Mission: The Health Communication and Informatics Research Branch (HCIRB) supports research that examines the fundamental processes and effects of health communication and informatics on cancer-related outcomes across the cancer control continuum via interpersonal, patient-provider, print, electronic, mass media, mobile, and technology-mediated mechanisms.

Scientific Priorities: HCIRB works closely with its extramural partners to inform the science of cancer communication toward the singular goal of reducing the death and suffering due to cancer. Cancer communication empowers consumers to make informed cancer-related decisions and to adopt behaviors to improve their health. Lives are saved through communication interventions that influence positive behavioral changes and HCIRB is dedicated to accelerating the research and development of a seamless communication infrastructure that increases access to and use of cancer information, improves consumer understanding of cancer information, enhances patient/provider interaction, and effectively moves research results into clinical practice and public health programs.

In November 2006, the NCI-designated Cancer Center Directors delivered a report to the NCI titled "Accelerating Successes Against Cancer." In the report, the NCI Cancer Center Directors boldly claimed that "we can substantially reduce deaths from cancer just be broadening the application of knowledge we have today." On page 24 of the report, the Cancer Center Directors highlighted the importance of communication research as an important catalyst for accelerating successes against cancer now, and they included an exhortation to expand health communication research via the Health Communication and informatics Research Branch at the NCI.

Strategic Targets
To address the communication needs in cancer, the Accelerating Successes report identified three targets of opportunity for communications science:

1. Raising public awareness of the benefits of cancer prevention and early detection;
2. Reducing the confusion that arises from contradictory and sometimes questionable scientific research that is reported by the news media; and
3. Expanding our scientific understanding of interventions – at both the individual and community level – that are most effective in reducing the burden of cancer now.

HCIRB has organized its priorities around these three goals.

Raising Awareness
In the rapidly evolving communication environment of the next decade, raising awareness will not simply be a matter of pushing more Public Service Announcements to the public through traditional media channels. Rather, it will require a strategic effort to improve the reach, effectiveness, and cost-efficiency of public facing efforts. Some specific points of opportunity currently under investigation are as follows:

• Understanding the content of framed messages from the perspective of health cognition research to optimize understanding, bolster self-efficacy, persuade [when appropriate], foster diffusion, and to support daily–often automatic–decision making.
• Understanding how a change in media channels can be exploited to protect the fidelity of evidence-based messages while taking full advantage of the accelerative properties of new media such as Facebook, Twitter, YouTube, and other examples of Web 2.0.
• Investing in the translational research methods that will be necessary for connecting research to practice within the National Cancer Program (i.e., the government agencies, NGO’s, practitioners, and public advocacy group that comprise the national effort) as described in the President’s Cancer Panel report of 2008.
• Working with other federal programs to improve the display of information in cigarette advertising, menu labeling, pharmaceutical labeling, and treatment/survivorship plans.
• Fostering better communication between physicians and patients across cultural barriers and levels of healthy literacy. One of the challenges the branch must face is to find a balance between "universal design" (in which differences are made irrelevant) and "tailoring" (in which messages are adapted for different sociodemographic groups based on behavior or preference).

Health Journalism Research
Data from the branch’s Health Information National Trends Survey (HINTS) have shown that the public confusion about health topics and cancer prevention recommendations remains high and is increasing. Some of the problem can be traced back to an explosion of information through a proliferation of communication channels that is the hallmark of the information environment in the present day. This includes health information in the news media, where cancer consistently ranks first among disease-specific news coverage. There is overwhelming evidence that health behaviors are responsive to shifts in news media coverage of a topic, and that news media coverage of health topics can heighten the salience of issues and define priority areas for attention. HCIRB is pursuing the following research topics in the area of health journalism research, with a focus on being responsive to the dramatic transformation that American journalism is currently facing:

• Sociology of Journalism/Institutional Research
• Audience fragmentation
• News aggregation and media production
• Online news in a Web 2.0 world
• Gatekeepers and information subsidies
• Health news construction (framing/priming)
• Media effects on health behavior and health policy
• Exposure, attention, and information processing
• Agenda-setting
• Communicating harms and scientific uncertainty
• Evidence-based training and resources for health journalists

Creating Effective Interventions
In 2009, the U.S. Congress passed the Health Information Technology for Economic and Clinical Health (HITECH) Act as part of its effort to stimulate the economy while creating much-needed infrastructure in areas such as health and medicine. In the following year, the Congress passed the Patient Protection and Affordable Care act, with provisions to improve healthcare by ensuring access to preventive services and maintaining better continuity of care for disease survivors. Independently, the current presidential administration has issued a mandate to federal agencies to open their data stores in an effort to create an era of open and participative government. All of these changes offer a new context in which to explore the diffusion of evidence-based communication interventions. Some of the targets of opportunity the branch is currently pursuing include the following:

• Taking advantage of the "meaningful use" criteria accompanying the HITECH act to improve support for physicians, patients, and their families. Current articulations of the mandated meaningful use criteria include provisions to demonstrate applications of health information technology that: (a) are safe, efficient, effective, (b) support patient engagement, (c ) ensure continuity of care, (d) translate up to better health at the population level, and (e) protect privacy. The branch is working with DHHS, NIST, CDC, NLM, and AHRQ to identify opportunities for our grantees in this space.
• Addressing the issues of provider-to-patient communication and provider-to-provider communication from a systems perspective. In its 2001 report on "Crossing the Quality Chasm," the Institute of Medicine pointed to poor communication as a "system property" in current healthcare. The branch is working with the National Academy of Sciences and the Institute of Medicine (both are part of the National Academies) to set a research agenda in the area of "Human System Integration" (aka Human Factors).
• Investigating the use of cancer-related data to improve decision making at the individual and community levels. One of the most important information assets maintained by the Division of Cancer Control and Population Sciences is its store of cancer-related data from SEER, HINTS, CHIS, NHIS, and other surveillance tools. Following the exhortations of DHHS Secretary Kathleen Sebelius, the HCIRB is investigating ways to make data work for individuals and communities in advancing cancer control goals.

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