A Theoretical Agenda for
With the growing number of entertainment-education (E-E) interventions world-wide, and the extensive evaluation research on their impacts, the time is ripe toexplore in-depth the theoretical underpinnings of entertainment-education. Thisintroductory article provides a historical background to this special issue of
Communication Theory on entertainment-education, and charts a 5-prongedtheoretical agenda for future research on entertainment-education. Theoreticalinvestigations of entertainment-education should pay greater attention to thetremendous variability among entertainment-education interventions (Agenda#1) and to the various resistances to entertainment-education interventions(Agenda #2). E-E theorizing will also benefit from close investigations of therhetorical, play, and affective aspects of E-E (Agenda #3). Further, E-E “ef-fects” research should consider employing a broader understanding of indi-vidual, group, and social-level changes (Agenda #4) and be more receptive tomethodological pluralism and measurement ingenuity (Agenda #5).
Entertainment-education, defined as the intentional placement of edu-cational content in entertainment messages, has received increasing at-tention from communication scholars in recent decades, mainly in theform of evaluation research on the effects of these interventions. Enter-tainment-education is not a theory of communication, but rather a strat-egy used to disseminate ideas to bring about behavioral and social change.
When the first recognizable entertainment-education (E-E) interventionswere launched on radio with The Archers
(in 1951) and on televisionwith Simplemente María
(in 1969), communication scholars were notinvolved in their design or in the evaluation of their effects (Singhal,Obregón, & Rogers, 1994). However, theorizing about E-E was about to begin.
After the broadcast of Simplemente María
in Mexico, Miguel Sabido
carefully deconstructed this telenovela
in order to understand its theo-retical basis. He then produced a series of six E-E television programsfor Televisa, which were evaluated as to their impacts (Nariman, 1993;Singhal & Rogers, 1999). In designing his E-E telenovelas, Sabido drewespecially on Albert Bandura’s (1977, 1997) social learning theory (whichlater evolved into social cognitive theory). This theoretical approach has
Copyright 2002 International Communication Association
tended to dominate most theoretical writing and research about enter-tainment-education, and Sabido’s methodology for the design of E-Eprograms, especially soap operas, influenced most later work on enter-tainment-education by communication professionals around the world.
There exists a natural fit between Bandura’s theory and entertainment-education interventions, which often seek to influence audience behav-ior change by providing positive and negative role models to the audience.
This special issue of Communication Theory
seeks to broaden the
theoretical understanding of entertainment-education interventions byinviting consideration of not only social cognitive theory but also ofother communication theories that have, or may, contribute to improvedunderstanding and design of future E-E programs. The theories to con-sider include social learning/social cognitive theory, the elaboration like-lihood model, audience involvement, dramatic theories, socialconstructivism, uses and gratifications, agenda setting, knowledge-gap,cultivation, and the diffusion of innovations. Further, in identifying com-mon themes that characterize entertainment-education interventions andevaluations, we also propose a theoretical agenda for entertainment-education scholars.
Initially, two main sets of communication scholars were engaged in
the investigation of the entertainment-education strategy: (a) a set ofcommunication scholars, including D. Lawrence Kincaid, Phyllis Piotrow,Douglas Storey, Thomas Valente, and their colleagues at the JohnsHopkins University’s School of Hygiene and Public Health (now theBloomberg School of Public Health), the Center for CommunicationPrograms, who mainly conducted evaluation research on entertainment-education broadcasts to promote family planning in developing nations,and (b) the present guest editors Everett M. Rogers and Arvind Singhal,at the University of Southern California/University of New Mexico andat Ohio University, respectively. Rogers and Singhal and their colleaguesmainly conducted evaluation research on the effects of entertainment-education broadcasts that was carried out in collaboration with Popula-tion Communications International (PCI), a nonprofit organization head-quartered in New York with a central interest in E-E.
These two sets of scholars have remained in close contact, and in
cooperation with other colleagues—notably Patrick L. Coleman (of JohnsHopkins University’s Center for Communication Programs), Vibert Cam-bridge (of Ohio University), and Martine Bouman (of the NetherlandsEntertainment-Education Foundation)—organized a series of three in-ternational conferences on entertainment-education, held at the Univer-sity of Southern California in 1989, at Ohio University in 1997, and atArnhem in the Netherlands in 2000. Today, a broad set of communica-tion scholars actively work to advance the theoretical foundations of E-E.
The scholars of the present era are exploring deeper understandings ofthe theoretical bases of entertainment-education and working in a moreeclectic manner than at previous times.
The Rising Tide of Entertainment
Where does E-E fit in the rising tide of entertainment worldwide? Enter-
tainment is making increasing inroads into people’s personal lives (Post-
man, 1985). Not only does the public consume more entertainment, it is
becoming a more integral part of people’s shopping, traveling, eating,
driving, exercising, and working experiences. The Mall of America, a
megamall in the Minneapolis area, attracts 40 million shoppers a year,
more visitors than Disney World, Disneyland, and the Grand Canyon
combined (Wolf, 1999). The Mall of America boasts an entertainment
complex, a walk-through aquarium, and a seven-acre amusement park,
all under one roof. Las Vegas in the U.S., Sun City in South Africa,
Genting in Malaysia, and Crown Resorts in Australia are all centered
around entertainment. These one-industry complexes offer gambling,
shows, golf, tennis, sightseeing, and other attractions. Thematically ori-
ented dining experiences such as Planet Hollywood, Hard Rock Cafe,
and House of Blues attract large numbers of customers. A ride on Virgin
Atlantic Airlines is more like a party in the air. Wolf (1999) labels this
rising tide of entertainment in our personal lives and in economy sectors
such as retail, travel, and food services, as the “entertainmentization” of
the world. Entertainment products and services—movies, television pro-
grams, videos, pop music, spectator sports, theme parks, radio, casinos,
magazines, newspapers, books, and toys—represent the fastest growing
sector of the world economy. In the United States, without counting the
sales of consumer electronics (VCRs, DVD players, television sets, etc.),
which are tools of entertainment consumption, entertainment represented
a $480 billion industry in 1999 (Wolf, 1999). Never before in history
has so much entertainment been so readily accessible to so many people
for so much of their leisure time (Zillman & Vorderer, 2000).
Despite the ubiquity and growing importance of entertainment in so-
ciety, which usually involves some type of human communication, com-munication scholars have largely neglected to give the entertainmentfunction much attention (Katz & Foulkes, 1962; Sutton-Smith, 1988).1Some 40 years ago, Katz and Foulkes (1962, p. 378) wrote: “It is a mostintriguing fact that in the intellectual history of social research that thechoice was made to study the mass media as agents of persuasion ratherthan agents of entertainment.” E-E interventions, by providing an op-portunity to study mass media as agents of both entertainment and persua-sion, represent an important and unique area of communication scholarship.
Why have many communication scholars been reluctant to investi-
gate the entertainment function of communication? Many perceive en-tertainment as frivolous in content and unimportant in its effects, mainlyamounting to taking up large amounts of the daily time of individuals,but not representing an important force for human behavior change.
This perception does not apply, however, to entertainment-education,which has generally been found to be an important agent of social change(Singhal & Rogers, 1999).
The global popularity of various entertainment media and genre, at-
tracted the attention of communication scholars and practitioners inrecent years, and contributed to the rise of E-E. By adding the lustre ofentertainment to the relatively “duller” fields of health promotion, edu-cation, and development, E-E fits well with the contemporary globaltrend to entertainmentization. In this respect, “E-E is the Viagra of healthcommunication” (Piotrow quoted in NEEF and JHU/CCP, 2001, p. 2).
Theoretic Agenda for Entertainment-Education
Previous E-E research has mainly been conducted in developing coun-
tries and dealt with health topics. The dominant theoretical basis has
been Bandura’s social learning or social cognitive theory. Consistent with
the thrust of the six articles in this special issue, we propose a five-pronged
theoretical agenda for the field of entertainment-education.
Agenda #1: Theoretical investigations of entertainment-education should pay greaterattention to the tremendous variability among E-E interventions.
Agenda #2: Theoretical investigations of E-E should pay more attention to the variousresistances to E-E interventions.
Agenda #3: E-E theorizing will benefit from close investigations of the rhetorical, play,and affective aspects of E-E.
Agenda #4: E-E “effects” research should consider employing a broader understandingof individual, group, and social-level changes.
Agenda #5: E-E “effects” research should be more receptive to methodological plural-ism and measurement ingenuity.
Agenda #1: Attention to Variability in
Theoretical investigations of E-E need to move past scholarly research,
effects E-E programs have, to better understand how
entertainment-education has these effects. In seeking answers, entertain-
ment-education scholars should pay greater attention to the various typesof entertainment-education interventions, including differences in theirscope, size, reach, intensity, and other attributes. Whereas E-E interven-tions come in all shapes and sizes, current theoretical debates do notacknowledge the substantial variability among E-E interventions, whichundoubtedly influence the answers to the what, how, and why questionsof E-E effects. With a few exceptions, almost all past E-E research hasconcerned radio or television soap opera broadcasts. E-E is not limitedto a soap opera format, or even to broadcasting.
Although some E-E interventions are national campaigns, some are
designed for a very specific, local audience, and some go beyond a “na-tional” space to include a much broader “cultural” space. For example,the Soul City
E-E campaign reaches almost 80% of its target audience inSouth Africa (Soul City Institute, 2001). In contrast, E-E street theaterinterventions in India and in Bolivia reached only a few hundred peopleper performance (Valente & Bharath, 1999; Valente, Poppe, Alva, deBriceno, & Cases, 1995). Other E-E campaigns, such as the UNICEF-sponsored Meena
animation films, and Street KidsInternational’s Karate Kids
animated film were targeted to a “cultural”space comprising several countries (Singhal & Svenkerud, 1994). Meena
was designed for use in various countries of South Asia, and Sara
wasdesigned for use in various countries of sub-Saharan Africa. Karate Kids
has been shown to combat the prostitution of street children in dozensof nations (Sthapitanonda-Sarabol & Singhal, 1998, 1999).
E-E programs vary widely in terms of the extent to which they use (a)
formative research, and (b) human communication theories in their mes-sage design. For instance, E-E interventions like Soul City
in South Af-rica spend 18 months conducting extensive formative research to de-velop one annual campaign cycle.2 Detailed message design and plan-ning processes are carried out, including pretesting of messages andmaterials. Also, E-E soap operas, especially those patterned after MiguelSabido’s methodology (for example, Hum Log
in 1984–1985 in India),purposely incorporated principles of Bandura’s social learning theory inthe design of positive, negative, and transitional role models (Nariman,1993; Singhal & Rogers, 1999). On the other hand, several E-E inter-ventions incorporate little formative research or theoretical input andare based primarily on the intuition and creativity of the production staff.
E-E interventions also vary widely in terms of their intensity and their
ability to deliver effects. E-E messages may be incorporated as a fewlines of dialogue in an existing media program (as the designated driverconcept was promoted in the Harvard alcohol project), or they maycompose an entire episode of a popular prime-time television series (suchas the discussion of Walter’s vasectomy in the CBS sitcom Maude
long-running E-E series, The Archers,
has broadcast over 8,000 episodeson the BBC since its launch in 1951. The answers to the what, how, andwhy effects questions vary considerably depending on whether the audi-ence experiences a one-time, live street theater performance or an ongo-ing, long-running, mediated E-E soap opera. Theoretical investigationsof E-E might be guided by such research questions as: How do the im-pacts of localized, interactive, and single-shot messages differ from theimpacts of repeated, long-running, and mediated E-E messages? Whatinfluence do long-running E-E soap operas have when they deal with acommon educational theme (for example, HIV/AIDS prevention) of es-sentially repeated messages, and does a presentation of various charac-ters in diverse settings hold audience attention? How do ongoing TVand radio serials, with the accompanying twists and turns in the char-acters’ lives, stimulate talk, elaboration, and reflection amongaudience members?
Also, how are the answers to the what, how, and why E-E effects
questions altered (or bolstered) when an E-E intervention (a) is devel-oped locally (as opposed to being implemented with technical assistancefrom an international aid agency); (b) is targeted nationally; (c) incorpo-rates extensive formative research and theoretical vigor; (d) is orches-trated as an ongoing, multimedia E-E campaign; (e) establishes and nur-tures “win-win” partnerships among various stakeholders (such as do-nors, government agencies, media organizations, development infrastruc-ture, creative personnel, and communication researchers); (f) aims toinfluence individual attitudes, boost self-efficacy and collective efficacy,change social norms, and put issues on the public agenda; (g) includes amedia advocacy component; (h) promotes a policy and legislative agenda;and (i) commands a “branded” image? The Soul City
E-E interventionin South Africa, which one may argue incorporates all the above-men-tioned attributes, differs markedly from most other entertainment-edu-cation interventions that have been investigated by communication schol-ars in the past. Thus, by gaining a theoretic understanding of the what,how, and why of E-E effects, careful attention should be paid to theattributes of a given E-E intervention, because, as noted previously, E-Einterventions take varied forms.
E-E interventions also operate in very different contexts, which un-
doubtedly impacts what effects they might have, and how and why. The
John Sherry article in this special issue, which investigates the challenges
and resistances facing E-E initiatives in media-saturated societies (such
as the United States), directly speaks to this issue of context.Agenda #2: Attention to Resistances to E-E
Current theoretical debates do not acknowledge the substantial resis-
tance to entertainment-education. These resistances should be theoreti-
cally investigated at the level of (a) message production, (b) messageenvironment, and (c) message reception.
Resistance to E-E Production.
On the message production side, there
is tremendous resistance to initiating E-E interventions. Commercialbroadcasters, for instance, are highly fearful of and resistant to charting“unknown” territories. Comfortable with time-tested media formulae,which consistently generate audience ratings, and hence profit, they fearthat advertisers and audiences will be turned off if their program is per-ceived as playing a “big brother” role. The fear of generating contro-versy, and thus losing audience, is anathema. Such resistance operatesmore commonly in media-saturated commercial broadcasting environ-ments such as the United States, where audiences are relatively frag-mented (see the Sherry article in this special issue).
Such resistance is so deeply institutionalized that despite the commer-
cial success in the United States of such E-E type programs as Roots
andAll in the Family,
the logjam to embrace E-E continues. The ABC mini-series, Roots,
and its sequel, Roots: The Next Generation,
focused onAfrican American people’s struggle for freedom from slavery. Broadcastas eight 90-minute episodes in 1977, Roots
was viewed by 130 millionAmericans, becoming a “nightly superbowl” for U.S. audiences. Sevenof the eight episodes of Roots
ranked among the top 10 in all-time tele-vision ratings at the time, achieving an audience share between 62 to71% (Hur & Robinson, 1978). Over 50% of its viewers hailed Roots
as “one of the best” television programs they had ever watched. Thelesson from Roots
was that quality television programs dealing with asocial cause could achieve very high audience ratings (Wander, 1997).
Commercial broadcasters in the United States, however, have failed tocapitalize on this lesson to produce similar E-E interventions.
Norman Lear’s All in the Family
was the top-rated sitcom in the United
States during the 1970s and was viewed, during its peak popularity, by arecord-breaking 50 million Americans (Vidmar & Rokeach, 1974). Thecentral character of this highly popular CBS sitcom was Archie Bunker,a highly prejudiced, working class American who employed racial slurs(Vidmar & Rokeach, 1974). Lear’s intention was to use humor to raisethe consciousness of viewers about ethnic prejudice, an intention thatwas realized only partially (as we discuss later in this section). However,All in the Family
is notable in that, despite its roaring commercial suc-cess, it faced tremendous institutional resistance from its eventual stake-holders. Three years, two networks, endless changes of cast, and numer-ous conflicts with network advertisers were required to get this televi-sion program on the air.
Theoretical investigations might consider what makes commercial pro-
ducers resistant to creating (or even experimenting with) entertainment-
education interventions? Why are “doing well” (commercially) and “do-ing good” (socially) perceived as being at odds with each other? Cansuch fears on the part of entertainment producers be allayed and per-ceived risks minimized? Have E-E advocates and scholars “positioned”E-E in ways so as to reinforce such institutional resistance? For instance,the thrust of E-E enthusiasts has been on projecting how the entertain-ment function enhances the education function. Would E-E scholarshipbenefit from asking the question in reverse? Does the educational func-tion, if creatively incorporated, enhance the entertainment function? IfHollywood finds that it can enhance entertainment value through cre-ative incorporation of educational content, will it embrace E-E?
Thus far, theoretical investigations of E-E have focused largely on
measuring audience effects, that is, attending to the audience receptionside, not the message production side. Theoretical investigations of E-Eproduction processes are needed, including how projects are formulated,negotiated, funded, partnered, researched, produced, packaged, posi-tioned, advertised, distributed, and broadcast. How are conflicts betweenpartnering agencies negotiated and mediated, and how can the interestsof donors, media gatekeepers, campaign coordinators, creative profes-sionals, audience members, and researchers be harmonized? These is-sues are key to understanding institutional resistance to initiating andproducing an E-E intervention, given that E-E interventions require moretime, resources, expertise, and collaborative arrangements. MartineBouman’s article in this special issue on “peacocks” (television profes-sionals) versus “turtles” (health communication experts) is a theoreticalinvestigation of the E-E collaboration process between health commu-nication experts and creative people, including both the difficultiesand possibilities.
Resistance in the Message Environment.
of E-E should acknowledge that entertainment-education is only one ofmany competing, and conflicting, discourses that exist in a given mes-sage environment. In highly saturated media environments like the UnitedStates, and to a somewhat lesser degree in developing countries, enter-tainment-education messages face competition from, and are resistedby, various other media discourses, which are often of the “entertain-ment-degradation” or “entertainment-perversion” type. Examples in theUnited States include television programs such as the Jerry Springer Show,
and reality television series such as Survivor, Temptation Island,
which valorize lewdness, sexual irresponsibility, greed, and otherantisocial messages. Johns Hopkins University’s Population Communi-cation Services’ (JHU/PCS) entertainment-education campaign in Mexicoin the mid-1980s also pointed to an example of resistance in the mes-sage environment of E-E discourse. While the JHU/PCS number-one hit
rock song, Cuando Estemos Juntos,
was promoting sexual abstinence toteenagers in Mexico, the second most popular song in Mexico was NoControl,
which promoted exactly the opposite message. A subtler, yetpotent form of resistance to E-E discourses comes from a sea of mediamessages in which, for instance, aggression is exemplified and portrayedas a preferred solution, socially sanctioned by super heroes who triumphover evil by violent means. Such portrayals legitimize, glamorize, andtrivialize human violence (Bandura, 2001, p. 277), complicating the taskof E-E interventions.
Resistance in E-E Reception.
Resistance also operates at the message
reception end as audience members selectively expose themselves to E-Emessages, selectively perceive them, selectively recall them, and selec-tively use them for purposes they value. One example of such audience-centered resistance is the Archie Bunker effect,
defined as the degree towhich certain audience members identify with negative role models inE-E interventions (Singhal & Rogers, 1999). In investigating NormanLear’s popular situation comedy, All in the Family,
Vidmar and Rokeach(1974) noted that Archie Bunker, the central “bigoted” character, rein-forced rather than reduced racial and ethnic prejudice among certainhighly prejudiced viewers. Highly prejudiced persons, as compared tolow-prejudiced viewers, were more likely to watch the television pro-gram and perceive Archie as a “lovable, down-to-earth, honest, and pre-dictable” person. They were more likely to condone his use of racialslurs than were low-prejudiced viewers (Vidmar & Rokeach, 1974). AnArchie Bunker-type effect has been observed in many entertainment-education programs, although it often is characteristic of a relativelysmall percentage of the audience. For instance, some female viewers ofthe Indian television soap opera, Hum Log,
identified Bhagwanti, a nega-tive role model for gender equality, as the character most worthy ofemulation. Some Jamaican male listeners admired the sexual exploits of“Scattershot,” the promiscuous skirt-chaser in the popular radio seriesNaseberry Street,
who impregnated many naïve young women.
In summary, entertainment-education interventions face a variety of
challenges and resistances from the start of the message production pro-
cess, to the message environment, and even during message reception.
Theoretically based research on entertainment-education should pay
greater attention to these various resistances, and identify ways to
overcome them.Agenda #3: Attention to the Rhetorical,
Play, and Affective Aspects of E-E
Theoretical investigations of E-E, to date, have largely provided cogni-
tive and rational explanations of effects, utilizing the hierarchy-of-ef-
fects, stages-of-change, and other models. Future investigations of E-E
should focus more on the rhetorical, play, and affective aspects of E-E,which emphasize the entertainment, rather than the education.
E-E almost necessarily involves the use of narrative, suggesting the
possibility of utilizing Walter Fisher’s (1987) narrative theory to investi-gate the rhetorical nature of E-E discourse. Fisher argued that humansare essentially storytellers, i.e., homo narrans,
and employ a narrativelogic in processing discourse and arguments. E-E soap operas, whetheron television, radio, or another channel, represent highly complex nar-ratives with various protagonists and antagonists, plots and subplots,and conflicts and resolutions. Theoretical investigations employing nar-rative theory might study why certain narratives are perceived by audi-ence members as being more coherent, believable, and involving thanare others. How is a narrative’s rhetorical influence mediated by the E-Eintervention’s medium, genre, broadcast frequency, length, and otherattributes? Green and Brock (2000) conducted experimental researchindicating the ability of narratives to “transport” an audience individualfrom his or her real-life situation into a hypothetical situation. In thisspecial issue, Slater and Rouner propose a cognitive approach to under-standing the narrative structure of E-E messages. We urge E-E scholarsalso to employ rhetorical approaches to understanding narratives (suchas Walter Fisher’s narrative theory), in order to gain an enhanced under-standing of the persuasive power of narratives.
E-E programs necessarily deal with the pleasurable aspects of com-
munication. Huizinga’s (1950) work on homo ludens
and Stephenson’s(1988) play theory of mass communication, both of which focus onhow communication serves the cause of self-enhancement and personalpleasure, are relevant to investigating E-E discourse. One may investi-gate questions such as: What pleasure do E-E viewers derive from con-flict-laden and suspenseful drama? Does repeated, prolonged empathicdistress from seeing a favorite character in imminent danger enhance theenjoyment of drama and the resolution of the threat (Zillman & Vorderer,2000, p. ix)? Here Zillman’s concept of “excitation transfer,” whichexplains why viewers appreciate suspense and undergo long periods ofsuffering to gain a short moment of pleasure, may be especially relevant(Zillman, 1995).
E-E programs necessarily deal with the affective and emotional as-
pects of human communication (Papa et al., 2000; Rogers et al., 1999).
Theoretical investigations of E-E should take the role of emotions moreseriously. To a large extent, communication scholars have dismissed emo-tions as unimportant, internal, irrational, uncontrollable, amoral, andahistorical (Planalp, 1999). Of the studies that exist, emotions have beenmainly investigated in interpersonal contexts (Anderson & Guerrero,1998), and to a limited extent in organizational contexts (Fineman, 1993),
but not systematically in mass-mediated contexts. E-E investigationsshould especially focus on the communication of affect, feelings, andemotions from media characters to audience members. For instance, whydo audience members laugh when characters laugh? Why do they cry? Howare audience members “infected” by the feelings of characters?
The role of emotions as a valid form of human experience, which may
trigger, for instance, the practice of preventive health behaviors, is oftenunderestimated, understated, and overlooked. For instance, witnessingthe death from AIDS of a favorite soap opera character, and seeing thegrief of his parents, infected widow, and child, may serve as a morepowerful trigger to adopting a prevention behavior than a rationallystructured media message promoting condom use (Airhihenbuwa, 1999;Singhal, 2001a). This matter is directly addressed in Suruchi Sood’s ar-ticle in this issue, on audience involvement through affective parasocialinteraction with characters of an E-E radio soap opera in India.
In summary, E-E theorizing would benefit greatly by investigating the
rhetorical, play, and affective aspects of E-E. Larry Kincaid’s paper about
drama theory in this special issue is a step in the right direction.Agenda #4: Rethinking the Old
Conceptualization of Behavior Change
A few years ago, we defined entertainment-education as “the process of
purposely designing and implementing a media message to both enter-
tain and educate, in order to increase knowledge about an issue, create
favorable attitudes, and change overt behavior” (Singhal & Rogers, 1999,
p. 229). Today, we consider this definition of E-E as limited, in that it
implies that individual-level
behavior change is the main purpose of this
Although many past applications of E-E sought to increase individuals’
knowledge, change their attitudes, and alter their overt behavior, anoverwhelming focus on individual-level behavior change runs the risk ofmistakenly assuming that all individuals (a) are capable of controllingtheir environment, (b) are on an even playing field, and (c) make decisionsof their own free will. Such is seldom the case. For instance, whether ornot a commercial female sex worker can protect herself from HIV isoften a function of whether or not her male client agrees to use a condom.
She is often voiceless, powerless, and vulnerable in such encounters(Singhal & Rogers, in press).
Theoretical investigations of entertainment-education should thus go
beyond the exclusive use of individual-level theories and models of pre-ventive health behaviors such as stages-of-change, hierarchy-of-effectsmodel, and social cognitive theory to more multilevel, cultural, and con-textual theoretical explanations (McKinlay & Marceau, 1999). Meta-phorically speaking, entertainment-education scholars should go beyond
investigating the bobbing of individual corks on surface waters and fo-cus on the stronger undercurrents that determine where cork clustersare deposited along a shoreline (McMichael, 1995).
Some recent E-E investigations have gone beyond studying individual-
level behavioral changes to investigate E-E instigated changes at the com-munity level (Papa et al., 2000). In a community-level investigation inIndia, a popular E-E radio soap opera, accompanied by group listening,local self-help groups, and progressive opinion leaders, brought aboutchanges in group, community, and organizational norms. Interacting withthe ground-based context, the year-long E-E radio soap opera led toenhanced levels of collective efficacy,
defined as the degree to whichpeople in a system believe they can organize and execute courses of ac-tion required to achieve collective goals (Bandura, 1997). The villagers,through a process of extensive deliberations, organized to change thesystem norm on dowry. Since the giving and receiving of dowry pay-ments involves a relationship between families, individual change alonecould not alter the practice (Papa et al., 2000). Deeply ingrained culturalnorms can often be altered only by concerted action from the collective.
E-E interventions can also model individual self-efficacy,
an individual’s perception of his or her capability to deal effectively witha situation, and one’s sense of perceived control over a situation. In thepopular E-E television series Soul City
in South Africa, a new collectivebehavior was modeled to portray how neighbors might intervene in adomestic violence situation. The prevailing cultural norm in South Af-rica is for neighbors, even if they wished to help the victim, not to inter-vene while the domestic abuse is being carried out. Wife (or partner)abuse is seen as a “private” matter carried out in a “private” space, withcurtains drawn and behind a front door that is closed. In the Soul City
series, the neighbors collectively decided to break the ongoing cycle ofspousal abuse in a neighborhood home. While a wife-beating episodeoccurred, they gathered around the abuser’s residence and collectivelybanged their pots and pans, censuring the abuser’s actions. This enter-tainment-education episode highlighted the importance of creativelymodeling collective efficacy to energize neighbors, who, for cultural rea-sons, felt previously inefficacious. Evaluation research found that expo-sure to the Soul City
E-E intervention was associated with the willing-ness to stand outside the home of an abuser and bang pots (Soul CityInstitute, 2000). After this episode was broadcast, pot banging to stoppartner abuse was reported in several locations in South Africa (Singhal& Rogers, in press). Patrons of a local pub in Thembisa Township ex-hibited a variation of this practice—they collectively banged bottlesupon witnessing a man physically abusing his girlfriend (Soul CityInstitute, 2000).
Theoretical investigations of E-E interventions can additionally ben-
efit from adopting a more nuanced understanding of various types of
desired behavior changes: (a) individual versus collective, (b) one-time
(e.g., getting an immunization) versus recurring (e.g., physical exercise),
(c) self-controlled (e.g., fastening an automobile seat belt) versus other-
dependent (e.g., paying and receiving dowry), (d) private (e.g., using a
condom) versus public (e.g., cleaning up an unsanitary neighborhood),
(e) preventive (e.g., using sunscreen) versus curative (e.g., administering
oral rehydration therapy to a baby with diarrhea), (f) costly (e.g., adopt-
ing a tractor) versus low cost (e.g., breast-feeding), and (g) high involve-
ment (e.g., enrolling in an adult literacy class) versus low involvement
(e.g., buying Girl Scout cookies). The theoretical question to pose is: Are
different types of E-E interventions more effective in achieving different
types of desired behavior changes? In summary, E-E “effects” research
would benefit from a broader understanding of individual, group, and
social-level changes.Agenda Item #5: Employing Methodological
Pluralism and Measurement Ingenuity
The history of research on entertainment-education shows that theories
can be tested and enhanced in the real world. When social learning theory
was initiated, Albert Bandura tested his theory in laboratory settings,
such as in the famous Bobo doll experiment on media violence and
children’s aggressive behavior (Bandura, Ross, & Ross, 1961). The Mexi-
can writer-producer-director Miguel Sabido took Bandura’s theory out
of the laboratory and into the real world, designing E-E soap operas
portraying socially desirable and undesirable models of behavior. Now
Bandura’s cognitive learning/self-efficacy theory is being applied in a
wide range of field settings, including in the form of interactive video
games by ClickHealth, a Silicon Valley high-tech company with which
Bandura and his colleagues are associated. For example, one ClickHealth
game is designed to teach children how to more efficaciously live with
diabetes. A randomized, controlled clinical trial found that this game
led to a 77% decrease in emergency room visits over a 6-month period
(Lieberman, 2001). Thus, from the perspective of theoretical usefulness,
E-E interventions are something like a piece of toast buttered on both
sides; they not only incorporate theory in their design, but also provide
an opportunity to test and advance a given theory.
Most past research on entertainment-education effects relied mainly
on audience surveys (sometimes coupled with content analyses of E-Emessages and with analyses of audience letters). Sypher, McKinley,Ventsam, and Valdeavellano’s article in this special issue points to theadvantages of employing methodological pluralism in complementingsurvey techniques with ethnographic methods, including the use of fo-
cus group interviews, participant observation, in-depth interviews, let-ters from audience members, and input from trained peer promoters.
The article by Michael Slater and Donna Rouner in this issue calls forgreater use of laboratory experiments on entertainment-education mes-sages in order to better understand the theoretical mechanisms throughwhich E-E affects individuals’ behavior. The article by D. LawrenceKincaid in this issue proposes a novel method for testing theories ofdrama, employing the techniques of image mapping and multidimen-sional scaling. Suruchi Sood explores the theoretic construct of audienceinvolvement in her article in this special issue, analyzing audience letterswritten to an entertainment-education radio soap opera in India.
Audience letters represent a rather “pure” form of audience feedback,
and E-E scholars should consider tapping the research potential of thesemessages more fully. These letters are usually unsolicited, unprompted(and, hence, free of researcher bias), in the writer’s own language, andrich in insights about how the E-E intervention affects the audience (Law& Singhal, 1999). Such data also costs very little to gather. Over 400,000letters from viewers were received by Dordarshan, the government tele-vision network in India, in response to an E-E soap opera Hum Log
(“We People”), providing rich insights about the program’s effects onhighly involved audiences.
Telephone hotlines also represent a useful programmatic and research
resource in E-E interventions. A popular song, “I Still Believe,” performedby Lea Salonga in the Philippines, was used to encourage telephone callsfrom adolescents to “Dial-a-Friend,” where they could receive informa-tion and advice about contraception and other sexually related topics.
Trained professional counselors maintained four hotlines, which aver-aged over 1,000 calls per week (Rimon, 1989). Telephone helplines forabused women also supplemented the Soul City
prime-time televisionseries on domestic violence. Some 180,000 calls were answered in 5months (when the Soul City
series on domestic violence was broadcastin late 1999), and monitoring of call data suggested that in places likeJohannesburg, only 5% of the calls could be answered during peak times;the remaining 95% got a busy signal (Soul City Institute, 2000).
E-E researchers increasingly realize the importance of having more
robust measures to assess audience members “degree of exposure” tothe E-E intervention and to gauge the degree to which E-E interventionsspur interpersonal communication between audience and nonaudiencemembers (which represents a measure of the “indirect” effects of an E-Eintervention in a version of the “two-step flow” process). A reliablemeasure of the audience members’ degree of exposure to an E-E inter-vention is essential, given its centrality as an independent variable topredict audience effects (Hornik, Gandy, Wray, & Stryker, 2000). In
audience surveys, respondents are usually asked the extent to which theyhave been exposed to the E-E intervention (whether a soap opera, or aminiseries, or some other genre), and data are recorded in terms of thenumber of episodes heard or seen, or perhaps on an ordinal scale of low,medium, or high exposure. Such self-reports to a general exposure ques-tion may be unreliable. Past research shows that E-E interventions tendto spur a great deal of interpersonal communication among audiencemembers and also among audience members and their spouses, chil-dren, relatives, and friends, who may not be directly exposed to the E-Eintervention. However, this important indirect effect of E-E interven-tions has not been adequately captured in past E-E research studies(Rogers et al., 1999).
In order to have more robust measures of degree of exposure and to
more adequately gauge indirect effects of E-E interventions, we recom-mend that during the production of E-E messages, multiple markers
should be proactively incorporated. Markers are distinctive elements ofa message that are identifiable. The simplest way of introducing a markerin an E-E intervention is to rename an existing product so that it be-comes identifiable with only that product. For instance, in the popularSt. Lucian family-planning radio soap opera Apwe Plezi
(After the Plea-sure), a new condom brand called Catapult was introduced. This newterm was identified by 28% of the radio program’s listeners, validatingtheir claim of direct exposure to the program, and by 13% of thenonlisteners, suggesting that the message was diffused via interpersonalchannels, and thus providing a test of diffusion of innovations theory(Vaughan, Regis, & St. Catherine, 2000).
Alternatively, a marker might consist of creatively naming characters
in E-E programs, like the skirt-chasing character Scattershot in NaseberyStreet,
a radio soap opera about sexually responsible fatherhood in Ja-maica (Singhal & Rogers, 1999). Scattershot became a common term inJamaican discourse, as in “Oh, you Scattershot you,” providing an op-portunity to trace the direct and indirect effects of listening to the radio program.
The most powerful markers model new culturally appropriate reali-
ties to break oppressive power structures in society, exemplified by thecollective pot banging by neighbors in the South African entertainment-education series Soul City,
so as to stop wife or partner abuse (Singhal& Rogers, in press). Markers, which model new realities, not only en-hance the message content of the E-E intervention, but also provide ad-ditional validation for whether or not audience members were directlyor indirectly exposed to the E-E intervention. In summary, theoreticalinvestigations of E-E “effects” would benefit by employing methodologi-cal pluralism and measurement ingenuity.
Summary and Conclusions
This article provides a historical background to this special issue of Com-
on entertainment-education and proposes a five-
pronged theoretical agenda for the field of entertainment-education.
Theoretical investigations of entertainment-education should pay greater
attention to the tremendous variability among entertainment-education
interventions (Agenda #1) and to the various resistances to entertain-
ment-education interventions (Agenda #2). E-E theorizing will also ben-
efit from close investigations of the rhetorical, play, and affective aspects
of E-E (Agenda #3). Further, E-E “effects” research should consider em-
ploying a broader understanding of individual, group, and social-level
changes (Agenda #4) and be more receptive to methodological plural-
ism and measurement ingenuity (Agenda #5).
What else does the future hold for theory and practice in entertain-
ment-education? In September 2000, when the 115 participants, includ-ing practitioners and scholars from 28 countries, met at the Third Inter-national Entertainment-Education Conference for Social Change in theNetherlands, they made the following commitment to advancing enter-tainment-education theory and practice: “Theory and practice are basedon inclusiveness, diversity, and a variety of genres, multi-disciplinarytheories, methods, formats, and channels. Theory and practice shouldincorporate intuitive and scientific, modern and traditional approaches,including folk media, community broadcasting, and emerging technolo-gies” (NEEF and JHU/CCP, 2001, p. 58).
In the future, E-E will more closely integrate “modern” and “tradi-
tional” entertainment outlets, and “big” and “little” media technolo-gies. The field of entertainment-education will go beyond its mass medi-ated (television, radio, film, video, and print) discourses to include crafts,art, textiles, murals, toys, and other creative expressions. For instance,in South Africa, “positive pottery” (made by HIV-positive people) in-cludes colorful AIDS ribbons etched with traditional African motifs. Simi-larly in East Africa, khangas
, the traditional fabric wrap worn by womenhas begun increasingly to carry health and development messages.
Also, the rise of the Internet opened new possibilities with respect to
conveying E-E interventions. For instance, a soap opera on the Internetis being used to target and encourage mammography screening in His-panic women (Jibaja et al., 2000). Such Web-based delivery of an E-Eintervention allows for tailoring,
defined as the individualization of acommunication message to audience members. Jibaja and others (2000)determined each Hispanic woman’s stage-of-change (Prochaska,DiClemente, & Norcross, 1992) regarding mammography screening, sothat they could then deliver a version of the soap opera most appropri-ate to whether the participant was already contemplating mammogra-
phy versus having adopted the practice but not yet committing to main-taining breast cancer screening behavior.
However, despite the rapid rise of Internet services worldwide, the
older, less educated, poor, and rural individuals, both in developed anddeveloping countries, do not yet have access to the Internet (Cole et al.,2000; Rogers, in press). These individuals tend to have the greatest needfor health and other types of information. The Internet can always beutilized as one part of a larger E-E campaign. For instance, Univisión,the main Spanish-language television network in the United States, of-fers its audience members an online Web site through which they caninteract with each other (as in “fan” communities), with their favoriteshows’ producers and stars, and with scriptwriters, to whom they candirectly provide feedback. By 2001, Univisión had accumulated a sub-scriber base of over 5 million Spanish-speaking individuals.
In the future, E-E interventions are likely to see more integration with
participatory communication approaches. The work of Brazilian the-ater director Augusto Boal, who founded the theatre of the oppressed(TO) movement, is especially relevant here. TO’s techniques—based onPaulo Freire’s principles of dialogue, interaction, problem posing, reflec-tion, and conscientization—are designed to activate spectators (“spect-actors”) to take control of situations, rather than passively allowing ac-tions to happen to them (Boal, 1979). The idea of a “spect-actor” emergedwhen Boal encouraged audience members to stop a theater performanceand to suggest different actions for the actors, who then carry out theaudience suggestions. During one such performance, a woman in theaudience was so outraged that an actor could not understand her sug-gestion that she came charging onto the stage, enacting what she meant(Singhal, 2001b). From that day on, audience members were invited uponto the stage. Boal discovered that audience members became empow-ered not only to imagine change, but also to actually—and collectively—practice it. TO’s techniques have been used by thousands of drama troupesall over the world, and by community organizers and facilitators asparticipatory tools for democratizing organizations, analyzingsocial problems, and transforming reality through direct action(Singhal, 2001b).
In the future, we believe entertainment-education will also go beyond
the boundaries of its mainstay messages—reproductive health, familyplanning, and HIV prevention—to include other pressing social issuessuch as peace, conflict mediation, race relations, and reconstruction.
The role of E-E will likely be realized further in struggles for liberationand empowerment, especially with the use of songs and other expres-sions as means of protest, resistance, dialogue, debate, and coping. Inessence, the future of E-E practice and research is one of exciting possi-
bilities, challenges, and debates. The six articles in this special issue willaddress some of these possibilities, raise new challenges, and stimulatenew debates.
Arvind Singhal is Presidential Research Scholar and Professor, School of Interpersonal Communi-
cation, Ohio University. Everett M. Rogers is Regents’ Professor, Department of Communicationand Journalism, University of New Mexico. Correspondence concerning this article or specialissue should be sent to Arvind Singhal at email@example.com
Even university communication departments located in such entertainment industry centers as
Los Angeles, Las Vegas, and New York have not been oriented particularly to studying or teachingabout the entertainment function. One recent exception is the Annenberg School of Communica-tion at the University of Southern California, which, since 1999, has taken entertainment as itsmain theme by establishing the Norman Lear Center; in fact, the entire university has adoptedentertainment as its core specialty (thus, the USC law school offers a specialization in entertainmentlaw, the engineering school focuses on the technology of entertainment production, and so forth).
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Celexa (citalopram hydrobromide) Tablets/Oral Solution NDA 20-822/NDA 21-046 Proposed Labeling Text Medication Guide Antidepressant Medicines, Depression and other Serious Mental Illnesses, and Suicidal Thoughts or Actions Read the Medication Guide that comes with you or your family member’s antidepressant medicine. This Medication Guide is only about the risk of suicidal thought
Intuitive Querying of e-Health Data Repositories Catalina Hallett, Richard Power, Donia Scott Abstract At the centre of the Clinical e-Science Framework (CLEF) project is a repository of well organised,detailed clinical histories, encoded as data that will be available for use in clinical care and in-silicomedical experiments. An integral part of the CLEF workbench is a tool to allow biom