change health behaviour. Lacet, 376(9748), 1261-1271.
      7. Lee, C-J., Gray, S.W., & Lewis, N. (2010). Internet use leads cancer patients to be active health care consumers. Patient Education & Counseling, 81, S63-69
      8. Lee, C-J & Hornik, R.C (2009). Physician trust moderates the internet use and physician visit relationship. Journal of Health Communication, 14(1), 70-76.
      9. Lewis, N., Hornik, R., & Gray, S. (2009). Cross source engagement with cancer-related information and its impact on doctor-patient relations. Health Communication, 24(8), 723-734.
      10. Kelly, B., Niederdeppe, J., & Hornik, R. (2009). Validating measures of scanned information exposure in the context of cancer prevention and screening behaviors. Journal of Health Communication, 14(8), 721-740.
  2. Smoking cues in anti-tobacco PSAs
    1. Lead researchers: Dr. Andrew Strasser, Ph.D.; Dr. Joseph Cappella, Ph.D.; Dr. Caryn Lerman, Ph.D.
    2. Overview: The study investigates the effects of smoking cues from anti-tobacco PSAs on smoking urges, message processing, persuasion, and smoking behavior in a sample of 300 chronic smoking adults. The study uses a 3 (smoking cue: no cue; peripheral cue; central cue) x 2 (low vs. high argument strength) between-subject factorial study design. 150 male and 150 female smokers are randomly assigned to one of these six conditions and view a series of four PSAs. The primary outcomes include smoking urges, message processing, and persuasion. Secondary outcomes include physiological reactivity and smoking behavior immediately following the session.
    3. Implications for cancer prevention and control: This research seeks to understand the influence of smoking cues, and its findings can offer guidance to creators of PSAs that encourage rather than undermine cessation attempts.
    4. Selected works published as a result from CECCR II funding:
      1. Kang, Y., Cappella, J.N., Strasser, A., & Lerman, C. (2009). The effect of smoking cues in antismoking advertisements on smoking urge and psychophysiological reactions. Nicotine and Tobacco Research, 11(3), 254-261.
      2. Leader, A., Lerman, C., & Cappella, J.N. (2010). Nicotine vaccines: Will smokers take a shot at quitting? Nicotine Tobacco Research, 12(4), 390-397.
      3. Wong, N. & Cappella, J.N. (2009). Antismoking threat and efficacy appeals: Effects on smoking cessation intentions for smokers with low and high readiness to quit. Journal of Applied Communication Research, 37(1), 1-20.

Secondary projects

  1. Message Core: Design, evaluation, and methods
    1. Lead researcher: Dr. Joseph Cappella, Ph.D.
    2. Overview: The Message Core provides assistance in message design and testing to major and pilot projects in the Penn CECCR; evaluates new methods for assessment of message characteristics; and advances theories of message effects relevant to cancer control.
    3. Implications for cancer prevention and control: The Message Core provides efficient, reliable, and valid pre-testing of cancer control messages using relevant and representative populations.
    4. Selected works published as a result from CECCR II funding:
      1. Brechman, J., Lee, C-J., & Cappella, J.N. (2009). Lost in translation? A comparison of cancer genetics reporting in the press release and its subsequent coverage in press. Science Communication, 30, 453-474.
      2. Kang, Y., Cappella, J. N., & Fishbein, M. (2009). The effect of marijuana scenes in anti-marijuana public service announcements on adolescents' evaluation of ad effectiveness. Health Communication, 24(6), 483-493.
      3. Kelly, B., Leader, A., Mittermaier, D., Hornik, R., & Cappella, J.N. (2009). The HPV vaccine and the media: How has the topic been covered and what are the effects on knowledge about the virus and cervical cancer? Patient Education and Counseling, 77(2), 308-313.
      4. Strasser, A., Cappella, J., Jepson, C., Fishbein, M., Tang, K., Han, E., & Lerman, C. (2009). Experimental evaluation of anti-tobacco PSAs: Effects of message content and format on physiological and behavioral outcomes. Nicotine and Tobacco Research, 11(3), 293-302.
      5. Kang, Y., Cappella, J. N. (2008). Emotional Reactions to and Perceived Effectiveness of Media Messages: Appraisal and Message Sensation Value. Western Journal of Communication, 72(1), 40-61.
  2. Developmental Core
    1. Lead researcher: Dr. Robert Hornik, Ph.D.
    2. Overview: The Developmental Core promotes innovative, interdisciplinary large and small developmental research projects in cancer communication research that support the mission of the Penn CECCR.
    3. Implications for cancer prevention and control: The Developmental Core brings young investigators from all over campus and from multiple disciplines to become involved with the broader CECCR activities and contribute to the field of cancer communication. Under CECCR II, Penn CECCR has supported three pilot projects:
      1. A Mixed Methods Study of the acceptability, feasibility, use of a Web-based Toolbox to Increase Physician Recommendation of Colorectal Cancer Screening (PI: Carmen E. Guerra, M.D., M.S.C.E.)
      2. Genetic Message Priming and Enrollment in, and Response to, a Smoking Cessation Program: A Pilot Study (PI: Robbie Schnoll, M.D. and Freda Patterson, Ph.D.)
      3. Brain response to presence of smoking cues in anti-tobacco PSAs (PI: Loughead, James, Ph.D.)
  3. An RCT to examine the effects of scanning (administrative supplement)
    1. Lead researcher: Dr. Robert Hornik, Ph.D.
    2. Overview: The study is designed as an ecologically valid, 12-month, randomized controlled trial to test the effects of information scanning (routine exposure to media information) on cancer prevention and screening behavior (exercise; fruit and vegetable consumption; mammography; colorectal cancer detection) in a population sample of 50-70 year olds. It makes use of a monthly newsletter distributed to participants via email (Penn Health Digest). A total of 15,000 individuals have subscribed to the newsletter.
    3. Implications for cancer prevention and control: The results of the study will provide evidence about the effects of information scanning on cancer-relevant behavior at a population level, justifying public communication programs stimulating media coverage of screening and prevention behaviors.