Annenberg School for Communication, University of Southern California

This 30-page summary report details discussions and findings from a 2-day conference sponsored by The Centers for Disease Control and Prevention (CDC) as part of the Hollywood, Health & Society (HH&S) project, which aims to provide entertainment industry professionals with accurate and timely information for health storylines. Twenty-six social scientists with backgrounds in mass communication research and theory gathered in Santa Monica, CA, USA at the University of Southern California (USC) Annenberg's Norman Lear Center. They sought to:

• assess existing research and theory with respect to entertainment-education (EE) strategies and multicultural audiences;
• identify research gaps; and
• propose a research agenda to better understand, anticipate and harness the effects of health-related television storylines on African American and Hispanic audiences in the United States.

Vicki Beck, Director of HH&S, began by "surveying the field"; her comments are summarised here. Based on HH&S's experience and research, she notes that EE programming can be particularly important for African American and Hispanic audiences. For example, she cites preliminary results from her programme's TV Monitoring Project, which indicate that as many as 614 health issues were presented on the 186 of the most popular television programmes among Hispanic viewers, African American viewers and the general US population. Based on evidence from studies that find that minority women are more likely to discuss what they have seen with others, Beck proposes bolstering the impact of health-related storylines by pairing them with a public service announcement (PSA) dealing with the particular issue portrayed and/or a toll-free number where viewers can seek additional information. For instance, a CDC study showed that providing an 800 number in conjunction with the airing of "Tony's HIV" resulted in the highest spike in callers to the national AIDS hotline during that
calendar year.

The conference sought to provide an opportunity for practitioners to exchange ideas about, and share evaluation findings from, communication-centred initiatives that have highlighted or drawn on the relationship between the mass media and African American and Hispanic audiences. Among the presentations:

• Vibert Cambridge from Ohio University spoke on international EE efforts: Worldwide, a total of 163 EE projects have been launched and/or evaluated in recent years. Health-related themes such as reproductive health, family planning, HIV/AIDS, and preventable diseases are common in these EE projects, some of which appear to have had significant impact - e.g., Ghana's Things We Do for Love. He proposed that strategies appropriated from the programmes developed in South Africa, Ghana, and the English-speaking Caribbean can be instructive in reaching Black America (which is growing and internally diverse).
• Ralph DiClemente from Emory University discussed a study exploring the relationship between exposure to rap music videos and variety of risk behaviours in 16-year-old African American women. The study found that, in the 12 months following baseline, young women who reported higher exposure to rap music videos were:
  
  
  • 3 times more likely to hit a teacher
  • 2.6 times more likely to get arrested
  • 1.6 times as likely to report using drugs and alcohol
  • twice as likely to report having multiple sex partners, and
  • 60% more likely to acquire a new sexually transmitted infection (STI).

  
  Among DiClemente's recommendations: further research into the the effects of rap musicians like Salt 'n Peppa, who incorporate positive, pro-social messages into their music.

• Rina Alcalay from UC Davis reported on the impact of mass mediated health messages on Hispanic audiences: Evidence suggests that Latinos pay particularly close attention to television and tend to believe what they see. This finding motivated Alcalay's own project, Salud para su Corazón [Health for Your Heart], which relied on both interpersonal and media channels to prevent heart disease among Hispanics. It "demonstrated clear gains in knowledge, but negligible changes in behavior." When reaching and influencing Latino audiences, Alcalay stressed, one needs to determine which available format will most likely produce the desired outcome, as well as to keep in mind that too much entertainment may distract from the educational content.
• Vicki Freimuth from the CDC recounted the impact of a made-for-TV movie about the Tuskegee Syphilis Studies ("Ms. Evers Boys on African Americans"): Through focus group discussions, evaluators learned that "the movie reinforced distrust of whites, the United States government and institutions more generally." A lack of awareness about both research terms and concepts, and about the rights-related safeguards such as informed consent and institutional review boards (IRB) that have been put in place over the past 30 years to protect research participants, "makes it extremely difficult to recruit African American and other minority participants for clinical trials, leaving these communities vulnerable to unforeseen drug interactions and side effects." Communication scholars and health care advocates need to address this gap, Freimuth urges.
• Michael Cody from USC summarised the extant literature with respect to domestic attempts at EE: "A number of published articles demonstrate that members of the general audience are strongly influenced by EE messages....Fewer studies demonstrate pro-social, positive effects of EE programming on African American...and Latino audiences..."

Two media industry panels were held and are summarised here. The first, focusing on Spanish-language telenovelas with leaders from that industry, included reflection on the sheer number (500 million, as of this writing), diversity, and loyalty of telenovela viewers. One lesson highlighted here is that "entertainment programming is a potentially powerful persuader, but prior to utilizing this powerful tool, we must first ensure that the appropriate infrastructure is in place (i.e., classes, clinics, social service providers, access to the Internet, sufficient staffing of hotlines, bilingual staff members, etc.)" In contrast to the hypotheses of a presenter whose comments are summarised above (DiClemente), these panelists "were skeptical that Mexican immigrants, and to a lesser extent their children, will identify with primetime programming on the major US networks....'Don't use American programming to address the Mexican or Latin mentality...they want to hear messages from where they come from.'")

The second, a panel of U.S. entertainment industry and social marketing representatives, had one panelist noting, "We are just the entertainers...but if we can get some important information across without being too preachy...we are willing to try." One mechanism cited as being particularly helpful for writers was having an array of interesting, health-related scenarios readily available to incorporate into their scripts; several panelists discussed their desire for factually accurate health information.

Following a panel held to explore strategies to generate increased funding for EE research, Vicki Beck concluded the programme by proposing that:

1. Future meetings should include a wider range of minority media representatives.
2. A network of individuals and institutions interested in promoting EE domestically should be established and maintained - an ongoing email listserve, as well as an annual or biannual conference, were proposed to disseminate relevant information and to exchange experiences.
3. Minority researchers should be identified, trained, and included in the process.