The development of a culturally sensitive educational video: How to facilitate informed decisions on cervical cancer screening among Turkish- and Moroccan-Dutch women.

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.

Toward spreadable entertainment-education: leveraging social influence in online networks.

Entertainment-education (EE) is a communication strategy that uses popular media to engage with audiences on prosocial topics such as health, social tolerance and sustainability. The purpose of EE serials on radio, television or the internet is to introduce new ideas, norms and practices by means of storytelling, as well as to offer points of engagement for audiences to talk about the themes raised by the intervention. However, in today's media landscape, it has become increasingly difficult to captivate audiences as they have fragmented across channels and have started to create and circulate content themselves. The concept of spreadable media allows us to deal with fragmentation and user-generated content in productive ways, as it recognizes the role of autonomous audience members in shaping the flows of media content in the online networks that underlie today's media landscape. In this article, we introduce spreadable EE: an innovative approach that builds on transmedia storytelling strategies to reach and captivate target audiences for a longer period of time, and that entails collaboration with online platforms, communities and social influencers to stimulate meaningful conversations. We enhance EE's theoretical, empirical and practical traditions with insights about how today's audiences have come to engage with media and propose strategic approaches to create and evaluate spreadable EE.

Mapping the Dutch vaccination debate on Twitter: Identifying communities, narratives, and interactions.

In recent years, vaccination rates in the Netherlands have declined slightly, but steadily. The Dutch National Institute for Public Health and the Environment (RIVM) commissioned a Committee for Vaccine Willingness (VWC) to study the societal context of the decline. One of the societal contexts is the Internet, where audiences discuss vaccination and refer to sources of health-related information of varying quality. Working for the VWC, we have explored the Dutch vaccination debate on Twitter in order to: (1) identify online communities in the vaccination debate, (2) identify vaccine-related narratives; and (3) understand how the online communities interact with each other. We identified seven different communities, including (public) health professionals, writers and journalists, anti-establishment, and international vaccination advocates. The debate is spearheaded by the writers & journalists community, while the health- and anti-establishment communities try to influence it. The health community circulates facts, figures and scientific studies, while negative messages about vaccination - either from a homeopathy or conspiracy perspective - are most prevalent in the anti-establishment. The facts and figures shared by the health community hardly reach other communities, whereas the myths introduced by the anti-establishment do spill over to other communities. Our study provides further evidence that negative perceptions about vaccination might be rooted in a wider sentiment of distrust of traditional institutions. We argue that Dutch health organizations should try to address questions, doubts, and worries among the general audience more actively, and present scientific information in a simpler and more attractive way.

Television Viewing Does Not Have to Be Sedentary: Motivation to Participate in a TV Exercise Program.

The present study explored which underlying motivations induced people to participate in a television exercise program called "The Netherlands on the Move!-television" (NOM-tv). A cross-sectional study was carried out among 1,349 viewers of NOM-tv. The respondents completed the intrinsic motivation inventory (IMI), assessing their levels of intrinsic motivation towards participating in the NOM-tv exercises. The results showed that higher levels of intrinsic motivation (i.e. enjoying the NOM-tv exercises, feeling competent to perform this activity, and willingness to put effort into the exercises) were the most important predictive factors of more frequent participation in the NOM-tv exercises. Future screen-based interventions to reduce sedentary behavior should aim especially at encouraging people's intrinsic orientations towards physical activity in an autonomy-supportive way.