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Soap operas, prime-time series among vehicles
TB experts in Minnesota are betting that a good story line, like a sugar coating, will help the medicine go down. In Minneapolis, which has a burgeoning population of Somali refugees and immigrants, TB controllers are teaming up with a young Somali film-school graduate to make what may be the world’s first soap opera devoted entirely to TB.
"We kept hearing the Somali culture is very oral, and that people would pay attention to
a good story with a message," says Marge Higgins, LSW, the state TB and refugee program coordinator.
Plus, when Higgins was out visiting patients in the field, she’d occasionally glimpse the soaps that are popular on the Minneapolis Somali cable channel. "They were very dramatic — they really grabbed you," she recalls. When the Somali film school graduate told Higgins he’d be willing to work on a tight budget because he was trying to build his resume, things began falling into place.
First, they’ve got to listen
The idea of using entertainment to get across a message about health isn’t unusual. "We’ve been using the entertainment industry to reach people for 16 years," says Patrick Coleman, MA, deputy director of the Center for Communications Program at Johns Hopkins University in Baltimore. The center, funded mainly by the U.S. Agency for International Development, helps health ministries in developing countries get messages to the public. To do so, the center often resorts to media with strong narrative components — street theater, radio shows, TV, or comedy or drama, says Coleman. Offices in the Center produce hundreds of health campaigns every year. About 15 years ago, the center produced a pop song praising sexual abstinence that topped the pop charts in Latin America.
The reason for couching health messages in an entertainment format is simple, says Coleman: "Competition." Those who work in health care
or any other social issue arena, he explains, "are competing with the entertainment industry for people’s hearts and minds. The first thing you have to do is get peoples’ attention, and using entertainment helps give you that entrée."
Once the decision has been made to go with an entertainment-style format, the same principles that apply to other kinds of communication still hold true, experts say. "You start by talking to your audience," says Coleman. "You have to find out what they do or don’t know about a subject. You need to identify any cultural or religious issues. Then you have to get the right message out."
"Knowing your audience" isn’t necessarily an easy proposition, communications experts add. For instance, producing Spanish-language materials means more than simply translating an English text into Spanish and then substituting dark-haired, Latino types for blond-haired Anglos, says Patricia Wren, PhD, an assistant research scientist at the University of Michigan’s School of Public Health in Ann Arbor.
"It’s not that simple," Wren says. "Spanish isn’t even always Spanish — there are 15 different countries where different kinds of Spanish are spoken."
The team that has put together the story line and script for the Minneapolis soap-opera project includes experts in film, TB, and the Somali culture, says Higgins. From the start, it was clear that the soap opera would have to convey the following key messages:
• TB is curable.
• Infection is different from disease.
• Contacts need to be tested.
"We decided not to go into too much detail about directly observed therapy, since the prospect of a public health representative coming to your house or job might be too threatening," she adds. Instead, the message would be "that someone will help you take your medicine."
The soap opera opens with a revelation: A young man is deeply distressed at the news that he has TB. His roommate and good friend, who knows more about the disease, tries to explain that a TB diagnosis is not a death sentence. The patient’s physician — played by an American physician who actually treats many of the Somalis in Minneapolis — calls to provide more encouragement.
The young man’s fiancée, sensing something is wrong, also makes an appearance. Gradually, with support from his family, the young man comes to grips with the change in his life.
Coleman’s center is grappling with an equally compelling subject: the HIV risk associated with having multiple sex partners. In this case, the
format is decidedly more ambitious: Coleman’s center is producing a 26-part TV series on the subject. The series will air in prime time on South African TV later this year.
Again, the project began with lots of audience research, followed by decisions about what messages were to be conveyed. "We started with key concepts in HIV," says Coleman. "Then we looked at key situations and at how young people would react. We talked to support groups. We took all that information, and we gave it to a professional scriptwriter."
Despite the heavy message content, the series won’t talk down to its audience, Coleman adds. "Audiences are so much more sophisticated now," he notes. "We’ll make this as real-life as possible, and at the same time we’ll give people something to think about."
With offices in 32 countries, the Hopkins center works mostly abroad. Occasionally, it also does projects commissioned by American public-health agencies. Recent projects for U.S. public-health agencies include an AIDS prevention project in Baltimore, a teen pregnancy prevention project for the state of Maryland, and a project promoting breast-feeding for a WIC program.
The center also maintains a reference library of teaching materials (some entertaining, others straightforward teaching tools). There are eight TB videos listed, for example; 75 English-language printed pamphlets about TB; 93 pamphlets about TB in other languages; and a listing of 24 agencies that produce TB educational materials.
To visit the Johns Hopkins Center for Communication Program’s library on-line, go to www.jhuccp.org/mmc.