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Subject: AEJ 05 LumpkinC MAC Generating Conflict for Greater Good: Contingency Theory as a Strategic Tool to Impact Health Disparities in African American Communities
From: Elliott Parker <[log in to unmask]>
Reply-To:AEJMC Conference Papers <[log in to unmask]>
Date:Sun, 5 Feb 2006 14:38:46 -0500

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This paper was presented at the Association for Education in Journalism and
Mass Communication in San Antonio, Texas August 2005.
         If you have questions about this paper, please contact the author
directly. If you have questions about the archives, email
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(Feb 2006)
Thank you.
Elliott Parker

Generating Conflict for Greater Good: Contingency Theory as a 
Strategic Tool to Impact Health Disparities in African American Communities

*Crystal Y. Lumpkins (Ph.D. Student) and Jiyang Bae (Ph.D. Student),
**Glen T. Cameron (Ph.D.) and Shelly Rodgers (Ph.D.-MU)
University of Missouri-Columbia
Doug Luke (Ph.D.) and Matt Kreuter (Ph.D.)
St. Louis University
*Contact author:
1691 N. Doulton Drive
Columbia, MO 65202
Phone: (573) 886-8534
E-mail: [log in to unmask] or [log in to unmask]
**Contact author:
214 A. Walter Williams
Columbia, MO 65203
Wk: (573) 884-2607
E-mail: [log in to unmask]

Authors' note: This research was supported by a grant from the 
National Cancer Institute, Centers of Excellence in Cancer 
Communication Research initiative (1P50CA095815-02)

Paper submitted for peer review to the Minorities and Communication 
Division of the Association for Education in Journalism & Mass 
Communication Conference in San Antonio, Texas
Submitted: April 1, 2005
To assess the use of strategic conflict management as a health 
advocacy tool in African American communities, cancer news stories in 
Black vs. mainstream newspapers were compared to determine whether 
they differed with regard to conflict factors. Conflict factors 
included health-related risk factors, health disparities, and 
community and personal behavior mobilization. The method was a 
content analysis of 24 Black and 12 mainstream newspapers, randomly 
selected from the U.S. The results showed that more conflict factors 
were present in Black vs. mainstream newspapers. Specifically, more 
health disparities for African Americans in the index and comparison 
groups were present in the Black vs. mainstream newspapers. 
Additionally, personal behavior mobilization was present more often 
in Black vs. mainstream newspapers. The findings are congruent with 
contingency theory and support the position that conflict factors are 
important in media advocacy research that focuses on minority populations.

	Black newspapers are an influential voice in the African American 
community and a trusted source that African Americans rely on for 
important information. Black newspapers have historically been an 
institution to fight racial injustice and also to preserve African 
American culture (Lacy, Stephens & Soffin, 1991). In many African 
American communities, Black newspapers have the same status as other 
well respected social institutions like schools and churches (Brown, 
1994; Sylvester, 1993).
A national survey of 2,522 African-American households in 1993 showed 
that 90% of respondents agreed that Black newspapers provided 
information not available in the mainstream press.  A majority of 
respondents also reported that reading a Black newspaper made them 
feel like part of the local community (Sylvester, 1993). In another 
national survey conducted in 1993-1994, 69% of African Americans 
reported recently reading a Black newspaper.  More than half (51 %) 
of African Americans who read the newspaper spend 30 minutes or more 
reading an issue of a Black newspaper (Sylvester, 1993).
	 While the Black newspaper is in a position to influence African 
Americans, it remains a largely untapped resource to give information 
concerning health issues that affect African Americans nationwide, 
specifically cancer. Cancer is the second leading cause of death 
among African-Americans (American Cancer Society, 1998, 2000); in 
fact, Blacks have a higher cancer incidence rate than Whites or any 
other racial group (American Cancer Society, 2002). Overall, 
approximately 130,800 Blacks were diagnosed with cancer in 2000 and 
an estimated 63,500 died from it (Atlanta, GA: American Cancer 
Society, 2000; American Cancer Society, Inc., 2000).  Among the 
leading causes of cancer deaths are lung, colon, rectum, prostate, 
breast and pancreas (American Cancer Society, 2000) of which breast 
and prostate cancer are substantially higher in Blacks when compared 
to Whites.
	The purpose then of this paper is to analyze the content of news 
stories concerning cancer coverage in Black newspapers to determine 
what, if any, conflict factors are used in news stories targeted to 
African Americans.  Conflict factors in the analysis include 
health-related risk factors, health disparities, and community and 
personal behavior mobilization. Those conflict factors will then be 
compared to those in mainstream newspapers to see if Black newspapers 
have better health coverage with regard to conflict factors.  This 
examination may determine not only what is present on the media 
agenda of African Americans with regard to cancer information, but by 
knowing what is present, we would also know what is absent in that 
agenda.  If Black newspapers do a better job of using conflict 
factors than mainstream newspapers, this will provide insights into 
both the content and tactics used to convey cancer-related 
information to Blacks.  This information can then be used to create 
strategic communication efforts aimed at increasing coverage of 
cancer and thereby filling in some gaps of information that would 
help African Americans understand cancer more fully and in a 
different context.
Cancer is an important and potentially polemical issue for African 
Americans.  The disease disproportionately affects Black men and 
women when compared to various ethnic groups. Prostate cancer 
disproportionately affects Black men when compared to all other 
ethnic groups.  They have prostate cancer 50 % more than White men 
and Ebony magazine reports that the prostate cancer rate among 
African American men is the highest in the world (Ebony, July 2004).
	Black women are 28 percent more likely to die of breast cancer than 
White women (Lee, 2004). Breast cancer is the most common form of 
cancer among African American women.  Even though researchers report 
African-American women have a slightly lower incidence of breast 
cancer as compared to White women, mortality rates are greater 
(Cancer Statistics for African Americans, 1996; El-Tamer, Homel, & 
Wait, 1999; Komen Breast Cancer Foundation, 1999, Lipkus, Iden, 
Terrenoire, & Feaganes, 1999; National Cancer Institute, 
1996).   Black women are generally diagnosed with breast cancer 
younger but the cases are reported to be more aggressive forms of 
breast cancer.
	Overall, all-site cancer mortality is higher among Blacks than 
Whites or other groups, and rates are disproportionate between Black 
and White men.  Whites who develop cancer have higher survival rates 
than Blacks at all stages of diagnosis.  These disparities are found 
for all of the five leading causes of cancer death (American Cancer 
Society, 2002.)	  Black newspapers, a trusted social institution in 
the Black community, can therefore be considered as a venue to 
disseminate cancer information aimed at filling gaps of information 
that would help African Americans understand the alarming statistics 
and disparities.
Contingency Theory
	Our research, guided by the contingency theory of accommodation in 
public relations, posits that public relations professionals 
determine the stance of an organization toward a given public at a 
given time as a consequence of strategic assessment of a welter of 
factors.  The stance falls upon a continuum that ranges from pure 
advocacy to pure accommodation (Reber & Cameron, 2003) depending upon 
changing circumstances.  Decisions about the degree of advocacy and 
related communication strategies comprise the strategic communication 
approach of the organization.  The strategies may seek to ameliorate 
or minimize conflict for the organization, or they may be strategies 
to increase conflict as a lever or pressure point to achieve 
organizational goals.   Applied to cancer news, contingency theory 
may suggest the merit of escalating conflict to some degree.  If 
cancer news stories can present information to African Americans that 
use conflict factors, stories might have a better chance of both 
being picked up by the media and read with greater interest and 
conviction by African American readers.
	  The contingency theory of accommodation, a public relations theory 
that suggests strategies for effective communication between 
organizations and their key audiences, essentially views public 
relations as strategic management of conflict in the interests of 
one's organization (Cancel, Mitrook and Cameron, 1999).  Cancel, 
Mitrook and Cameron, offered the contingency theory of conflict 
management as a "new direction for research in public relations to 
better understand how the public relations field manages conflict and 
reaches out to publics in the external communication environment," 
(Cancel, 1999, p. 172 ).  By raising the level of awareness 
through conflict, African American publics, as well as the publics 
who deliver health care to African Americans, can be moved toward 
greater advocacy on behalf of the population.  This theory can serve 
as a framework for strategic construction of key health messages in 
health news releases disseminated to Black newspapers.  The framework 
also works for the Black newspaper as it views its readership base as 
a key public in the community.  Strategic conflict management could 
improve the process of communicating health disparities as a strategy 
to effect ultimate change in communities.	
The underpinnings of this theory then support the argument that 
health information disseminated to Black newspapers may effectively 
take a conflict-orientation to promulgate a strong, advocative 
position that garners more coverage of cancer. The presence of 
conflict factors such as health disparities, risk factors and 
community mobilization in health news releases disseminated to Black 
newspapers could possibly lead to health stories concerning 
life-threatening cancers and thus greater awareness among African 
Americans.  By the same token, newspapers that adhere to civic 
journalism principles will also benefit from a strategic use of 
conflict in news content to affect the same ends as health advocates.
Civic Journalism
  Civic journalism or public journalism becomes central to the 
current study as a potential platform for strategic conflict 
management in the interests of the local community.  This theoretical 
framework suggests the role of the media is to exchange traditional 
objective coverage for a more active, even proactive, role in the 
community (Stein, 1994).  Applied to cancer news, civic journalism 
would lead to cancer news stories that present information to African 
Americans capitalizing on fairly alarming conflict factors in Black 
communities to motivate readers; consequently, readers may have a 
better chance of receiving pertinent information to reduce risk 
factors and health disparities as well as making that information 
personally relevant.  African Americans would have information and 
referral to resources as empowerment mechanisms for change.   The 
inclusion of such information could then lead to community 
mobilization- meaning individuals would be better equipped and able 
to take the steps necessary to led healthier lives – as well as to 
affect changes in personal risk factors that drive some of the 
African American health disparities pertaining to cancer.
	  Because Black newspapers have been a social institution in the 
Black community for decades, Black newspapers compared to mainstream 
newspapers can be instrumental in strategically communicating 
pertinent cancer news stories by presenting evidence and compelling 
stories concerning disparate risk factors, disparate health outcomes, 
and disparate health services to generate both community and personal 
mobilization. By using the news value of conflict to actually 
generate coverage, health communicators may choose to take a more 
aggressive contingency stance and thereby raise the awareness and 
understanding of cancer as a disease and a health threat in African 
American communities.
The Role of Black Newspaper
The Black newspaper, a media outlet that has been around for more 
than 170 years, has traditionally been the voice for Blacks.  When 
journalist John Brown Russworm, and the Rev. Samuel E. Cornish 
published the first edition of Freedom's journal in 1827, they were 
embarking upon a rich history of championing political and social 
cause in the Black community (New York Amsterdam News, 2002).
	African American newspapers have been defined as newspapers that are 
owned and managed by African Americans and are targeted to African 
American consumers – the newspapers then are those that 'serve, 
speak, and fight for the black minority," (Wolseley 1989, p. 4).
Black newspapers have traditionally served as an outlet for stories 
of interest and also an alternative to mainstream newspapers (Pride & 
Wilson 1997; Wolseley, 1972). Historically, the Black press was the 
only place that African Americans felt their story could be told and 
in some cases reported in an objective manner.  Blacks felt that the 
Black press more accurately reflected issues in the Black community 
and served as an alternative to negative representations of Blacks 
(Pride & Wilson 1997; Wolseley, 1972).
In 77 cities throughout the United States with populations of more 
than 200,000, 71% or 55 cities have at least one Black newspaper 
(Gebbie, 2000; U.S. Bureau of the Census, 1990).  The fact that most 
Black newspapers are locally controlled shows that there is a 
proclivity for these newspapers to be more attentive and responsive 
to local issues (Wolsely, 1972; Convissor, Vollinger & Wilbur 1990; 
Oliver, & Maney, 2000).

Conflict Factors
	The health status among African Americans is disparaging.  The 
numbers of African Americans suffering due to issues such as 
socio-economic, environmental and cancer or disease are 
disproportionately high (Marks, Reed, Colby & Ibrahim, 
2004).  Greater still are statistics which show cancer as the second 
leading cause of death among African-Americans (American Cancer 
Society, 1998, 2000); cancer incidence and mortality rates are the 
highest among African Americans (Jernigan, J.,, 2001).
In some cases the health belief among African Americans has created a 
barrier of fear and mistrust of doctors and thus prevents them from 
participating in treatment or prevention (Matthews, A. K., 
2002).   Many African Americans have referred to the Tuskegee 
syphilis experiment where hundreds of rural African American men were 
denied treatment and misinformed about their medical condition 
(Pickle, K., 2002).
   Not only has medical personnel and mistrust been barriers, but 
access to adequate medical care has contributed to health 
disparity.  Crisis magazine reports that according to the Census 
Bureau, "more than 20 % of African Americans are uninsured, compared 
to 15 % of the overall population," (Lee, 2004).  The same report 
goes on to state that the Agency for Healthcare Research and Quality 
found medical bias to be a cause of health care disparities (Lee, 2004). 	
Risk factors among African Americans are high as well.  Living 
conditions, such as substandard housing, have had a major impact on 
health.  Crisis magazine shows that studies have linked race, disease 
and hazardous environments (Lee, 2004).  The magazine reports that a 
1983 study by the U.S. General Accounting Office found that three out 
of four hazardous waste landfills in the Southeast were located in 
predominately Black or poor neighborhoods.  In 1992, another report 
by the Environmental Protection Agency released showed that "Blacks 
were more likely to be exposed to hazards in their work and living 
environments than other groups" (Lee, 2004).
As part of the social environment, the media are in a unique position 
to influence when emphasizing specific health topics with a 
conflict-orientation in news coverage.
In a study examining conflict issues in news stories, researchers 
found that the more prominent the local conflict story is, the less 
imbalanced it will be - the higher the reporter's priority for local 
conflict, the less imbalanced the conflict stories will be ( Fico & 
Balong, 2003).
Race is often tied to coverage of health issues and risk factors and 
can be seen as a conflict issue.
In a study that involved 3,400 telephone interviews with African 
Americans, Latinos, and Whites, researchers found divergent attitudes 
toward media coverage of health issues.  African Americans and 
Latinos were more critical of health coverage when compared to Whites 
and complained that the media lacked coverage of specific health 
topics (Levine, Foster, Fullilove, Fullilove, Briggs, Hull, Husaini 
and Hennekens, 2001).
In a content analysis of five daily Black newspapers in 2002, the 
coverage of HIV/AIDS yielded results that showed the framing of 
life-threatening stories concerning health affected public 
perception.  "Media portrayals of HIV/AIDS and those affected by the 
disease can strongly influence public perception of disease and 
risk," (Pickle, Quinn & Brown, 2002).  Researchers further concluded 
that the framing of the "threat" or conflict of the HIV/AIDS epidemic 
in these Black newspapers would increase knowledge and ultimately 
behavior through efforts of public health practitioners (Pickle et. 
al, 2002).  By the advocacy stance the Black newspapers took instead 
of an accommodative stance in this case, more people were aware of 
the dangers of the deadly disease.
In another study, Condit, Parrott, Bates, Bevan and Achter examined 
the impact of messages concerning genes and race on attitudes through 
an experimental study that exposed participants to Public Service 
Announcements about race, genes, and heart disease.   Participants 
who received a message which specified either 'Whites' or 'Blacks' as 
the subject of the message demonstrated increased levels of racism 
(Condit et. al, p 402).
This article goes on to state that media scholars have demonstrated 
mass-mediated messages do routinely stereotype racial minorities in 
the U.S.  Robert Entman and Andrew Rojecki are cited as providing 
exploration on media content about race and public attitudes.  Their 
study revealed "negative stereotypes of Blacks in mass media and the 
lack of positive images of Blacks, enhance(s) White hostility to 
African Americans."  The study also showed that media stereotypes 
influence predominant attitudes about race among Whites, which Entman 
and Rojecki summarize as 'racial denial'" (Condit et. al, p 
403).    The study states that while the portrayal of racial groups 
in relation to health messages is not explicitly stated, social 
theorists have hinted that such messages about health might be 
problematic.  This may be due to "how the media reify race, portray 
members of different groups as fundamentally different from each 
other or because they assign differing qualities to members of these 
different groups," (Condit, et. al, 2004).  The researchers conclude 
in this study that messages linking genes, health and race do 
increase discriminatory attitudes in some audiences and that public 
health sources should be careful when linking health, race and 
genetics targeted to the public.
Mainstream newspapers should then strengthen ties with the African 
American community as the mainstream media has been distrusted among 
many African Americans. Mainstream media was said to "sensationalize 
and distort information, portraying the lives of people with AIDS as 
isolate and desperate," (Pickle et. al, p. 428).
	Magazines are also a source that African Americans rely on for 
information and show the lack of cancer-related information 
disseminated to Blacks in the general media.  In the 2000 HIV/AIDS 
study, research showed African American magazines lagged behind 
mainstream media in AIDS coverage and employed the same terminology 
as the mainstream media (Krishnan, Duran, & Winkler, 1997; Landis, 
Freimuth & Cameron, 1992).  An empirical study of cancer coverage of 
the major Black magazines (Ebony, Jet and Essence) from 1987-1994 
showed that only 84 stories focused on cancer out of 596 issues and 
649 health articles (Hoffman-Goetz et al. 1997).
These conflict factors could heighten health disparity awareness 
among Blacks in communities across the country, and thereby help 
alleviate health disparities.
After reviewing previous literature, this study concludes that when 
Black newspapers and mainstream newspapers are compared, there is a 
lack of news coverage concerning health disparities and risk factors 
and the coverage needs to be increased to address the health needs of 
African Americans.  Thus, this study attempts to analyze the coverage 
patterns of the two categories of newspapers: Black newspapers and 
mainstream newspapers.  The following research questions are advanced.
RQ1: 	What are the similarities and differences between Black vs. 
Mainstream newspapers with regard to conflict factors?
Mobilizing Factors

The Black newspaper continues to provide African Americans with an 
avenue for public dialogue, addressing issues relevant to Blacks that 
the general media does not (Jones-Web et al, 1997; Sylvester, 1994; 
Domke 1994).    In essence, the Black newspaper has traditionally 
served in the capacity of what media scholars call civic or public 
journalism.  "Public journalism," a type of coverage that encourages 
editors to exchange traditional objective coverage, is a way the 
media can play an active role in the community (Stein, 
1994).  Research on community coverage also shows that readers expect 
newspapers to be the watchdog and cheerleader for unity in the 
community and not simply gatekeepers (Case, 1994).	
  	While studies show African Americans feel Black newspapers cover 
health issues related to African Americans more than mainstream 
newspapers (Brodie, Jellson, Hoff, Parker, 1990) coverage is centered 
on medical advances, news drugs, and medical experts instead of 
specific health information that may mobilize readers including risk 
reduction, disease prevention and early detection (Centers for Media 
and Public Affairs, 1997; Freimuth, Greenberg, DeWitt, Romano, 
1984;Milio, 1985; Atkin, Wallack, 1990; Signorielli, N., 1993).  Very 
few newspaper articles on cancer, in both Black and mainstream, 
contain mobilizing information to help the reader take some action to 
reduce his or her risk (Hoffman-Goetz, L, 2000; Macdonald, 
Hoffman-Goetz, 2001; MacDonald, Hoffman-Goetz, 2002).
In another study where health behavior coverage was examined in more 
than 80,000 stories in 1, 354 newspaper issues, health behavior 
stories were almost nonexistent.  Of 1,373 stories (1. 7%) that 
addressed diet, physical activity, or tobacco, only a few were 
prominently located in the paper, and only half had a prevention 
focus. A large portion of the news stories had no local angle, local 
quotes, or call to action for individuals or the community, and a 
mere 10% were generated by local reporters (Caburnay, Kreuter, Luke, 
Logan, Jacobsen, Reddy, Vempaty, & Zayed 2003).
By the same token, mainstream newspapers should also make strategic 
efforts to report and cover stories that concern African American 
health.  This important role should not be the exclusive purview of 
Black newspapers nor ceded to Black newspapers by default.  According 
to an article in Editor and Publisher, New York Times Managing Editor 
Gene Roberts is quoted as saying "'Many newspapers,' he charged, 'are 
being run "like chain shoe stores" with no sense of being important 
community institutions with critical responsibilities to the 
public.'  One solution, he offered, would be to make newspapers the 
subject of public debate, holding them accountable for covering the 
communities they serve, (Case, 1996).
In a qualitative study of television cancer news coverage, African 
Americans seeking health information stated that the information was 
simply not there for them to get or was convoluted and too hard to 
understand.  The women in particular wanted to know more about 
specifics about breast cancer and how the cancer progresses.  With 
health communicators and public relations professionals providing 
journalists with the necessary information, African Americans can 
receive the information they need to get tested or receive proper 
medical treatment (Marks, Reed, Colby & Ibrahim, 2004).
	Both mainstream and Black newspapers should consider these 
mobilizing issues when setting their news agendas. These newspapers 
have the responsibility to cover these issues as well as they are to 
be the watchdog for society (Stein, 1994).  Even though Black 
newspapers have a greater presence and are more trusted in the Black 
community, mainstream newspapers also may have the responsibility to 
add this to their discussion of story ideas and agenda.  Conflict 
factors used in local cancer-related news stories could not only lead 
to a greater awareness but both personal and community mobilization.
After reviewing literature, this study concludes that there is a lack 
of news coverage concerning health disparities, risk factors with 
regard to mobilizing information in both Black and mainstream 
newspapers.  Thus, this study attempts to analyze the coverage 
patterns of the two categories of newspapers: Black newspapers and 
mainstream newspapers.  The following research question was asked:
RQ2: 	What are the similarities and differences between Black vs. 
Mainstream newspapers with regard to mobilization factors?


	The method was a content analysis, a method that analyzes 
communication in a systematic, objective and quantitative manner for 
the purpose of measuring variables (Kerlinger, 2000). A stratified 
random sample of 24 Black and 12 mainstream newspapers were selected 
from 24 U.S. cities using the procedures described by Riffe, Lacy and 
Fico (1998). All cancer news stories were content analyzed in the 36 
newspapers during an 11-month period between January 2004 and 
November 2004. A cancer news stories was defined as any story that 
contained the term "cancer" or any cancer-related mention (e.g., 
tumor, lump, malignant, etc.) in the headline and/or first two 
paragraphs of the news story. These included stories about screening, 
detection, treatment and prognosis were among the cancer stories that 
were included. Thus, the unit of analysis was the news story, defined 
in terms cancer events, issues or features. A total of 1,197 news 
stories were coded—796 (66.5%) from Black newspapers and 401 (33.5%) 
from Mainstream newspapers.
Coding Categories
	We examined two general types of variables—conflict and mobilization 
factors. A conflict factor was defined in terms of those facts or 
details that highlight risk or health disparities between two or more 
groups. There were two types of conflict factors: risk factors and 
health disparities, defined below. Mobilization was defined in terms 
of those factors or details that would enable individuals to "take 
action" or make informed decisions about health behavior, in this 
case, cancer behavior. There were two types of mobilization: personal 
behavior mobilization and community mobilization, defined below.
Risk Factors Defined
A risk factor was defined in terms of facts or details about 
potential causes of cancer that would increase the chance of 
developing cancer. Risk factors included: asbestos, diet/nutrition, 
exercise, genetics/family history, overweight/obesity, pollution, 
radiation, reproductive/hormonal factors, smoking/tobacco, 
therapeutic drugs, underweight, and viral risk factors. An "other" 
category was also included.
Health Disparities Defined
	A health disparity was defined in terms of inequalities or 
inequities noted between different demographic groups. For example, 
African Americans have a higher overall cancer incidence and 
mortality rate compared to Caucasians. We examined both the index and 
comparison groups. In the example above, if we were to state that 
African Americans are twice as likely to die from cancer then Whites 
then African Americans would be the index group and Whites is the 
comparison group. If we were to say that African Americans are three 
times more likely than Asian Americans to die from cancer, then 
African Americans are the index group and Asian Americans are the 
comparison group. We also coded types of demographic comparisons 
made. In the example above, ethnicity is the demographic comparison. 
Other demographic comparisons included gender, age or socioeconomic status.
Mobilization Defined
The two types of mobilization were personal behavior mobilization and 
community mobilization. Personal behavior mobilization was defined in 
terms of those facts or details that describe how readers can take a 
specific action (e.g., call state senator, write a letter to the 
editor, get breast cancer screening etc.) to reduce health risks, 
prevent cancer or change behavior related to cancer. Community 
mobilization was defined in terms of those facts or details that 
describe how groups, businesses, organizations, government agencies, 
etc. can take a specific action to reduce risks, prevent disease or 
impact policy related to cancer.
	Three graduate students (two females and one male) coded the data. 
Intercoder reliabilities were calculated using Scott's pi index 
(1955), which corrects for the number of categories used and the 
probable frequency of use. An overall intercoder agreement of .98 was 
reached, which exceeds the minimum accepted reliability of .75.


The first research question pertained to conflict factors. 
Specifically, we wanted to examine which conflict factors were 
present in Black versus mainstream newspapers and whether these 
differed with regard to frequency. Multiple chi-square analyses were 
used to examine this research question. As for risk factors, our 
results revealed that risk factors differed significantly for Black 
versus mainstream newspapers (c2 (11, N=49) =11.062, p>.10). As shown 
in Table 1, mainstream newspapers provided more facts about 
smoking/tobacco (28.6%) while Black newspapers provided more facts 
about genetics/family history (see Table 1).
In terms of health disparities, our results revealed that there were 
significant differences between Black and mainstream newspapers when 
reporting disparities for the index group (c2 (3, N = 40) = 16.89, p 
< .01).  Specifically, mainstream newspapers were more likely to use 
age as an index (40%) whereas Black newspapers were more likely to 
use ethnicity as an index (71%) (see Table 2).
As for the comparison group, Caucasians were more frequently compared 
with African Americans in Black newspapers (91%) while Caucasians 
were not often compared in mainstream newspapers (50%). African 
Americans were not a comparison group in mainstream newspapers 
(0.0%).  These differences were significant (c2 (3, N = 36) = 17.54, p < .01).
Research question 2 sought to examine the use of mobilizing 
information in Black versus mainstream newspapers. Two chi-squares 
were conducted to examine this question. Neither newspaper used 
community mobilization to a large degree (Black=6.3% and 
mainstream=7.1%) and the differences were not statistically 
significant (p > .10). However, there was a significant difference 
between Black and mainstream newspapers in reporting personal 
mobilizing information (c2 (1, N = 153) = 12.59, p <. 
01).  Specifically, Black newspapers provided personal mobilizing 
information (36%) more often than mainstream newspapers (7%).

Overview of Results
The primary purpose of this study was to compare cancer news stories 
in Black vs. mainstream newspapers to determine whether they differed 
with regard to conflict factors.  Conflict factors included 
health-related risk factors, health disparities, and community and 
personal behavior mobilization. The results showed that risk factors, 
health disparities and personal behavior mobilization differed 
significantly for Black versus mainstream newspapers.  Mainstream 
newspapers provided more facts about smoking/tobacco while Black 
newspapers provided more facts about genetics/family history. Also, 
mainstream newspapers were more likely to use age as an index whereas 
Black newspapers were more likely to use ethnicity as an index. 
Personal behavior mobilization was present more often in Black newspapers.
Implications of Results
  	The theoretical frameworks used in the study could have far 
reaching impact on the way information is gathered and disseminated 
by Black newspapers.  While Black newspapers generally ascribe to 
much of what civic journalism suggests, there could be much to gain 
from the contingency theory which suggests the continuum of 
communication between an organization and its public continuously 
moves depending on the situation.  In the case of conflict factors 
such as health disparities, risk factors and community and personal 
mobilization, the cancer coverage as well as the agenda-building role 
of health advocates could be more advocative, even adversarial in approach.
	Black newspapers are significantly more likely than mainstream 
newspapers to show health disparities in their stories about cancer 
using African Americans as the index group and Caucasians as the 
comparison group.  This fact supports including conflict into news 
releases as a way to serve the conflict news value, a known news peg 
in the newsmaking literature in general which evidence here suggests 
may actually be a stronger news value in Black papers than in 
mainstream papers. Conflict, according to contingency theory, would 
be a useful strategy in the sense that it elevates the awareness of 
the problem and the likelihood of mobilization.  However, it should 
be noted that the presence of conflict factors, in this case, health 
disparities, while significantly higher for Blacks compared to 
mainstream, was still very low in Black newspapers (25 out of 1200 
stories or 21 out of 1200 stories, depending on group, index or 
comparison).  There is room to further shift the stance of both 
health advocates outside and within Black newspapers.  A shift in 
stance may be in order for health communicators and for those who use 
information subsidies from health information operations as news is 
made within the walls of newspapers.
	Health communicators have the opportunity to write stories that 
could have an impact on how Black newspapers report or cover health 
issues and information.  If the stories contain conflict factors, the 
information may be compelling enough for communities to act and 
therefore mobilize them to do something about their 
situation.   "Studies show that newspapers, magazines, and television 
provide people with most of their information about prevailing social 
issues," (Pickle, 2002).  Thus, media representation of African 
Americans suffering or getting treated for cancer can influence 
public perception of cancer and risk.  Media could then be utilized 
to help health communication efforts concerning cancer among African Americans
	This examination may determine not only what is present on the media 
agenda of African Americans with regard to cancer information, but by 
knowing what is present, we would also know what is absent in that 
agenda.   If Black newspapers do a better job of using conflict 
factors than mainstream newspapers, this will provide insights into 
both the content and tactics used to convey cancer-related 
information to Blacks.   This information can then be used to create 
strategic communication efforts aimed at filling in the gaps of 
information that would help African Americans understand cancer in a 
different context.
Limitations and Direction for Future Research
	The paper utilized information from content analysis of hundreds of 
Black newspapers. Future research could involve qualitative research 
that would include talking to editors and reporters at Black 
newspapers to find out more about the process of gathering news and 
how cancer-related stories are selected.  Future research would then 
involve analyzing the implication of conflict frames and how the news 
value of conflict is used to shape news stories.  Media are not only 
setting agendas but are in the process of creating frames when 
presenting the news. The question of how much conflictual, disparity 
coverage is too much, especially as a function of greater or lesser 
accompanying information to mobilize the community and the 
individual, remains to be studied.
	Black newspapers are in a unique place to disseminate health 
information to African Americans who are suffering from disparate 
conditions pertaining to cancer.  Increasing conflict factors such as 
risk factors, health disparities and community mobilization in news 
stories could offer a way to not only increase health awareness among 
Blacks but strengthen community efforts to seek prevention and 
treatment of cancer for Blacks. Our findings suggest that there is a 
gap of information between Black newspaper coverage and its 
audience.  While the Black newspaper serves as a civic partner to the 
Black community, coverage of disparate risk factors for cancer, 
disparate health outcomes, and disparate health services for Blacks 
are too rarely included in news fare.  Also, community mobilization 
factors are rarely mentioned and are reported in stories at about the 
same rate as mainstream newspapers. The current study lays the 
foundation for theory building in this area and provides possible 
conflict factors that can be used in news stories to decrease health 
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Table 1. Percentage of Risk Factors in Black vs. Mainstream Newspapers
		Black	Mainstream
Risk Factors
  	Asbestos	3%	0%
	Diet/nutrition	9%	21%
	Exercise	11%	7%
	Genetics/family history	29%	7%
	Overweight/obesity	6%	0%
	Pollution	3%	0%
	Radiation	3%	0%
	Reproductive/hormonal factors	6%	7%
	Smoking/tobacco	23%	29%
	Therapeutic drugs	0%	7%
	Viral risk factors	3%	0%
	Others	6%	21%
		___	___
	TOTAL:	100%	100%
Table 2. Percentage of Health Disparities in Black vs. Mainstream Newspapers
		Black	Mainstream
Disparity Index
  	Age	3%	40%
	Ethnicity	71%	20%
	Gender	26%	20%
	Socio-economic status	0%	20%
		___	___
	TOTAL:	100%	100%


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