A Case Study of Sesame Workshop’s Cleaner, Happier, Healthier Intervention in Bangladesh, India, and Nigeria: Reporting on Exposure and Impact
Dina L. G. Borzekowski
The Cleaner, Happier, Healthier hygiene intervention was developed and tested in 2013, featuring the Sesame Workshop characters. Through broadcast television, four public service announcements (PSAs) addressed washing hands with soap, using a latrine, wearing sandals, and drinking clean water. The main audiences were young preschool children and their parents or guardians.
Research occurred in Bangladesh, India, and Nigeria, exploring the reach and impact of these PSAs. Although low percentages, from well-drawn samples of extremely vulnerable populations in these countries, reported awareness and recall of these messages, such percentages can reflect large numbers of viewers. Considering data from the participating children, measures of knowledge and attitudes were associated with engaging in several of the behavioral outcomes. As well, awareness and recall of the PSA messages predicted “all the time” for several of the hygiene behaviors. In contrast, parents’ reports of PSA awareness and recall were not associated with reports of children’s hygiene behaviors.
Conducting reach studies is extremely difficult, especially in developing countries and communities. Despite the challenges, this study is encouraging. Participants reported seeing the messages, and in several models, this “reach” predicted reports of hygiene and health behaviors. Lessons learned from this case study and research can offer valuable insight into the production of future health PSAs, especially with harder-to-reach populations.
Robert M. McCann
In the last 20 years or so, the field of intergenerational communication as seen from an intergroup perspective has evolved to encompass a wide range of social, cultural, and relational contexts. Research into communication and age in organizations represents one particularly exciting and rapidly changing area of investigation within the intergenerational communication domain. The workplace, by its very nature, is rich with intergroup dynamics, with age in/out group distinctions being but one of many intergroup characterizations. Stereotypical age expectations—by management and coworkers alike—can serve as powerful harbingers to behavioral outcomes such as ageist communication, considerations of (early) retirement and reduced and/or lost training among older workers, and even reduced intentions among young individuals to take up careers involving older people. Ageist behaviors (including communication) are also at the core of many types of discriminatory practices toward older (and sometimes younger) workers. Age diversity strategies, which include intergenerational contact programs, cross-generational mentoring, age diverse teams, and the use of positive symbols of older age, are becoming more common in organizations.
Shawn Meghan Burn
Bystander intervention is a form of helping that occurs when onlookers intercede to provide direct or indirect aid to a victim. When bystanders step in to prevent or reduce harm to others, they act as agents of primary and secondary health prevention. But theory and research suggest the bystander intervention process is complex and multiple social-psychological and situational barriers imperil bystander action. Bystanders are often ill-prepared to intervene when others are at risk for emotional or physical harm. They may not notice that someone needs help due to distraction from self-focus, engagement in social interaction, intoxication, or aspects of the situation like crowding or noise. Due to inadequate knowledge, bystanders may misdiagnose the situation and believe intervention is unnecessary. The negative consequences of nonintervention may be unknown to them such that the situation fails to increase their empathic arousal and motivate their action. Lacking knowledge, they may not recognize the seriousness of the situation and or the potential costs of inaction, and so are insufficiently alarmed. Pluralistic ignorance can arise when multiple uncertain bystanders conceal their concern and hesitate to act, assuming others’ inaction means intervention is inappropriate or unnecessary. When there are multiple witnesses, bystanders may assume their help is unneeded, place intervention responsibility on others, or feel less responsible for helping due to diffusion of responsibility. When the victim is not a member of their in-group, or is assumed at fault for their predicament, they may feel less empathy and a reduced responsibility to help. Or, bystanders may assign responsibility for intervention to the victim’s friends or fellow in-group members, or to those “in charge” of the setting. Even when bystanders realize help is needed and take responsibility for helping, they may not act if they do not know how or lack confidence in their ability to successfully carry out the actions required to help. When they have the skills, they may not help if they perceive the costs of action to outweigh the benefits of action. Audience inhibition arising from group norms supporting inaction and from bystander worry about what others will think about them if they act unnecessarily or ineptly can prevent bystander action by increasing bystanders’ perceived helping costs.
Recognition of bystanders as a potentially valuable public health asset has increased interest in promoting bystander intervention. Bystander intervention promotion and communications empower bystander action by combating intervention- and audience-specific barriers to bystander intervention using targeted information, communications, and skills training. Theory and research suggest that effective promotions and communications foster context-specific attitudes, beliefs, norms, and skills such that bystanders: (1) are able to quickly and accurately identify a situation as intervention-appropriate; (2) experience action-motivating arousal (including empathy) in the face of the event; (3) have positive attitudes towards intervention and perceive the benefits of action as outweighing the perceived costs; (4) are empowered to act and feel confident in their ability to effectively intervene (bystander efficacy); and (5) are resistant to evaluation apprehension and norms contraindicating action. Effective bystander intervention promotion draws on social psychology and communications studies, and best practices for health promotion and prevention programs. The application of social marketing and formative and summative program evaluation methods enhance the potential of bystander intervention promotions and communications to empower bystander action.
Celebrity politicians are having a profound impact on the practice of politics within the United States and United Kingdom in the 21st century. With the adoption of social media platforms, celebrity and image candidates have deployed new strategies for attracting constituents. Taken together, the proliferation of celebrity politics and the ubiquity of digital platforms have fostered a unique atmosphere in the contemporary political moment, wherein “outsider” candidates may leverage their fame to launch themselves into the public spotlight. In turn, through their celebrity brands and digital presence both populists such as the U.S. President Donald Trump and left-wing leaders including U.K. Labour leader Jeremy Corbyn have established an “authenticity” in which they “occupy” a public space to define their candidacies. Consequently, as celebrities and image candidates promote political agendas among target audiences/citizens, it is necessary to reflect upon their significance in election campaigns, policy agendas, and activism.
Sophie Christman Lavin and E. Ann Kaplan
Ecocinema involves the human gaze looking at cinema through the lens of the environment, in a manner analogous to the way feminists provided the cinematic lens of gender in the 1970s. However, as with feminism, enormous differences pertain in regard to how the ecocinema lens is mobilized.
In analyzing films from the late 1800s to the early 21st century, ecocinema studies has evolved to include critical lines of inquiry from perspectives of psychology, feminism, socioeconomics, science, and activism. Research frames used in these inquiries include: setting and landscape in films, ecological analyses of mainstream and independent fictional films, posthuman cinematic representations, transnational and regional, and more recently, trauma in speculative dystopian films. Ecocinema critics analyze films of various types, including Hollywood, independent, transnational, documentary, animated, art cinema, and especially climate fiction (“cli-fi”) films.
Ramachandra Guha’s transnational typology of environmental ideologies will provide a useful starting place for the mapping of different perspectives in ecocinema. Guha distinguished utopian wilderness environmentalism, pervasive in the United States, from the agrarian focus typical in India. Meanwhile, most developed nations utilize scientific industrial methods to exploit the environment. Oftentimes, these latter approaches are grounded in growth economies and are thus in conflict with the unrealistic ideals of so-called neo-primitivism (NP). Neo-primitivism involves returning to simple, sustainable lifestyles within or close to the natural world—lifestyles that do no environmental damage. NP is beloved by many, but the consensus is that it is idealistic to consider going back to this way of life. A film such as Avatar (produced and directed by James Cameron in 2009) addresses the complexity of diverse constructions of nature by providing examples of utopian wilderness ideology that compete with, and are opposed to, the destructive scientific industrialism that disregards and dominates nature without compunction. Other films, such as Amazon Sisters (Sweeny, 1992), Elemental (Koch, Roshan, & Vaughan-Lee, 2012), Into the Wild (Blocker, Hildebrand, Kelly, & Penn, 2007), or Grizzly Man (Beggs & Herzog, 2005), act as simultaneous celebrations and critiques of wilderness ideologies and deal with gender and racial identities, and thus they have been a central focus of ecocinema scholarship.
Although films from all genres have historically engaged environmental issues, it was rarely in a way that made a self-conscious or critical statement about the human impact on the natural world from the perspective of ecological concerns—this is the focus of ecocinema. See for example, Birt Acres’s Rough Sea at Dover (1895), the Lumiere Brothers’ Oil Wells of Baku (1896), Thomas Edison’s Sorting Refuse at Incinerating Plant, NYC (1903), and the British South Africa Company’s Rhodesia To-Day (1912). In the early 21st century, the genre that most often engages with the contemporary politics of climate change is the documentary. Documentaries, such as An Inconvenient Truth (Guggenheim, 2006), Manufactured Landscapes (Baichwal, 2006), Into Eternity (Eskilsson & Madsen, 2010), Chasing Ice (Ahrens & Orlowski, 2012), E-Waste Tragedy (Esteve, Popp, Úbeda, & Dannoritzer, 2014), This Changes Everything (Cuarón & Lewis, 2015), among others, critique human damage to the planet and thus position viewers as ethical witnesses. Such works hope to influence the outcome of our shared anthropocentric future.
The analyses of ecocinema are addressed using two distinct methods—the macro and the micro. The macro method studies how films represent the large-scale processes of earth-based climate systems, and its lens evaluates how films represent climate and environmental dilemmas facing humans as a species. The micro-lens provides enhanced analyses that explore how gender, race, and class figure into the cultural work climate fantasies perform. This lens indexes the ways in which various cultures are often disproportionately impacted by climate systems.1 Oftentimes the macro and micro levels are both incorporated in a single film and reveal the intersection between climate and culture, as seen in Taklub (Trap, Castillo & Mendoza, 2015), a film that portrays Super-typhoon Haiyan and its impact on residents in Tacloban, Philippines. As background to mapping the texts, evolving science discourses will be emphasized as evidence for global warming but with the understanding that this evidence relies on modeling. Although our main concern with this cultural work in ecocinema is how climate change impacts across gender, race, and class, the inequalities revealed also speak to the politics of climate change evident in cinematic treatments of the issue.
Roxanne L. Parrott, Amber K. Worthington, Rachel A. Smith, and Amy E. Chadwick
The public, including lay members who have no personal or familial experience with genetic testing or diagnosis, as well as individuals who have had such experiences, face many intrinsic decisions relating to understanding genetics. With the sequencing of the human genome and genetic science discoveries relating genes to cancer, heart disease, and diabetes, the scope of such decisions broadened from prenatal genetic testing related to reproductive choices to genetic testing for contributors to common causes of morbidity and mortality. The decision about whether to seek genetic testing encompasses concerns about stigma and discrimination. These issues lead some who can afford the cost to seek screening through online direct-to-consumer sites rather than in clinical settings. Many who may benefit from genetic testing lack awareness of family health history that could guide physicians to recommend these diagnostic tests. Families may not discuss health history due to genetic illiteracy, with the public’s genetic illiteracy increasing their illness uncertainty and decreasing the likelihood that physicians will engage in conversations about personalized medicine with their patients. Physicians may nonetheless order genetic tests based on patients’ symptoms, during preoperative workups, or as part of opportunistic screening and assessment associated with a specific genetic workup. Family members who receive positive genetic test results may not disclose them to life partners, other family members, or insurance companies based on worries and anxiety related to their own identity, as well as a lack of understanding about their family members’ risk probability. For many, misguided beliefs that genes absolutely determine health and disease status arise from media translations of genetic science. These essentialist beliefs negatively relate to personal actions to limit genetic expression, including failure to seek medical care, while contributing to stereotypes and stigma communication. As medical science continues to reveal roles for genes in health across a broad spectrum, communicating about the relationships that genes have for health will be increasingly complex. Policy associated with registering, monitoring, and controlling the activities of those with genetic mutations may be coercive and target individuals unable to access health care or technology. Communicating about genes, health, and risk will thus challenge health communicators throughout the 21st century.
Elisabetta Crocetti and Monica Rubini
A main developmental task for young people is to form a coherent and stable sense of personal and social identity. In fact, in adolescence (from ages 10 to 18), the multiple biological, cognitive, and social changes that occur stimulate young people to rethink about themselves, to reflect on the kind of person they want to become, and to find their own place in the society. Similarly, in emerging adulthood (from ages 19 to 29), young people have the possibility to explore a large array of alternatives in multiple life domains (e.g., education, work, relationships, worldviews) before enacting enduring adult commitments. Process-oriented identity models have been proposed to capture the dynamic process by which young people form and revise their identity over time, committing to relevant life domains, reflecting on their choices, and reconsidering them when they no longer fulfill personal aspirations and/or social expectations.
This dynamic process is strongly intertwined with interpersonal and group communication processes. In fact, youth identity formation does not occur in a social vacuum; rather, young people form their identity by means of continuous interactions with significant others and relevant social groups. In particular, in youth, family, peers, and school represent main social contexts in which communication processes are likely to affect young people’s identities. Thus, communication processes are crucial for obtaining identity-relevant information that might foster individuals’ reflection on themselves and processes of social comparisons. Furthermore, through communication processes young people can manage their own reputation, striving to achieve and maintain a good reputation within relevant groups. Individuals’ efforts to enhance reputation are, indeed, important for gaining symbolic (e.g., satisfaction of esteem needs) and instrumental (e.g., the likelihood to be trusted by others and becoming influential) benefits that are important for youth psychosocial adjustment and well-being.
Religion encompasses many forms of communication: between groups, within groups, and with God (or other deities). Such communication can be especially powerful when group members highly identify with their religious group and the beliefs therein. Equally, it can be divisive, as evidenced by religion-based intergroup conflict and intolerance (which often overlaps along ethnic or political lines). However, not all religious communication is verbal or explicit. Religious individuals also commonly transmit their beliefs, values, and identities through symbols, physical spaces, and music. Likewise, communication with God is often pursued with silent prayer, meditation, or ritual, which also serve to reinforce one’s spirituality alongside religious group boundaries. Taken together, these varying forms of communication have implications not only for religious intergroup relations (e.g., intergroup contact or conflict), but also for intragroup relations (e.g., the strengthening of social ties) and individual health outcomes (e.g., effective communication with health care providers and coping practices). Given the importance of religious identity for many individuals, the benefits for individual well-being and intragroup relations, and yet the intergroup strife that religious group divisions can incite, the ways in which we communicate our religious group identities deserve closer attention.
Robert M. McCann
Research into age and culture strongly suggests that people of different adult generations, regardless of culture, typically regard others and act in ways that display bias in favor of one’s own age group. While people across cultures share some basic patterns of aging perceptions, there is considerable variance in views on older people from one country to the next. Over the past two decades, the tenor of communication and aging research has shifted dramatically. Traditional research into aging across cultures painted a picture of Asia as a sort of communicative oasis for elders, who were revered and communicated to by the younger generations in a respectful and mutually pleasing manner. Compelling evidence now suggests the opposite, which is that (interregion variability in results notwithstanding) elder denigration may be more pronounced in Eastern than Western cultures. Accelerated population aging, rural-to-urban shifts in migration, new technologies, rapid industrialization, and the erosion of cultural traditions such as filial piety, may partially account for these results. Additionally, there are well-established links between communication and the mental health of older people. Specifically, communication accommodation in all of its forms (e.g., over accommodation, nonaccommodation, accommodation) holds great promise as a core predictor of a range of mental health outcomes for older people across cultures.
Janice L. Krieger and Jordan M. Neil
Strategic communication is an essential component in the science and practice of recruiting participants to clinical research studies. Unfortunately, many clinical research studies do not consider the role of communication in the recruitment process until efforts to enroll patients in a timely manner have failed. The field of communication is rich with theory and research that can inform the development of an effective recruitment plan from the inception of a clinical research study through informed consent. The recruitment context is distinct from many other health contexts in that there is often not a behavioral response that can be universally promoted to patients. The appropriateness of a clinical research study for an individual is based on a number of medical, psychological, and contextual factors, making it impossible to recommend that everyone who is eligible for a clinical research study enroll. Instead, clinical research study recruitment efforts must utilize strategic communication principles to ensure that messages promote awareness of clinical research, maximize personal relevance, minimize information overload, and facilitate informed choice. This can be accomplished through careful consideration of various aspects of the communication context described in this chapter, including audience segmentation, message content, message channels, and formative, process, and outcome evaluation, as well as the enrollment encounter.