Measurement of social norms for entertainment-education.

BACKGROUND: 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. METHODS: 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: 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. CONCLUSIONS: This study provides a useful tool for practitioners and scholars to use globally to measure important social norms constructs in entertainment-education.

Period Poverty: an Epidemiologic and Biopsychosocial Analysis.

In the United States, approximately one in five persons experience period poverty, defined as the inability to obtain resources needed for healthy, safe, and dignified menstrual management. Limited access to an inadequate number of menstrual supplies may lead to longer-than-recommended use, which can increase skin chafing, disruption of vaginal flora, and intravaginal toxin overgrowth. However, period poverty goes beyond simply having enough menstrual products and can encompass the embarrassment, stigma, shame, and barriers in conversation surrounding menstruation. Discussion and critical examination of the multilayered attributes surrounding period poverty have been intermittent in academic literature, particularly from a domestic lens. Thus, this narrative review and theoretical analysis aimed to describe the epidemiology of period poverty and analyze its biological, socio-emotional, and societal implications. We applied a descriptive epidemiology approach of person, place, and time, and employed a social-ecological lens to examine risk factors. Our findings describe the incidence, distribution, and possible ways to alleviate period poverty. Practitioners, medical providers, and public health professionals may have limited knowledge of period poverty, what it entails, and who it impacts, but they have great potential to address it and associated menstrual inequities in their work. With its widespread implications for psychosocial and community-level health, this phenomenon needs urgent attention to promote menstrual equity as an issue of human rights and social justice. We conclude with research and policy recommendations for alleviating period poverty.

Qualitative findings from Girlsplained: a social media application of the Sabido methodology for sexual health and HIV prevention in the United Kingdom.

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.

Experiences of New Mothers During the Coronavirus Disease 2019 (COVID-19) Pandemic.

OBJECTIVE: To describe postpartum experiences of women who gave birth during the coronavirus disease 2019 (COVID-19) pandemic, to identify short-term and long-term opportunities to address maternal-child health during this pandemic. METHODS: This qualitative photo-elicitation study asked 30 women between 3 and 10 weeks postpartum to take photographs that encompassed their experience as a new mother during the pandemic. Two trained interviewers elicited elements of this experience using the photos as an anchor during virtual, hour-long interviews. Interview transcripts were analyzed using directed content analysis, including open coding to identify key ideas, codebook development, and codebook refinement. Half of transcripts were team coded to ensure coding accuracy. After coding, the study team organized codes to inform the development of an explanatory model. RESULTS: Interviews identified important stressors new mothers experienced that were worsened during the pandemic, namely fear, child care, older children, loss, isolation, and employment. Interviews also highlighted key support structures (self-care, interpersonal, and structural supports) that were at times helpful in alleviating stressors and at others were inadequate to counter stress and even enhanced stress. CONCLUSION: For postpartum individuals overall, the pandemic resulted in increased strain during an already stressful time. These findings demonstrate inadequacy of support systems for postpartum women and may highlight action items for stakeholders to improve postpartum care during the pandemic and in the future.

Entertainment-Education Campaigns and COVID-19: How Three Global Organizations Adapted the Health Communication Strategy for Pandemic Response and Takeaways for the Future.

COVID-19 created a substantial set of challenges for health communication practitioners in the process of planning, implementing, and evaluating entertainment-education (EE) campaigns. EE is a theory and evidence-based communication strategy that employs entertainment media for educational messaging. Here, we briefly review EE campaigns in response to previous health emergencies and present three cases of EE responses to the COVID-19 pandemic from leading global organizations (PCI Media, BBC Media Action, and Sesame Workshop). Responses ranged from adaptation and re-distribution of existing content to creating new content under social-distancing restrictions and utilizing transmedia. These cases demonstrate that EE initiatives responding to future pandemics may be well served by starting with existing infrastructure to quickly build capacity, support, and trust; working with partners to tailor programs to the local context; and continuing to focus on good storytelling while simultaneously considering evolving media formats and theory.

Results from a literature review of menstruation-related restrictions in the United States and Canada.

Initiation of menstruation is often associated with secrecy and silence, leading to menstruation-related restrictions enforced by various structural and social factors. Most of the research investigating menstruation-related restrictions has been conducted in low- and middle-income countries. It is unknown 1) which populations in the United States and Canada may face menstruation-related restrictions, and 2) what type of restrictions are practiced by these populations. A literature review found 21 articles published between 2000 and 2019 covering menstruation-related social and structural restrictions in the United States and Canada. In addition to more research, we encourage clinical providers to have culturally competent conversations with patients to understand potential menstruation-related restrictions.

Narrative Persuasion and Social Norms in Entertainment-Education: Results from a Radio Drama in Mozambique.

Narrative persuasion and social norms are part of the most recent theorizing behind the health communication strategy known as entertainment-education. There is little research, however, that compares these theoretical constructs from Mozambique, a setting that has not been researched to the same extent as other EE practice locations. This study uses mixed methods data from the midline evaluation of Ouro Negro (English translation: Black Gold), an EE radio program for individual health and social change in Mozambique to answer two research questions: what is the relationship between exposure to Ouro Negro and narrative persuasion?, and what is the relationship between narrative persuasion with Ouro Negro and social norms? Quantitative results related to the first question indicated that exposure significantly predicted three narrative persuasion constructs in multivariate regression models, results confirmed by a storytelling activity in focus groups. Quantitative results for the second question, which utilized propensity score matching, were not significant, and findings from a qualitative 2 × 2 table activity confirmed that behaviors were not normative in the directions promoted by the radio drama. Implications and recommendations for future entertainment-education research are discussed.

Unaccompanied Children at the United States Border, a Human Rights Crisis that can be Addressed with Policy Change.

In recent years, unaccompanied minors have been journeying to the United States (U.S.)-Mexico border in great numbers in order to escape violence, poverty and exploitation in their home countries. Yet, unaccompanied children attempting to cross the United States border face treatment at the hands of government representatives which violates their inherent rights as children. The result is a human rights crisis that has severe health consequences for the children. Their rights as children are clearly delineated in various, international human rights documents which merit increased understanding of and recognition by the U.S. government. This paper calls for the improvement of policies and procedures for addressing the rights of unaccompanied immigrant children; it provides specific, rights-based recommendations which work together to safeguard the rights of the child at the U.S. southwestern border.

Encoded Exposure and Social Norms in Entertainment-Education.

Entertainment-education is an effective health communication strategy that combines or embeds educational messages into entertainment programs to bring about social and behavior change. For years, scholars have considered how entertainment-education works. Some contemporary theories posit that entertainment-education does not engender behavior change directly but does so through mediating variables. This study adds to the literature on this topic by exploring the direct relationship between exposure and social norms instead of their relationship through behavior as a mediator. Novel to this study is the use of encoded exposure, a continuous and recognition-based measure of exposure that includes ever watching, recall, involvement, and dose in its operationalization. Using cross-sectional data from Kyunki … Jeena Issi Ka Naam Hai, an entertainment-education program in India, this exploratory analysis indicates a positive and significant relationship between encoded exposure and social norms. How can this finding be applied to future programs? Questions remain, and replication is needed, but if it is not essential to go through behavior in order to change social norms, then implications emerge for the theory and practice of entertainment-education.

Building a citywide, all-payer, hospital claims database to improve health care delivery in a low-income, urban community.

Developing data-driven local solutions to address rising health care costs requires valid and reliable local data. Traditionally, local public health agencies have relied on birth, death, and specific disease registry data to guide health care planning, but these data sets provide neither health information across the lifespan nor information on local health care utilization patterns and costs. Insurance claims data collected by local hospitals for administrative purposes can be used to create valuable population health data sets. The Camden Coalition of Healthcare Providers partnered with the 3 health systems providing emergency and inpatient care within Camden, New Jersey, to create a local population all-payer hospital claims data set. The combined claims data provide unique insights into the health status, health care utilization patterns, and hospital costs on the population level. The cross-systems data set allows for a better understanding of the impact of high utilizers on a community-level health care system. This article presents an introduction to the methods used to develop Camden's hospital claims data set, as well as results showing the population health insights obtained from this unique data set.