Stories That Engage the Audience: An Investigation of Breast Cancer Narratives on Social Media

BACKGROUND. Narratives represent a promising tool for health communicators to share information and build connections. Because social media have been widely used for cancer-related communication and support, it is vital to harness social media narratives for cancer prevention and control. This study aimed to identify the “active ingredients of breast cancer narratives on social media that effectively engage users.
METHOD. We obtained all Facebook posts by five influential breast cancer non-profit organizations from 2016 to 2021, from which popular narrative posts were sampled (N = 410). After achieving satisfactory inter-coder reliability, three expert coders content analyzed the narrative characteristics of these posts.
RESULTS. Negative binomial regressions were conducted for each engagement outcome: emotional support (sum of love and care), likes, shares, and comments. In general, narrative length, survivor’s perspective, mention of social support, explicit requests for donation or engagement, and vivid visual forms (e.g., videos) predicted higher engagement. Emotional intensity was negatively associated with engagement. Results also highlighted the role of identity-related information: Posts featuring racial minority survivors were consistently less engaging, whereas posts that reconstructed gender identity by rejecting feminine beauty received more emotional support and comments.
CONCLUSIONS. This study offers an important first look at a wide array of textual and visual attributes of cancer narratives and their impact on social media. Although these narrative features examined are by no means comprehensive, the findings provide a framework for understanding how health communicators can leverage social media to share cancer narratives to reach and engage the target audience.