Day: June 25, 2014

It is over 14 years since we’ve had TV in our home except for an old set to watch movies. Yet I recognize that TV can do wonders in changing people’s attitudes and behavior.
Perhaps you remember reading about the effect of TV in Brazil. The family size is less than half of what it was 50 years ago. Although there are many factors that have brought about this rapid decrease, one of them was unintentional. TV telenovelas (what used to be called “soap operas” when I was a kid) are very popular in Brazil. They depict families dealing with the usual joys and problems that people handle all over the world. Can you imagine being the director and trying to supervise four kids on a TV set? As a consequence upper middle class TV families have only one or two kids, and this has become the Brazilian ideal.
Consciously or unconsciously, people follow the models that they see in the media. That is why advertising is so powerful. And that power can be put to good use.
Miguel Sabido pioneered using radio and TV to educate and change behavior. “What we know today as the Sabido methodology, or ‘Entertainment-Education,’ was not born miraculously one day”, he wrote. “It started as a childhood dream, conceived almost 50 years ago, when I understood that the housekeepers at my house in Mexico literally believed everything they saw in Mexican telenovelas (‘soap operas’).”
The first time Sabido actually tested using the media to educate and entertain was in 1977. He launched a primetime telenovela to educate viewers on family planning in Mexico. Acompañame (Accompany Me) focused on the issue of family harmony and educated viewers about family planning. During the time it was aired there was a 33% increase in attendance at family planning clinics as well as a significant increase in the sale of contraceptives. Acompañame was followed by other telenovelas with similar messages, all helping to lower the Mexican population growth rate.
Today the foremost organization to use the Sabido method of entertainment/education is the Population Media Center (PMC). The Center works in 18 countries, including the USA. They have branched out from just informing their audiences about family planning; now they promote empowerment of women, avoidance of HIV, and encourage education and reproductive health in general. They use “…serialized dramas on radio and television, in which characters evolve into role models for the audience for positive behavior change.”
An example is the Center’s program to combat abuse. One third of girls and women will suffer physical, mental or sexual abuse during their lifetimes. Usually the perpetrators are males who learn the pattern of abuse when they are young. This abuse can devastate women and be harmful to the men, too. Fortunately, PMC has a program geared to combat abuse worldwide. Designed for computer-savvy young teens, Breakaway is available in four languages.
“Sixteen and Pregnant” is a very popular series on MTV, showing pregnant teens who struggle with life after becoming pregnant. In the episode that is available free online, Aleah, 18, contends not only with the pregnancy but also diabetes and an irresponsible boyfriend. Now 5 years old, this program is a very popular reality show that has made its mark with adolescents. There are also follow-up shows, “Teen Mom”, that track some of the young mothers’ lives.
“Sixteen” and its spinoffs have had a major influence on teens in the USA. The teen birth rate has (fortunately!) hit all time lows—and part of that success is due to “16”. A careful analysis suggests that one third of the decrease can be attributed to “16”! The poor economy is another reason that adults and teens both are having fewer babies, and the availability of family planning for teens ahs decreased the number of unplanned pregnancies. Fewer births, fortunately, is not the result of increased abortions, all too common in TV commercials.
There were two ironies in the episode of “16” I watched. Most egregious was an advertisement—of which there were many. One ad, for a cherry-flavored cola, used sex to sell its product.
The sad fact is that Aleah lives in St. Louis, which has a wonderful, innovative family planning program. The Choice Project provides women of all ages with free contraception.
We can celebrate that the teen birth rate has plunged. The study of “16” ends with these words: “We find that media has the potential to be a powerful driver of social outcomes.”

© Richard Grossman MD, 2014