April 7-9, 2022 • Hyatt Regency • Lexington, KY
Communication Strategies to Promote Comprehensive Well-being
Communication Strategies to Promote Comprehensive Well-being
Abstract: In Search of Entertainment-Education’s Effects: Storylines and Calls to a Sexual and Reproductive Health Hotline in Mexico
Introduction. Substantial gaps exist in the theoretical and practical understanding of entertainment-education (EE; Frank & Falzone, 2021), as studies often fail to account for the ways in which intrinsic-message characteristics influence subsequent behaviors (Green, 2021). These theoretical and practical gaps serve as the impetus for an international collaborative project that evaluated Vencer el Miedo (‘Overcome the Fear’), a Spanish-language telenovela that aired in Mexico from January to March 2020, reaching over 3-million viewers each day. The telenovela was specifically produced with the aim of improving sexual and reproductive health (SRH) knowledge and behavior by modeling effective ways to discuss and negotiate safer sex practices. Importantly, the show was accompanied by a phone hotline called OrientaSEX that was operated by professional counselors from Planned Parenthood’s Mexican affiliate MEXFAM. Method. Taking a multimethod approach, the study combined: (a) content analysis in line with social cognitive theory (Bandura, 2001); and (b) an interrupted time series analysis of calls made to the OrientaSEX hotline during the time the show was on air. Using principles of vicarious learning, the content analysis identified five key teachable moments (incident, positive influence, negative influence, decision, and consequence) in the two SRH-related storylines (delay of first sex among young adolescents and prevention of unplanned pregnancy/STDs among adolescents). Then, an interrupted time series analysis was used to assess whether increases in the daily volume of calls to the OrientaSEX hotline, could be predicted by incidents of key characters receiving negative or positive reinforcements, while controlling for a variety of covariates. Results. After accounting for duplicates, the dataset included 8,054 unique calls to the hotline. The majority of callers identified as female (59.9%) and the average age was 20.38 (SD=10.16). Callers tended to have education at the high school level or below (87.5%) and nearly half did not have health insurance (48.8%). The content analysis identified four sequences in which key characters experienced positive/negative consequences as a direct result of their positive/negative choices. In three of the four cases, these teachable sequences preceded a significant increase in the volume of calls, ranging from 27.7% (95%CI [24.4,30.2]) to 53.9% (95%CI [44.3,63.5]). Additional analyses focused on the moderation of the storylines (e.g., positive vs. negative reinforcement) and the health-related characteristics of the callers (e.g., access to healthcare). Discussion. The present study deviates from the traditional approach to EE evaluation by linking media content variables with SRH-related behavior. The findings suggest that both negative and positive modeling can encourage action in the form of information-seeking. While these results are limited to a single context, this study introduces important nuance into the theory and practice of EE by examining whether plot variations translate into story-consistent behaviors. As such, it offers a promising avenue for future naturalistic interventions in EE.