(1) Macalester College, USA, (2) University of New Mexico, USA, (3) Ohio University, USA, (4) Ministry of Community Development, Women Affairs, and Children, Arusha, Tanzania
Published in the Journal of Health Communication in 2000, this study evaluates the impact of a long-running entertainment-education radio soap opera in Tanzania on knowledge, attitudes, and adoption of HIV/AIDS preventive practices. Theoretically, the intervention and evaluation followed psychosocial models, diffusion and social-movements theories emphasising social cognitive concepts such as self-efficacy, role modeling, cultural belief systems, and relational variables such as social networks, opinion leaders, and community organisation and mobilisation. Data collected through surveys at different stages of the intervention were supplemented with anecdotal information gathered from the letters from the audience. Results of the study identified factors contributing to positive knowledge, attitudinal, and behavioural change among women and men.
The intervention utilised an entertainment-education radio soap opera series broadcast nationwide in Swahili, the national language of Tanzania, twice a week from 1993 to 1999. The soap opera, entitled Twende na Wakati (Let's Go with the Times) promoted HIV/AIDS prevention, family planning, gender equity, and other health issues. The soap opera was designed to stimulate interpersonal communication about AIDS among the listeners by presenting them with negative, transitional, and positive role models for HIV prevention behaviours.
The residents in the Dodoma region were designated as the control group in the experimental design. The soap opera was not transmitted to this region between 1993 and 1995, but the region received the retransmission of the first two years of episodes (episodes broadcast between 1993-1995 in the rest of the country) from 1995 to 1997.
Data were gathered through five personal interview surveys in mid-1993 and at one-year intervals through 1997. The survey questionnaire asked people to report their demographic information, exposure to and perceptions of the soap opera and other HIV/AIDS information, and other relevant attitudes and preventive practices. The sampling frame was constructed by listing 78 districts, which unambiguously fell in either the treatment or comparison areas, and randomly selecting three wards in each district. Respondents consisted of self-selected women (from ages 15 to 49) and men (from ages 15 to 60) living in these wards. Each ward had an average of 71 respondents. The sample size in the treatment area increased from 896 to 1,113 listeners between 1994 and 1997. The sample size in the comparison areas was 422 in 1996 and 467 in 1997. There was a sampling bias due to the use of a self-selection method, resulting in a sample that was skewed toward higher socioeconomic status and those with access to radio.
Exposure to the soap opera grew overtime in both the treatment and the comparison area. In the treatment area, the percentage of people who were exposed to the soap opera had increased from 47% in 1994 to 58% by 1997. In the control area, the exposure was 51% in 1996 and 71% in 1997. About 60% of those who were exposed to the soap opera were regular listeners. Awareness of HIV/AIDS had increased throughout the intervention. Seventy-three percent of the listeners from the treatment area reported learning about AIDS from the soap opera in 1994, which increased to 85% of the listeners in 1997.
The researchers found positive effects of the radio soap opera on the adoption of HIV/AIDS prevention practices among the listeners. The findings suggested that, after accounting for the potential effects of other national anti-AIDS programmes, 16% of the people in the treatment group had adopted AIDS prevention methods in 1996, and 12% in 1997, as the direct result of listening to the radio soap. The listeners who had adopted an HIV/AIDS prevention method reported reducing the number of their sexual partners (77% in 1995) rather than adopting condom use (15% in 1995) or ceasing to share razors (6% in 1995).
The radio soap opera had a marginal to only modest impact on the listeners' knowledge of HIV/AIDS. An HIV/AIDS knowledge scale was constructed from respondents' scores on correct mechanisms of transmission, false rumors about HIV infection, correct mechanisms of prevention, and incorrect means of prevention. The radio soap listeners scored about 1.5 points higher on the HIV/AIDS knowledge scale than did nonlisteners, but the listeners' scores did not increase more than nonlisteners' scores from 1994 to 1997.
The radio soap opera contributed to these changes through intervening variables, including (1) self-perception of risk of contracting HIV/AIDS, (2) interpersonal communication about HIV/AIDS, and (3) identification with the primary characters and their role models in the radio soap opera. Between 1995 and 1997, the perception of being at risk of AIDS as a result of being exposed to content of the soap opera experienced gains in the treatment area (8%) and comparison area (22%). Interpersonal conversations about the content of the programme increased throughout the intervention to reach 65% of the listeners by 1997. These discussion were primarily held with friends (55%) and spouses (37%).
Vaughan, P. W., Rogers, E. M., Singhal, A., & Swalehe, R. M. (2000). Entertainment-education and HIV/AIDS prevention: A field experiment in Tanzania. Journal of Health Communication, 5 (1), 81-100.