Erasing epilepsy stigma: eight key messages.

Historically, epilepsy has been ignored by the public health community, despite the fact that there are more than 2 million people with epilepsy in the United States. Although epilepsy affects 1 in 26 people during their lifetime, the general public lacks basic knowledge and holds misperceptions about epilepsy that contribute to its associated stigma. Consequently, people with epilepsy continue to fare poorly, with lower physical, mental, and social well-being. Recently, the 2012 Institute of Medicine (IOM) report Epilepsy Across the Spectrum: Promoting Health and Understanding inspired a new sense of enthusiasm in the epilepsy community that can serve as a catalyst to change public perceptions about epilepsy. To erase stigma, the IOM committee made recommendations in two areas: (a) informing the media and (b) coordinating public awareness. The committee also identified eight key messages about epilepsy that the public should know. Health promotion and education professionals can play a critical role in disseminating these messages to the general public in their local communities and supporting interventions and policies to change the face of epilepsy.

Research implications of the Institute of Medicine Report, Epilepsy Across the Spectrum: Promoting Health and Understanding.

In March 2012 the Institute of Medicine (IOM) released the report, Epilepsy Across The Spectrum: Promoting Health and Understanding. This report examined the public health dimensions of the epilepsies with a focus on the following four areas: public health surveillance and data collection and integration; population and public health research; health policy, health care, and human services; and education for providers, people with epilepsy and their families, and the public. The report provided recommendations and research priorities for future work in the field of epilepsy that relate to increasing the power of data on epilepsy; prevention of epilepsy; improving health care for people with epilepsy; improving health professional education about epilepsy; improving quality of life for people with epilepsy; improving education about epilepsy for people with epilepsy and families; and raising public awareness about epilepsy. For this article, the authors selected one research priority from each of the major chapter themes in the IOM report: expanding and improving the quality of epidemiologic surveillance in epilepsy; developing improved interventions for people with epilepsy and depression; expanding early identification/screening for learning impairments in children with epilepsy; evaluating and promoting effective innovative teaching strategies; accelerating research on the identification of risk factors and interventions that increase employment and improve quality of life for people with epilepsy and their families; assessing the information needs of people with epilepsy and their families associated with epilepsy-related risks, specifically sudden unexpected death in epilepsy; and developing and conducting surveys to capture trends in knowledge, awareness, attitudes, and beliefs about epilepsy over time and in specific population subgroups. For each research priority selected, examples of research are provided that will advance the field of epilepsy and improve the lives of people with epilepsy. The IOM report has many other research priorities for researchers to consider developing to advance the field of epilepsy and better the lives of people with epilepsy.

Effects of a television drama about environmental exposure to toxic substances.

OBJECTIVE: This study assessed short-term outcomes of viewing an episode of a prime-time television drama in which a child developed cancer after environmental exposure to an illegal pesticide. The study explored the effects among viewers of feeling transported into a narrative world. METHODS: Respondents (n = 2,139) to a post-episode Internet panel survey were asked if they had seen the show and asked questions about their demographic information, their frequency of viewing the television show, the degree to which they had felt transported into a narrative world created by the drama, and their knowledge and beliefs about the health effects of environmental exposure. Conversations with key informants from federal agencies and advocacy groups were also held. RESULTS: Episode viewing and narrative transportation were positively associated with knowledge of toxic exposure effects, and transported viewers reported being more likely to report an unusually high number of cancer cases to authorities. The show also appeared to have prompted a clarification of federal pesticide-testing policy. CONCLUSIONS: Entertainment Education is a promising strategy for disseminating key points of information about environmental health.

The impact of a primetime cancer storyline: from individual knowledge and behavioral intentions to policy-level changes.

We assessed the educational impact of a primetime network TV storyline that addressed cancer patient navigators. An online survey was administered after the episode aired. Exposed respondents saw the episode (n = 336); unexposed respondents did not (n = 211). Exposed respondents were more likely to report they would recommend a patient navigator (61% vs. 48%, p = 0.01). Clips of the episode were shown to raise awareness of patient navigators in a Congressional Committee meeting before the Patient Navigator Act was signed into law (2005). Entertainment education can have a positive impact on cancer knowledge and can contribute to policy-level decisions.

Entertainment-education in a media-saturated environment: examining the impact of single and multiple exposures to breast cancer storylines on two popular medical dramas.

In the United States, entertainment-education (E-E) initiatives in primetime television that provide public health information are at risk for diminished impact due to the media-saturated environment in which they must compete. One strategy to overcome this limitation is to use multiple primetime TV shows to reinforce similar health messages in multiple storylines. The current study explores such an approach by evaluating the impact of two separate breast cancer genetics storylines featured on two different TV programs as the result of outreach to writers and producers. These storylines aired within approximately 3 weeks of each other on the popular medical dramas, ER (NBC) and Grey's Anatomy (ABC), and included information about the BRCA1 breast cancer gene mutation and the risks it poses to women who test positive for it. The evaluation used data collected from a panel sample of 599 female survey respondents at three points in time. Results show that while the individual storylines had a modest impact on viewers' knowledge, attitudes, and behaviors related to breast cancer, combined exposure seemed to be most effective at changing outcomes. Implications of our findings for future E-E interventions and evaluations are discussed.

Evaluating a Minor Storyline on ER About Teen Obesity, Hypertension, and 5 A Day.

This study evaluates the effects of an ER (NBC) storyline about teen obesity, hypertension, and 5 A Day on knowledge, attitudes, and behavior. The storyline depicted an African American teen who presented at the emergency room with burns from a workplace injury. Upon diagnosis, the teen was discovered to have hypertension and counseled to eat more fruits and vegetables and get more exercise. The evaluation was conducted using three separate datasets, one of which provided data on a sample of primetime viewers before and after the storyline aired. Results showed that the storyline affected self-reported behavior change and had modest impacts on knowledge, attitudes, and practices. Interestingly, these effects were stronger for men than for women, possibly due to men's lower knowledge levels at baseline. Issues including identification with characters and the value of even modest effects on large audiences and the implications of our findings for future evaluations of entertainment education (EE) and other health communication programs are discussed.

Does entertainment-education work with Latinos in the United States? Identification and the effects of a telenovela breast cancer storyline.

This article examines the proposition that a popular form of entertainment, the telenovela, can educate Spanish-speaking viewers in the United States if accurate health information is presented in a dramatic, narrative format. Health professionals consulted on a breast cancer storyline in a Spanish-language telenovela, Ladrón de Corazones, and the impact on viewers' knowledge and behavioral intentions were assessed using three methods. First, an analysis of call attempts to 1-800-4-CANCER demonstrated a significant increase in calls when a PSA featuring the number aired during the program. Second, a nationwide telephone survey indicated that viewers, especially those who identify with Spanish-language television characters, gained specific knowledge from viewing the story and that male viewers were significantly more likely to recommend that women have a mammogram. Third, these trends were confirmed and further explored using focus groups of Ladrón viewers. Implications for educating viewers using dramatic serials in the United States are discussed.

Association between exposure to an HIV story line in The Bold and the Beautiful and HIV-related stigma in Botswana.

HIV stigma militates against prevention and care efforts and is a significant problem in sub-Saharan Africa. During 2001-2003, after collaboration with CDC scientists from the Centers for Disease Control and Prevention, the television drama The Bold and the Beautiful aired an HIV-related story line. The story line involved a man who tested positive for HIV, was accepted by his HIV-negative fiancée, and with her, adopted an AIDS orphan in Africa. We wished to test the hypothesis that viewers of this story line would report significantly lower AIDS-related stigma than nonviewers. We surveyed a sample of residents of Botswana shortly after the story line aired there. We assessed the association between viewership of the soap opera and HIV stigma. Compared with nonviewers of the show, viewers indicated significantly lower levels of HIV stigma, when other related factors were controlled statistically. These results are suggestive that stigma was reduced after watching a television drama in which HIV infection was treated in a nonstigmatizing, humane manner.

Embedding health messages into entertainment television: effect on gay men's response to a syphilis outbreak.

The entertainment education (EE) approach seeks to impact audiences' health behavior by embedding messages in mass media productions, storylines, and characters that appeal strongly to them. Effect on behavioral intentions was examined following a storyline about syphilis in men who have sex with men (MSM) presented in a popular dramatic series. Five hundred and one MSM drawn from gay Internet chat rooms completed the questionnaire. Differences in item responses between those who did and did not view the syphilis storyline were calculated, and linear regression was used to examine predictors of intentions to take action. Those who viewed the syphilis storyline were more likely to report intention to get screened and to tell others to get screened for syphilis. Seeing the episode was a predictor of these intentions. Education was also a predictor of intention to tell others to get screened. Results suggest that exposure to a storyline about syphilis in gay men had a positive public health outcome on users of Internet chat rooms for MSM. Further studies are warranted to examine the extent to which and how the EE approach can produce health-relevant outcomes for U.S. populations, just as the approach has done in the developing world.