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The increase in clandestine migrants to Italy following the 2010 Tunisian uprising has been an issue of popular and political concern in both countries. This article investigates Harga (2021, 2022), a top-rated and critically acclaimed drama series. Produced and aired by Tunisian national television as a vehicle of entertainment-education, Harga strove to make a geopolitical intervention in the process of irregular migration. Combining textual analysis with interviews conducted with the production's producers and participants, the article explores how local and transnational actors came together to create a counternarrative to the popular success stories of clandestine migrants. This approach contributes to a better understanding of the relationship between media and socio-cultural and political dynamics as well as of their effect on formulating mediated narratives on clandestine migration. Due to Harga 's documentarist depiction of the social and political driving forces behind irregular migration and its open criticism of Tunisian authorities, the show is investigated within the framework of post-uprising Tunisia's mediascape, and domestic and international political environment. In this regard, it offers a good case study for examining how local politics, transnationalism, and postcolonialism are intertwined in formulating discourses on irregular migration. [ABSTRACT FROM AUTHOR]

While there has been a marked increase in measurement and scholarship surrounding social norms in recent years, there is little evidence related to social norms measurement in the context of health campaigns utilizing entertainment-education. Entertainment-education goals and objectives have shifted over time to include social norms and an update is needed to merge contemporary practice with the most recent measures from the literature. The aim of the present study was to analyze commonly used quantitative measures and their properties for social norms and entertainment-education, specifically on the topic of family planning, to bolster ongoing research and practice efforts by validating items for social norms measurement in entertainment-education programs. The study used data from a survey conducted with 438 married women aged 19–34 in the Central Province of Zambia in 2019 who were exposed to the entertainment-education initiative Kwishilya (Over the Horizon), a Bemba-language, 156-episode radio program designed to shift social norms on family planning. Multiple items were included to measure descriptive norms, injunctive norms, and outcome expectations. Exploratory factor analysis and estimates of scale reliability were conducted to understand the properties and structure of the social norms items. Results showed a five-factor solution best fit the data, which accounted for 45.7% of the variance, exhibited fair reliability, and loaded largely as expected. This study provides a useful tool for practitioners and scholars to use globally to measure important social norms constructs in entertainment-education. [ABSTRACT FROM AUTHOR]

Entertainment-education has been touted as a potent delivery channel for health education campaigns. Yet, there is little evidence of its causal effects. This paper aims to fill the gap in the literature by using a field experiment in India to study two questions on the efficacy of health entertainment-education. First, can health entertainment-education, particularly through films that show role models and draw on emotions, lead to lasting, positive change in health knowledge and behavior? Second, can financial incentives for ex-post health literacy boost the effectiveness of health entertainment-education? The results show that health entertainment-education successfully increased health knowledge (e.g. knowledge about cleanliness and hygiene) by 16 percent. These gains persist almost one year later, although there were no observed impacts on health behaviors. Further, financial incentives do not appear to have any effects. These insights contribute to our knowledge of what works for health education in low-income settings, so that future education campaigns can be crafted with more meaningful impact. [ABSTRACT FROM AUTHOR]

The study examined the preferences and perceptions of agricultural extension personnel on the use of music as a tool for agricultural information dissemination. Forty-four out of 50 extension agents in Ondo state were randomly selected for the study. Chi-square and the Pearson Product Moment Correlation were used to analyse data. The study revealed that all (100.0%) respondents accepted the use of music as a tool for agro-information dissemination. The music genre most preferred was gospel (63.64%). All (100.0%) respondents also had a favourable disposition towards its use. Only work cadre was significantly associated with the perception of the use of music for agro-information dissemination (?2 = 13.036). In designing music-based messages, consideration should be given to the incorporation of a variety of genres or styles to appeal to a broader audience.

Entertainment-Education interventions can be influential communication strategies to help facilitate audiences to live more sustainable lifestyles. Understanding the process of influencing viewers' behaviour is essential to further design and enhance Entertainment-Education interventions. This current research uses focus groups to explore the role the first season of the Australian Broadcasting Corporation's television series, War on Waste, played in encouraging an uptake in reusable coffee cup behaviour in Melbourne's millennial generation (people born between 1982 and 2000). The results indicate the investigative style, local context and joint-learning experience were all elements that promoted reusable coffee cup behaviour. Millennials described this behaviour as being more widely adopted – compared to other behaviours shown in War on Waste – because it aligned with their lifestyles, was considered 'easy' and projected their environmental values. This case study aims to provide practitioners with a useful framework that can be applied to broader Anthropogenic issues to generate behaviour change at scale. [ABSTRACT FROM AUTHOR]

Background: Mental health conditions and psychiatric disorders are among the leading causes of illness, disability, and death among young people around the globe. In the United States, teen suicide has increased by about 30% in the last decade. Raising awareness of warning signs and promoting access to mental health resources can help reduce suicide rates for at-risk youth. However, death by suicide remains a taboo topic for public discourse and societal intervention. An unconventional approach to address taboo topics in society is the use of popular media. Method: We conducted a quantitative content analysis of mainstream news reporting on the controversial Netflix series 13 Reasons Why Season 1. Using a combination of top-down and bottom-up search strategies, our final sample consisted of 97 articles published between March 31 and May 31, 2017, from 16 media outlets in 3,150 sentences. We systematically examined the news framing in these articles in terms of content and valence, the salience of health/social issue related frames, and their compliance with the WHO guidelines. Results: Nearly a third of the content directly addressed issues of our interest: 61.6% was about suicide and 38.4% was about depression, bullying, sexual assault, and other related health/social issues; it was more negative (42.8%) than positive (17.4%). The criticism focused on the risk of suicide contagion, glamorizing teen suicide, and the portrayal of parents and educators as indifferent and incompetent. The praise was about the show raising awareness of real and difficult issues young people struggle with in their everyday life and serving as a conversation starter to spur meaningful discussions. Our evaluation of WHO guideline compliance for reporting on suicide yielded mixed results. Although we found recommended practices across all major categories, they were minimal and could be improved. Conclusion: Despite their well intentions and best efforts, the 13 Reasons Why production team missed several critical opportunities to be better prepared and more effective in creating social impact entertainment and fostering difficult dialogs. There is an urgent need to train news reporters about established health communication guidelines and promote best practices in media reporting on sensitive topics such as suicide. [ABSTRACT FROM AUTHOR]

Overweight is one of the major health-related challenges in industrialized countries and mostly preventable through a healthy diet and regular engagement in physical activity. Health communication practitioners and researchers, therefore, started using the media's persuasive potential by creating entertainment-education (E-E) programs that promote healthy nutrition and exercise. By observing the characters in E-E programs, audience members can learn vicariously and eventually develop personal bonds with them. The current study investigates the effects of parasocial relationships (PSRs) with characters of a health-related E-E show, as well as the impact of parasocial breakups (PSBUs) on health-relevant outcomes. Using the setting of the show The Biggest Loser (TBL), we conducted a quasi-experimental longitudinal field study. Participants (N = 149) watched shortened episodes of the show once a week for 5 weeks. Results showed that PSRs with the reality TV characters did not increase over time and after repeated exposure. Findings furthermore suggest that PSR did not influence self-efficacy perceptions or exercise behavior over time. Parasocial breakup distress intensity was neither related to self-efficacy nor to exercise behavior. Interpretations of these findings and implications for better understanding the effects of PSRs and PSBUs are discussed. [ABSTRACT FROM AUTHOR]

Cancer is a primary societal challenge worldwide, with over 23 million new cases/year, and 10 million deaths/year. Estimates of preventable cancer deaths rise as high as 70%, but such estimates rely heavily on individual behaviors, which in turn are correlated with knowledge and attitudes towards health and cancer. This paper describes the iterative evidence-based development of the first entertainment-education series on cancer prevention to be televised, and reports its effectiveness evaluation. A nominal group defined the guiding principles that were translated into key characteristics for a series named ' 2' Life-changing minutes '. Pilot episodes were produced and evaluated in two complementary studies—a focus group study with medical doctors and a survey study with prospective viewers. Results from these studies guided the optimization and production of the full series, which was broadcast on national public TV, in prime time. An evaluation study was performed afterwards with naturally-occurring viewers and results show audience reach on par with purely entertainment series, that health messages can be clearly conveyed through fictional narratives, and that the series has high levels of appreciation and health promotion potential. ' 2' Life-changing minutes ' constitutes a novel and effective proposal for health promotion, that challenges the primacy of information and statistics still common in health communication, with a new format based on stories, characters and social contexts to successfully promote health. [ABSTRACT FROM AUTHOR]

Abstract Background Adolescents in Mexico experience high pregnancy and birth rates. A collaboration with Grupo Televisa led to the development of an entertainment-education telenovela intervention, Overcome the Fear (OTF), which aired in 2020 to a national audience and addressed adolescent sexual and reproductive health (SRH) topics. This study details the development and evaluation of OTF’s impact on adolescent contraceptive practices and parent-adolescent SRH communication in Mexico. Methods We conducted cross-sectional survey interviews (street-intercept and telephone) with 12–19-year-olds (n = 1640) and parents of adolescent children (n = 820) post-broadcast across Mexico’s five most-populated metropolitan zones. Quotas were implemented for gender, zone, and OTF viewership (viewer vs. non-viewer). Bivariate statistics and multivariable binary logistic regression models assessed the relationship between OTF viewership (including parent-adolescent co-viewing) and adolescent contraceptive practices and parent-adolescent SRH communication. Adolescent and parent data are not dyadic and were analyzed separately. Results Nearly half of adolescents (47.9%) and parents (47.7%) were viewers. Among adolescents, bivariate analyses suggest that viewers had less negative attitudes towards contraception (p

Abstract Background In the Netherlands, all women aged 30–60 years are invited to participate in the national cervical cancer screening programme, which is aimed at early detection and treatment of precancerous lesions. One fourth of the Dutch population has a migration background, with Turkish and Moroccan immigrants being the largest immigrant populations. Turkish‐ and Moroccan‐Dutch women show lower screening participation rates and a higher incidence of cervical cancer, compared to native Dutch women. Since current information materials are not tailored to these women's needs, we developed a short culturally sensitive educational video to facilitate informed decision‐making for cervical cancer screening among Turkish‐ and Moroccan‐Dutch women. This article describes the development process of this video and the lessons learned. Methods Using the Entertainment–Education communication strategy, we collaborated with an interdisciplinary team of Turkish‐ and Moroccan‐Dutch women, researchers, public health experts, and creative media professionals. We developed the video following the different stages of the Media Mapping model: Orientation, Crystallization, Design/Production, Implementation, and Dissemination. Each stage is described in the paper. Results The video was developed in Moroccan‐Arabic, ‐Berber and Turkish, and emphasized three main themes: (1) more certainty about having cervical (pre)cancer and the possibility to prevent treatment, surgery, or premature death, and because of this, being there for the children, (2) according to the Islam, a woman should take good care of her health, and (3) anxiety, shame, and privacy. Conclusions A short culturally sensitive educational video, delivered as part of a larger intervention together with the current information brochure, was developed based on theory and grounded in the needs of Turkish‐ and Moroccan‐Dutch women. The value and effectiveness of this intervention to facilitate informed cervical cancer screening decisions are evaluated in a randomised controlled trial. Patient or Public Contribution We collaborated with Turkish‐ and Moroccan‐Dutch women during the development process of a short culturally sensitive educational video. Turkish‐ and Moroccan‐Dutch women were also invited to watch the raw footage to verify whether the content and presentation matched their needs and requirements.

The Deaf community members of this community-campus partnership identified the lack of health information in American Sign Language (ASL) as a significant barrier to increasing the Deaf community's health knowledge. Studies have shown that the delivery of health messages in ASL increased Deaf study participants' cancer knowledge. Once health messages are available on the Internet, strategies are needed to attract viewers to the website and to make repeat visits in order to promote widespread knowledge gains. This feasibility study used the entertainment-education strategy of coupling cancer information with jokes in ASL to increase the appeal and impact of the health messages. ASL-delivered cancer control messages coupled with Deaf-friendly jokes were shown to 62 Deaf participants. Participants completed knowledge questionnaires before, immediately after, and 1 week after viewing the paired videos. Participants' health knowledge statistically significantly increased after viewing the paired videos and the gain was retained 1 week later. Participants also reported sharing the newly acquired information with others. Statistically significant results were demonstrated across nearly all measures, including a sustained increase in cancer-information-seeking behavior and intent to improve health habits. Most participants reported that they would be motivated to return to such a website and refer others to it, provided that it was regularly updated with new jokes.

Introduction: This article presents the results of an experimental study that sought to contrast the effect of the entertainment education message (written versus audiovisual) on the cognitive processes of reception, as a function of the need for cognition. Method: 109 MSM participated, randomly distributed, in two experimental conditions (written versus audiovisual message). Results: We found that the need for cognition moderated the effect of message modality on cognitive elaboration and in contra-argumentation, but not on reactance. Data shows that written message increased cognitive elaboration in participants with low need for cognition and generated less contra-argumentation in participants with a higher need for cog-nition. Conclusions: The effectiveness of an entertainment-education message is determined by both the characteristics of the message (the modality of presentation) and the individual differences of people (the need for cognition). In particular, the need for cognition is a relevant variable for understanding the cognitive processes of reception (cognitive elaboration and contra-argumentation) that play a fundamental role in the study of narrative persuasion. [ABSTRACT FROM AUTHOR]

Background: In the Netherlands, all women aged 30–60 years are invited to participate in the national cervical cancer screening programme, which is aimed at early detection and treatment of precancerous lesions. One fourth of the Dutch population has a migration background, with Turkish and Moroccan immigrants being the largest immigrant populations. Turkish‐ and Moroccan‐Dutch women show lower screening participation rates and a higher incidence of cervical cancer, compared to native Dutch women. Since current information materials are not tailored to these women's needs, we developed a short culturally sensitive educational video to facilitate informed decision‐making for cervical cancer screening among Turkish‐ and Moroccan‐Dutch women. This article describes the development process of this video and the lessons learned. Methods: Using the Entertainment–Education communication strategy, we collaborated with an interdisciplinary team of Turkish‐ and Moroccan‐Dutch women, researchers, public health experts, and creative media professionals. We developed the video following the different stages of the Media Mapping model: Orientation, Crystallization, Design/Production, Implementation, and Dissemination. Each stage is described in the paper. Results: The video was developed in Moroccan‐Arabic, ‐Berber and Turkish, and emphasized three main themes: (1) more certainty about having cervical (pre)cancer and the possibility to prevent treatment, surgery, or premature death, and because of this, being there for the children, (2) according to the Islam, a woman should take good care of her health, and (3) anxiety, shame, and privacy. Conclusions: A short culturally sensitive educational video, delivered as part of a larger intervention together with the current information brochure, was developed based on theory and grounded in the needs of Turkish‐ and Moroccan‐Dutch women. The value and effectiveness of this intervention to facilitate informed cervical cancer screening decisions are evaluated in a randomised controlled trial. Patient or Public Contribution: We collaborated with Turkish‐ and Moroccan‐Dutch women during the development process of a short culturally sensitive educational video. Turkish‐ and Moroccan‐Dutch women were also invited to watch the raw footage to verify whether the content and presentation matched their needs and requirements. [ABSTRACT FROM AUTHOR]

Impoverished rural communities are disproportionately affected by a neglected tropical disease called Chagas disease. Because it is a disease that affects the poor, governments inconsistently respond and, when they respond, governments use insecticides that are expensive for the affected communities and unhealthy for their inhabitants. Primary prevention of Chagas disease is essential. The present study reports on an entertainment education approach that sought to raise awareness of Chagas and its insect vector, the triatomine bug. As part of our ongoing efforts in rural Ecuador, we worked with the children of Chaquizhca to create plays that would promote awareness of triatomine bugs and associate the bugs with Chagas disease. Through an analysis of the plays the children wrote, we demonstrate opportunities and challenges that local scale entertainment education approaches face in when adopting community-centered participatory approaches in rural communities. [ABSTRACT FROM AUTHOR]

ISIS's media projected the group's vision of an Islamic utopia upon declaring its so-called Caliphate in 2014. In response, many counter-messaging campaigns have emerged. Although many examine ISIS's media and anti-extremism interventions, very few assess faith-based initiatives in Arab countries. Integrating two bodies of scholarly literature on religious and political conversions and entertainment-education, this study explores al-Siham al-Marika, a faith-based Arab drama portraying life under ISIS. The study uses mixed-methods to analyze the show's religious underpinnings, the depiction of positive/negative role models, and the portrayals of religious-political conversions. Focusing on spiritual outcomes, the show illustrates cross-cultural differences in conceptualizing rewards and punishments and uses drama to bolster the persuasive power of religious-political conversion narratives. The study concludes with a discussion on the implications of faith-based entertainment-education in combating extremism and its potential role as a catalyst for bridging the perceived schism between religion and popular culture in some Muslim societies. [ABSTRACT FROM AUTHOR]

The health communication strategy known as entertainment–education can be traced in large part to Miguel Sabido and the methodology he developed using telenovelas in Latin America in the 1960s and 1970s. Entertainment–education has evolved from a long-running narrative approach using traditional media to the addition of new media and transmedia formats. In recent years, entertainment–education programs using social media have increased, yet few studies have explored the shared characteristics and experiences of social media users who engage with these programs. This qualitative study aimed TO examine publicly available social media data (i.e. YouTube and Instagram comments) in response to Girlsplained, an online entertainment–education program designed with objectives related to sexual health and HIV prevention among Black, Asian, and minority ethnic women in the United Kingdom. A process of directed content analysis uncovered five themes of engagement: characters and the narrative; social media; gender and race; HIV/PrEP; and sex and pregnancy prevention. [ABSTRACT FROM AUTHOR]

Abstract Background Entertainment-education (E-E) media can improve behavioral intent toward health-related practices. In the era of COVID-19, millions of people can be reached by E-E media without requiring any physical contact. We have designed a short, wordless, animated video about preventive COVID-19 behaviors that can be rapidly distributed through social media channels to a global audience. The E-E video’s effectiveness, however, remains unclear. Methods/design This is a multi-site, parallel group, randomized controlled trial comparing the effectiveness of an E-E video on COVID-19 against (i) an attention placebo control (APC) video and (ii) no video. For our primary outcomes, we will measure knowledge about preventive COVID-19 behaviors. We will also use a list randomization approach to measure behavioral intent toward preventative COVID-19 behaviors. In each trial arm, participants will be randomized to a control list or a control list plus an item about social distancing, washing hands, cleaning household surfaces, sharing of eating utensils, and the stockpiling of essential goods. Using an online platform, we will recruit 17,010 participants (aged 18–59 years) from the USA, the UK, Germany, Spain, France, and Mexico. Trial registration German Clinical Trials Register #DRKS00021582 . Registered on May 12, 2020. Discussion This trial will utilize several randomization procedures, list experimentation methods, and state-of-the-art online technology to demonstrate the effectiveness of an E-E video to improve knowledge of, and behavioral intent toward, the prevention of COVID-19. Our results will inform future E-E video campaigns for COVID-19 and similar public health intervention needs.

In the United States, Hispanic children experience dramatically different educational outcomes compared to other racial and ethnic groups. Educational disparities begin at the earliest phases of formal education; left unaddressed, challenges can persist. To address this, Univision, the most-watched Spanish-language network in the United States, launched Camino al Éxito (Road to Success), a multimedia prosocial storytelling campaign designed to reach parents with helpful messages about key risk transitions through the K-12 education life cycle. Following narrative engagement theory, this study sought to understand the role of narrative-based information utilized in this entertainment-based prosocial campaign by examining U.S. Hispanic parents' (N = 153) responses to a short TV documentary and a printed campaign resource document. Those exposed to the documentary showed significantly higher posttest mean levels of knowledge than the print condition. Results suggest that documentary storytelling can be effectively employed in prosocial entertainment media campaigns for social change. [ABSTRACT FROM AUTHOR]

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Radicalization amongst youth is a challenge facing the Arab world. Recent reports indicate that over 20,000 Arab fighters traveled to join ISIS in Iraq and Syria and another 5-15 percent of millennials across seven Arab countries consider some violent extremist groups to be on the right path. In response, Arab countries have experimented with entertainment-education (E-E) by using anti-extremism narratives in popular culture to address radicalization at the societal level. This study explores whether those narratives can elicit viewers’ parasocial interaction (PSI)—pseudo friendships with or animosity toward mediated personas that can catalyze persuasion—with fictional characters. Using qualitative and quantitative content analyses of more than 8,600 YouTube comments, this study explores Arab viewers’ responses to a recent E-E project, al-Siham al-Marika (The Piercing Arrows) drama series, that portrays life under ISIS’s control. The findings identify recurrent themes in the pool of comments, such as show debates, religious contestations, political disputes, empathy for victims, and engagement with plotline/characters. More importantly, they reveal at least one out of six comments (n=1477) exhibits PSI with fictional characters, addressing them as part of their social milieu. The study further traces the variations in the nature of PSI in relation to mediated positive role models, negative role models, and transitional characters in the narrative. It concludes with a discussion of E-E’s potentials as an anti-extremism messaging strategy and PSI’s role as a useful metric in assessing such narratives.

Objective: Entertainment-education interventions remain underutilized in sexual and reproductive health (SRH) despite evidence that they can be effective and place a low burden on staff. This study explores perceived facilitators and barriers for implementing an entertainment-education video intervention for 18- to 19-year-old African American and Latina women in SRH clinics., Design: Cross-sectional online survey (n=100) and telephone interviews (n=19) were completed May through August 2018., Setting: SRH clinics were located across 32 US states and 1 Canadian province., Participants: SRH clinic staff were diverse in type of clinic, role, and geography and were recruited using purposive sampling., Methods: Bivariate analyses were used for quantitative data, and thematic analysis was used for qualitative data., Main Outcome Measures: Intervention acceptability, perceived feasibility, and likely uptake were assessed using agreement statements (survey) and open-ended questions (interviews and survey)., Results: Interviewed clinic staff described the intervention as engaging, educational, and promising for improving client SRH knowledge and behaviors. Nearly all (95%) survey respondents said showing the video would be feasible. Most (56%) indicated likely uptake, which was significantly associated with perceived feasibility (P=.000), acceptability (P≤.001), and working at a public health clinic (P=.023). Implementation barriers included the video's potential relevance to only certain clients and the need for additional information or staff and/or management buy-in., Conclusions: This is the first study to assess perceived implementation facilitators and barriers of an entertainment-education video intervention among SRH clinic staff. The intervention was well received, with certain barriers potentially alleviated by offering information about entertainment-education and multiple implementation methods. These findings can help improve dissemination efforts for video-based entertainment-education interventions in clinics serving young women of color., Competing Interests: Conflict of Interest: The authors are affiliated with Sentient Research, which owns the copyright for Plan A. The intervention and its evaluation were supported by grant TP2AH000036 from the Department of Health and Human Services, Office of Population Affairs. Contents are solely the responsibility of the authors and do not represent the official views of the Department of Health and Human Services or the Office of Population Affairs.

This article is part of an entertainment-education research (EE) from the perspective of narrative persuasion. It presents the results of experimental research aimed at contributing to the improvement of the design of EE strategies to promote HIV testing in men who have sex with men (MSM). Specifically, we assessed the effect of the entertainment-education message (written vs. audiovisual) and the moderating role of the ability to generate mental imagery in the persuasive impact of EE pieces. In this experimental research, 109 MSM were randomly distributed into two experimental conditions (audiovisual versus written message). The results showed that the ability to generate mental imagery moderated the effects of the EE message modality on narrative transportation and the identification with characters. Besides, it was verified that narrative transportation and identification with characters are relevant mediating mechanisms, but these indirect effects were conditioned by the ability to generate mental imagery. These results suggest an advance in the knowledge process of narrative persuasion, the role of individual differences, and the provision of relevant information for the design of EE interventions.

Despite widespread condemnation of child marriage in Bangladesh, the practice is still deeply ingrained in Bangladeshi society. Multiple initiatives have been developed to end child marriage, yet prevalence rates have only been decreasing slowly. In 2017, the United Nations Children's Fund (UNICEF), The Government of Bangladesh's Ministry of Children and Women's Affairs, the United Nations Population Fund (UNFPA), and other partners launched a transmedia campaign, Icchedana, to address social norms surrounding several issues surrounding the well-being of adolescent girls. Data were collected in 2017 and 2019. After conducting a literature review and identifying five determinants of child marriage (poverty, the practice of dowry, family honour, education, and violence against women and girls) in Bangladesh, we used questions that were specifically relevant to child marriage. Two questions from each level of the social-ecological model (SEM) were selected. The SEM was utilized in this paper because it acknowledges that change must occur at each level for change to occur. The findings show that having watched Icchedana was associated with positive attitudes towards ending child marriage in Bangladesh and provide insight into the knowledge, attitudes, and beliefs about child marriage in Bangladesh. [ABSTRACT FROM AUTHOR]

The Sabido Methodology (TSM) is recognised as a discrete methodology of entertainment-education (EE). EE programmes are intentionally designed to entertain and educate through the weaving in of important health and social messaging into powerful storytelling. Sabido-style dramas are highly effective in promoting social and behaviour change around a myriad of issues and its usefulness has been widely documented in long-running serial dramas on traditional media. There is little documentation, however, of how TSM could be applied to newer media, such as social media (SM). Girlsplained was created with the aim of addressing the sexual health of young Black, Asian and minority ethnic (BAME) women in the United Kingdom. Key lessons from the effort can be used to build a proposed framework for adapting TSM to SM, i.e., The Sabido Methodology for Social Media (TSM4SM). We hypothesise 4 key features of TSM4SM should include: 1) the major tenets of TSM in a web-based drama with shorter story arcs; 2) the use of humour as per the Laugh Model framework to create a fourth character; 3) the use of transmedia to create a SM feed following the life of the transitional character based on TSM principles; and 4) a target audience of younger people. [ABSTRACT FROM AUTHOR]

Abstract Objectives Entertainment-education (E-E) media can improve behavioral intent toward health-related practices. In the era of COVID-19, millions of people can be reached by E-E media without requiring any physical contact. We have designed a short, wordless, animated video about COVID-19 hygiene practices—such as social distancing and frequent hand washing—that can be rapidly distributed through social media channels to a global audience. The E-E video’s effectiveness, however, remains unclear. The study aims to achieve the following objectives. To: 1. Quantify people’s interest in watching a short, animated video about COVID-19 hygiene (abbreviated to CoVideo). 2. Establish the CoVideo’s effectiveness in increasing behavioural intent toward COVID-19 hygiene. 3. Establish the CoVideo’s effectiveness in improving COVID-19 hygiene knowledge. Trial Design The present study is a multi-site, parallel group, randomized controlled trial (RCT) comparing the effectiveness of the CoVideo against an attention placebo control (APC) video or no video. The trial has an intervention arm (CoVideo), placebo arm (APC), and control arm (no video). Nested in each trial arm is a list experiment and questionnaire survey, with the following ordering. Arm 1: the CoVideo, list experiment, and questionnaire survey. Arm 2: the APC video, list experiment, questionnaire survey, and CoVideo. Arm 3: the list experiment, questionnaire survey, and CoVideo. For each list experiment, participants will be randomized to a control or treatment group. The control group will receive a list of five items and the treatment group will receive the same five items plus one item about COVID-19 hygiene. We will use the list experiment to reduce response bias associated with socially desirable answers to COVID-19 questions. The questionnaire survey will include items about the participant’s age, sex, country of residence, highest education, and knowledge of COVID-19 spread. After completing the list experiment and questionnaire survey, participants in Arms 2 and 3 will receive the CoVideo to ensure post-trial access to treatment. Participants This will be an online study setting. We will use Prolific Academic (ProA: https://www.prolific.co ) to recruit participants and host our study on the Gorilla™ platform ( www.gorilla.sc ). To be eligible, participants must be between the age of 18 and 59 years (male, female, or other) and have current residence in the United States, the United Kingdom, Germany, Spain, Mexico, or France. Participants will be excluded from the study if they cannot speak English, German, French, or Spanish (since the instructions and survey questions will be available in these 4 languages only). Intervention and comparator The intervention is an E-E video about COVID-19 hygiene (CoVideo). Developed by our co-author (MA) for Stanford Medicine, the CoVideo is animated with sound effects, and has no words, speech, or text. The CoVideo shows how the novel coronavirus is spread (airborne, physical contact) and summarizes the public’s response to the COVID-19 outbreak. Key components of the CoVideo are the promotion of five hygiene practices: i) social distancing and avoiding group gatherings, ii) frequently washing hands with soap and water or sanitizer, iii) cleaning surfaces at home (e.g., kitchen counters), iv) not sharing eating utensils, and v) avoidance of stockpiling essential goods (such as toilet paper and face masks). The CoVideo, which was designed for universal reach and optimized for release on social media channels, can be viewed at https://www.youtube.com/watch?v=rAj38E7vrS8 . The comparators are an APC video (Arm 2) or no video (Arm 3). The APC video is similar in style to the CoVideo; it is also animated with a duration of 2.30 minutes, has sound effects but no words, speech, or text. The video message is about how small choices become actions, which become habits, which become a way of life. It is available at https://www.youtube.com/watch?v=_HEnohs6yYw . Each list experiment will have a control list as the comparator. The control list is needed to measure the prevalence of behavioral intent toward COVID-19 hygiene. Main outcomes This study will measure primary and secondary outcomes related to COVID-19 hygiene. By hygiene, we mean the adoption of behaviors or practices that reduce the chances of being infected or spreading COVID-19. As our primary outcome, we will measure changes in behavioral intent toward five hygiene practices: social distancing, washing hands, cleaning household surfaces, not sharing eating utensils, and not stockpiling essential goods. As a secondary outcome, we will measure knowledge about behaviors that can prevent the spread of COVID-19. Randomization Using a web-based randomization algorithm, Gorilla will randomly allocate participants to the intervention (CoVideo), placebo (APC), or control (no video) arm (sequence generation) at a 1:1:1 ratio. Within each trial arm, Gorilla will randomly allocate participants at a 1:1 ratio to the control or treatment group. Items in the lists will be randomly ordered to avoid order effects. The presentation order of the list experiments will also be randomized. Blinding Because ProA handles the interaction between the study investigators and participants, the participants will be completely anonymous to the study investigators. The outcome measures will be self-reported and submitted anonymously. All persons in the study team will be blinded to the group allocation. Numbers to be randomized The Gorilla algorithm will randomize 6,700 participants to each trial arm, giving a total sample size of 20,100. Trial status The protocol version number is 1.0 and the date is 18 May 2020. Recruitment is expected to end by 22 June 2020. Thus far, the study investigators have recruited 2,500 participants on ProA. Of these participants, 800 have completed the study on the Gorilla platform. Trial registration The study and its outcomes were registered at the German Clinical Trials Register ( www.drks.de ) on May 12th, 2020, protocol number: #DRKS00021582. The study was registered before any data was collected. Full protocol The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.

Abstract Background In South Africa, rates of exclusive breastfeeding remain low and breastfeeding promotion is a national health priority. Mobile health and narrative entertainment-education are recognized strategies for health promotion. In-home counseling by community health workers (CHWs) is a proven breastfeeding promotion strategy. This protocol outlines a cluster-randomized controlled trial with a nested mixed-methods evaluation of the MObile Video Intervention for Exclusive breastfeeding (MOVIE) program. The evaluation will quantify the causal effect of the MOVIE program and generate a detailed understanding of the context in which the intervention took place and the mechanisms through which it enacted change. Findings from the study will inform the anticipated scale-up of mobile video health interventions in South Africa and the wider sub-Saharan region. Methods We will conduct a stratified cluster-randomized controlled trial in urban communities of the Western Cape, to measure the effect of the MOVIE intervention on exclusive breastfeeding and other infant feeding practices. Eighty-four mentor-mothers (CHWs employed by the Philani Maternal Child Health and Nutrition Trust) will be randomized 1:1 into intervention and control arms, stratified by neighborhood type. Mentor-mothers in the control arm will provide standard of care (SoC) perinatal in-home counseling. Mentor-mothers in the intervention arm will provide SoC plus the MOVIE intervention. At least 1008 pregnant participants will be enrolled in the study and mother-child pairs will be followed until 5 months post-delivery. The primary outcomes of the study are exclusive breastfeeding at 1 and 5 months of age. Secondary outcomes are other infant feeding practices and maternal knowledge. In order to capture human-centered underpinnings of the intervention, we will conduct interviews with stakeholders engaged in the intervention design. To contextualize quantitative findings and understand the mechanisms through which the intervention enacted change, end-line focus groups with mentor-mothers will be conducted. Discussion This trial will be among the first to explore a video-based, entertainment-education intervention delivered by CHWs and created using a community-based, human-centered design approach. As such, it could inform health policy, with regards to both the routine adoption of this intervention and, more broadly, the development of other entertainment-education interventions for health promotion in under-resourced settings. Trial Registration The study and its outcomes were registered at clinicaltrials.gov (#NCT03688217) on September 27th, 2018.

The present study examined direct and indirect effects of adolescent narrative engagement on substance use behaviors via refusal self-efficacy. This study also tested moderation effects of communication about substance use with parents, siblings, and friends on substance use behaviors. Students in 8th grade (N = 225) participated in surveys at two different time points. Path analyses revealed a positive association between identification with main characters and refusal self-efficacy as well as negative associations between refusal self-efficacy and the past 30-days substance use. Communication with parents and friends significantly moderated the relationship between refusal self-efficacy and the past 30-days substance use. [ABSTRACT FROM AUTHOR]

Background: Limited evidence exists on the effectiveness of using an entertainment-education methodology to address multiple public health issues and of using participatory street theatre to improve public understanding related to public health. Objective: To assess the feasibility, acceptability and impact of the Actor–Doctor project, an intervention involving theatre professionals and medical specialists to jointly deliver street-theatre-based public health education. Design: A real-world, mixed-methods post-intervention study evaluated the Actor–Doctor project among 486 participants in Ahmedabad, India, in 2017. Setting and method: Focus group discussions with actors and semi-structured interviews with doctors and implementers assessed project feasibility, acceptability and perceived impact. Post-intervention surveys among actors, audience and a control group assessed impact on knowledge and attitudes related to select public health issues. Quantitative data were analysed using multivariable regression, and qualitative data were analysed using an inductive thematic analysis. Results: The Actor–Doctor project was feasible to implement, as 20 street theatre performances on five public health themes were developed and staged. Members of the audience showed higher knowledge of environmental health, anaemia and openness to discussing sexual health issues, compared to a control group (omega squared 0.03–0.24; p <.001). Actors and doctors collaborating to create theatre-based public health education derived satisfaction from the project. Balancing scientific accuracy and entertainment, especially humour was challenging. Conclusion: The Actor–Doctor project was instrumental in improving public-health-related engagement between actors, doctors and the public. [ABSTRACT FROM AUTHOR]

Background: Entertainment-education (E-E) media can improve behavioral intent toward health-related practices. In the era of COVID-19, millions of people can be reached by E-E media without requiring any physical contact. We have designed a short, wordless, animated video about preventive COVID-19 behaviors that can be rapidly distributed through social media channels to a global audience. The E-E video's effectiveness, however, remains unclear.Methods/design: This is a multi-site, parallel group, randomized controlled trial comparing the effectiveness of an E-E video on COVID-19 against (i) an attention placebo control (APC) video and (ii) no video. For our primary outcomes, we will measure knowledge about preventive COVID-19 behaviors. We will also use a list randomization approach to measure behavioral intent toward preventative COVID-19 behaviors. In each trial arm, participants will be randomized to a control list or a control list plus an item about social distancing, washing hands, cleaning household surfaces, sharing of eating utensils, and the stockpiling of essential goods. Using an online platform, we will recruit 17,010 participants (aged 18-59 years) from the USA, the UK, Germany, Spain, France, and Mexico.Trial Registration: German Clinical Trials Register #DRKS00021582 . Registered on May 12, 2020.Discussion: This trial will utilize several randomization procedures, list experimentation methods, and state-of-the-art online technology to demonstrate the effectiveness of an E-E video to improve knowledge of, and behavioral intent toward, the prevention of COVID-19. Our results will inform future E-E video campaigns for COVID-19 and similar public health intervention needs. [ABSTRACT FROM AUTHOR]

Southeast Asian women in California have high cervical cancer incidence and mortality rates, but low levels of Pap screening. No published reports have addressed screening among Thai women. Entertainment-education (EE) is a useful strategy for low-literacy, culturally diverse populations. This quasi-experimental study determined whether a soap-opera-themed, Thai-language EE video was superior to a print handout for increasing knowledge, attitudes, and behavioral intention toward Pap testing. No uniform differences were found between the intervention group (video) and the control group (brochure). Both educational modalities appeared to result in selected increases in knowledge and attitudes.