Dr. Laura Crosswell, Eye Tracking and Dissecting Health Messaging to the Public
“I am primarily a researcher, I’m not a journalist, but I can research things that are affecting the way that the public is understanding and how it is being reported….” Why is it important to look behind the veils of advertising, persuasion, and manipulation, specifically relating to health? Crosswell who just authored a book called Politics, Propaganda, and Public Health: A Case Study in Health Communication and Public Trust, explains how her grandmother’s cervical cancer led her to her current media and marketing analysis expertise. Interview Q and A by Madison Cleveland.
Q: Tell me a little about what you do at the journalism school and what you do at the medical school?
I am an Assistant Professor of Health Communication and I have a joint appointment, which means that 75% of my position is for the Reynolds School and 25% is for the medical school. My role at the medical school is that I belong to a research group that looks at implicit bias, but really it is to unite the principles of media literacy and effective communication in a way that helps relay health messages to the public. These two disciplines don’t always unite, which is why this is such a rare and unique position and a great opportunity to have.
Q: How did you end up at UNR?
It has been a long road. I am originally from Pennsylvania and I went to school at Clemson in South Carolina. Then I got my Masters at College of Charleston, which led me to get my PhD in Louisiana at LSU. Then I worked at Arizona briefly, there was a startup school, ASU, in Lake Havasu City. I was there for two years and then I saw this rare and incredible position at UNR. I interviewed and I loved Reno and the journalism faculty as well as the medical school faculty. I just knew if I didn’t get the job at UNR I would be living in my parent’s basement because I wanted to be here, so I’m lucky that it happened.
Q: What is eye tracking in simple terms?
Eye tracking in simple terms… I feel like there isn’t much that is simple with eye tracking, but in simple terms, it is basically looking at physiological responses to different stimuli, so different components of media content we can look at and the benefits of eye tracking data are that… so with surveys we get explicit responses from people, so they can say that they saw something and that it may have influenced their attitudes, but we can’t really confirm that they saw something and we don’t really have an objective measurement on whether they really did see something, so it really just helps us in terms of web design because you can use it to see if it is difficult to navigate. It is just giving that objective component that just really gives insight into what people are seeing, how it is influencing their responses to the content in a way that they might not even recognize.
Q: You just recently wrote a book, Politics, Propaganda, and Public Health, what are some of the thing you talk about? Who did you write it for?
In my Master’s program, my grandmother was diagnosed with cervical cancer and around that same time I was seeing ads for HPV and cervical cancer and there hadn’t been much conversation about cervical cancer or HPV and then the Gardasil vaccination came out.
(From Wikipedia: Gardasil, also known as Gardisil or Silgard or recombinant human papillomavirus vaccine [types 6, 11, 16, 18], is a vaccine for use in the prevention of certain strains of human papillomavirus, specifically HPV types 6, 11, 16 and 18.)
So it was kind of timely in the sense that I was in a Master’s program, so I was in a position where I needed to do research and there was also this personal connection so I kind of became driven to learn more, but what I started noticing was that there were three different stages. The first was a commercial segment that said, ‘Hey did you know about the connection between HPV and cervical cancer?’ Then a few months later a new phase came out that said, ‘Tell somebody, tell your sister, tell a loved one, tell a friend’, it was all women in the commercial. Then eventually the vaccination came out, which is a vaccination to prevent the transmission or the infection of the HPV virus. What was unique to me was that I kept seeing Merck pharmaceuticals branding but it was very subtle.
Q: Can you go into the different parts of their rollout campaign and how this intertwined with your interests and also American politics?
The first phase of the campaign was sponsored by a non-profit which was audibly said out loud, but Merck was not even though they were much larger. I wondered why that was and I was very interested in advertising, persuasion, manipulation, specifically as it relates to health.
The more I investigated the more I learned of different and deeper connections. I was able to grow as a scholar as this topic as grew. It came up again in the 2012 presidential debates and that is when I was getting my PhD so I did research in Texas because the governor had mandated the vaccination, Merck pharmaceuticals had funded money into Rick Perry’s campaign and then in the media, there was a lot of mudslinging.
Michelle Bachman had incorrectly said that the vaccination caused mental retardation, which it absolutely does not. Politicians were also mistakenly saying that it is a vaccination for cervical cancer, which it is not, it is a vaccination for HPV, which one of the commercials indicated as well.
Each chapter takes a different part of this campaign and uses a different method. So I do focus groups in the U.S. and in Europe because pharmaceutical marketing is unique in that is it only allowed in the U.S. and in New Zealand.
I traveled to Paris to do a focus group to better understand citizen perceptions of pharmaceutical marketing because they were considering allowing it. I did focus groups in the U.S. regarding the campaign. I did eye-tracking to see if people were actually seeing or fixating on the branding and how that was influencing their attitudes toward it.
What we found was that people who were quicker to fixate trust the campaign less as well as people who fixated longer. Without eye tracking, those participants would not be able to tell me that. With the eye tracking, I was able to correlate the data and see patterns in that. I also included a textual analysis of the campaign... I talk about the symbolic implications and how it became gendered. I then did focus groups here in Nevada. I focused on the gender issue regarding the vaccinations because now there are efforts to get a campaign that targets males because by 2020 the males are the most likely to have HPV related cancers.
The book kind of just takes a multi-method approach to better understand how these messages influence public trust in the politicians that are talking about it and the pharmaceutical companies who are involved with it and the vaccination itself, because this could be an incredible breakthrough, but it can only advance public health if people are trusting the messages that are being delivered to them.
Above a Gardasil commercial in Spanish.
Q: How are you able to bridge the gap between medical terminology and journalistic terminology?
I don’t know that I do bridge the gap, but I do hope that I am able to bring both perspectives to the table. That’s what I do, I go to the research meetings and I bring in my training as a media scholar and I learn from them what the issues are and so it’s very cool. It is almost like I am always a student, which is great because that is always what I wanted to be forever and always. I think the medical side helps me in my media expertise because I can say this is what is being talked about and this is how it is being reported about, so here is the missing connection.
I am primarily a researcher, I’m not a journalist, but I can research things that are affecting the way that the public is understanding and how it is being reported and how to better report things so that it is more clearly understood so I can pass that along to journalists and/or medical professional to help relay the conversation in an effective way.
Q: What are the differences between your journalism work and your work in the medical school?
In the journalism school, the main difference is I teach, and I don’t teach at the med school. At the journalism school, I do a lot of physiological research. We have the Center for Advanced Studies research lab where I spend a lot of time. It is a very individual way of research in the Reynolds school but at the medical school, it is almost always in a group setting. I mentioned earlier that I belong to a research group that looks at implicit bias and the purpose of that group is not only to understand implicit bias better and learn how to effectively recognize that we all have biases and how we can acknowledge them and still be effective in our positions.
It is also to look at the curriculum and figure out how to make it better. I really admire what the School of Medicine’s objective is. It is to not only produce effective doctors, and doctors that are good at their jobs, but also healthy doctors and doctors that understand these different components of ourselves and they do perspective taking and they work it into the curriculum. They are always evaluating it. I just listen to this and observe and really learn from their discussions and see how that relates and how I can merge the two components of my positions and create something that is beneficial for both worlds.
Q: How do you break down your work for a wider audience? Do you take your work internationally?
In writing the book I realized that was a really challenging task. I’ve been trained my whole life to write academically since I went straight through school. I had this huge body of data and I just wanted to show people that this is what was going on. I think consumers need to be more knowledgeable about where information is coming from. I think the responsibilities are on both parties. It is on the consumers or the audiences and it is also on those entities that are putting messages out there.
Like I said in my book, I do think there needs to be some sort of regulations proposed that mitigate this kind of dubious approach to health messaging in terms of pharmaceutical advertising. I tried to take the academic jargon and just figure out how to put that into a language that people would want to actually read. So the first time around it was kind of a mess because it was academic then really informal talk, so it took a few takes, but now I think hopefully we got it to a place that is both informative and does not dumb down the information, but it is in a language that people can relate to and they can pick it up and consider the issues that are being discussed.
In terms of international audiences, I hope that one day your work will be read internationally or that you might get recognized internationally. I just feel lucky that I have had the opportunity to do research internationally and incorporate that into something I am so passionate about. I feel like there are opportunities to continue international work on this specific topic and then my second book might go international. Just kidding there won’t be a second book. [Dr. Crosswell is also known to be sarcastic]
Q: Anything else you want to mention?
If anybody wants to check out the Reynolds Media research lab we always have more room for people who want to participate in studies, so come in and check it out.
For more information on Dr. Crosswell or ways to contact her, find her via her professor bio here: https://journalism.unr.edu/faculty-staff/laura-crosswell/
