Characterizing the Influence of Television Health Entertainment Narratives in Lay Populations: A Scoping Review

"Women's Lives Are on the Line, and Our Hands Are Tied": How Television Is Reckoning With a Post-Dobbs America

BACKGROUND

Since the 2022 Dobbs v. Jackson Women's Health Organization Supreme Court decision revoked federal protection for abortion rights, many states have restricted abortion. Although news media covers this shifting landscape through reporting, this article documents how entertainment content is responding to this new reality in its storytelling.

METHODS

The sample is from a public database of abortion plotlines on American television (abortiononscreen.org). I separated the sample of 150 plotlines into two groups: plotlines that filmed and/or aired pre-Dobbs (January 2020-August 2022) and those that aired post-Dobbs (September 2022-December 2023). Coding occurred in Microsoft Excel.

RESULTS

Post-Dobbs, there was an increase in procedural abortion depictions compared with pre-Dobbs, but no change in the consistently low number of depictions of medication abortion. The post-Dobbs sample included a 10% increase in teen characters compared with pre-Dobbs. Pre-Dobbs, the vast majority of plotlines (77%) did not portray any barriers to abortion care. Post-Dobbs, 33% depicted barriers. The most common reason for abortion seeking in both samples was age (11%). Pre-Dobbs, the next most common was a mis-timed pregnancy (10%). Post-Dobbs, the next most common was health concerns (11%).

CONCLUSIONS

Since Dobbs, more television plotlines are portraying obstacles to abortion care, yet they continue to tell stories of white, non-parenting teenagers who make up a small percentage of real abortion patients. Plotlines overrepresent procedural abortion over the more common medication abortion. Depictions of health-related reasons for abortion seeking obscure more commonly provided reasons for abortions, such as mistimed pregnancies, caregiving responsibilities, and financial concerns. Considering the low levels of abortion knowledge nationwide, understanding what (mis)information audiences encounter onscreen is increasingly important.

The knowledge, training, and willingness of first year students in Xuzhou, China to perform bystander cardiopulmonary resuscitation: a cross-sectional study

Background

Bystander Cardiopulmonary Resuscitation (CPR) can significantly improve the rate of return of spontaneous circulation in patients with cardiac arrest. Since first year students with no specific academic background are energetic and quick to learn, many Chinese schools offer first-aid training course including CPR to them before they start school. However, data on CPR knowledge, training, and willingness among first year students are lacking in most regions of China, which makes the effectiveness of CPR training unknown.

Objectives

To evaluate first year students' knowledge level, training experience and rescue willingness for CPR of first year students in Xuzhou, and to analyze the influencing factors of CPR knowledge level and rescue willingness of first year students in Xuzhou.

Design

A cross-sectional study.

Participations

A total of 9,887 first year students from three universities in Xuzhou city were selected by multi-stage random cluster sampling method.

Methods

A self-designed five-part structured questionnaire was used to investigate the knowledge, training and willingness of CPR among first year students. Independent sample t-test, χ2 -test and Logistic regression were used for data analysis.

Results

The average score of CPR knowledge was 2.44 (±1.60), 99.13% of the respondents were willing to participate in CPR training, and 66.25% had received CPR training. Respondents with rural household registration, relatives who had suffered from serious diseases, relatives engaged in the medical profession, good self-rated quality of life, CPR training, and willing to CPR training had higher CPR knowledge levels. 76.77% of the respondents were willing to perform bystander CPR. Women, those who had received CPR training, and those who were willing to receive CPR training were more willing to help patients with sudden cardiac arrest. Lack of first aid knowledge and skills (82.61%) was the biggest obstacle hindering respondents from performing rescue.

Conclusion

Most of the first year students of Xuzhou University in China have CPR training experience and have a strong willingness to train. Most are willing to perform bystander CPR, but have a low knowledge level. Colleges and universities can adopt diversified training methods, make plans for regular CPR retraining and other strategies to improve the quality and effect of CPR training for college students.

"Better Than Any DARE Program": Qualitative Analysis of Adolescent Reactions to EVALI Television Storylines

Introduction. Research suggests that awareness of e-cigarette, or vaping, product-use associated lung injury (EVALI) among adolescents is associated with increased harm perception of e-cigarettes. The depiction of EVALI on three primetime medical dramas offers an opportunity to examine the use of these storylines for tobacco prevention education. Methods. We conducted four focus groups with seventh- and eighth-grade students at an urban middle school. Participants viewed three clips of scenes followed by a facilitated discussion as to the influence of the clips on knowledge and perceptions of e-cigarettes and the use of clips for tobacco prevention education. Two research assistants double-coded notes from the focus groups using a qualitative content analysis approach. Results. Our final sample included 78 adolescents; we obtained self-reported demographic information for 75. The majority of participants were 13 to 14 years of age (82.7%) and identified as cisgender female (52.0%) and Black (52.0%). No participants had knowledge of EVALI prior to viewing the clips. Comments made both during and after watching suggest the clips may have reinforced knowledge and perceptions of harm; participants stated that the clips could be a useful intervention tool. Viewing the clips also generated unprompted discussion about flavored products, tobacco advertising, other television programs, and marijuana. Conclusions. Clips featuring the depiction of EVALI on medical dramas may be an effective tool for raising awareness of e-cigarette use-related harms. These results offer a promising first step for future collaborative research between public health, adolescents, and schools to develop tobacco prevention education utilizing these clips.

Abortion in entertainment media, 2019-2024

PURPOSE OF REVIEW

Entertainment media contribute to how people understand and make sense of health issues, especially stigmatized ones such as abortion. This paper reviews the peer-reviewed literature published between 2019 and 2024 on how abortion is depicted in scripted television and film available for viewing in the United States.

RECENT FINDINGS

The majority of recent studies focus on qualitative content analysis of a composite of television shows, documenting the myriad ways that these programs reflect and are distinct from the reality of abortion access in the United States. The quantitative studies find small but significant increases in abortion knowledge related to exposure to television abortion plotlines, but no increases in support for abortion postexposure. No studies track the impact of exposure to multiple abortion plotlines at multiple points in time. Only one study included a sample of entertainment content creators to understand their motivations for creating abortion plotlines.

SUMMARY

Media depictions of abortion are often rife with misinformation, and may influence the U.S. public's general knowledge and beliefs about abortion. More research is needed to understand possible relationships between television and film abortion content and its impact on viewers.

Factors Associated With COVID-19 Vaccination Among Racial/Ethnic Minority Groups With HIV in South Florida

BACKGROUND

Racial/ethnic minority groups with HIV in the United States are particularly vulnerable to COVID-19 consequences and can significantly benefit from increased uptake of COVID-19 vaccines. This study identified factors associated with full COVID-19 vaccination among people with HIV.

SETTING

Ryan White HIV/AIDS Program in Miami-Dade County, FL.

METHODS

Data were collected from 299 Ryan White HIV/AIDS Program adult clients during January-March 2022 using a cross-sectional phone survey. Multivariable logistic regression was used to estimate adjusted odds ratios (aORs) with 95% confidence intervals (CIs). All analyses were weighted to be representative of the race/ethnicity and sex distribution of clients in the Ryan White HIV/AIDS Program.

RESULTS

Eighty-four percent of participants were fully vaccinated with a primary vaccine series; stratified by race/ethnicity, the percentages were 88.9% of Hispanic, 72.0% of black/African American, and 67.5% of Haitian participants. Fully vaccinated participants were less likely to be black/African American than Hispanic (aOR = 0.18; 95% CI: 0.05 to 0.67) and more likely to not endorse any misconceptions about COVID-19 vaccines (aOR = 8.26; 95% CI: 1.38 to 49.64), to report encouragement to get vaccinated from sources of information (aOR = 20.82; 95% CI: 5.84 to 74.14), and to perceive that more than 50% of their social network was vaccinated (aOR = 3.35; 95% CI: 1.04 to 10.71). Experiences of health care discrimination, structural barriers to access vaccines, and recommendations from HIV providers were not associated with full vaccination.

CONCLUSIONS

These findings highlight the importance of delivering accurate and positive messages about vaccines and engaging social networks to promote COVID-19 vaccination among people with HIV. This information can be leveraged to promote uptake of subsequent boosters and other recommended vaccines.

Challenges with using popular entertainment to address mental health: a content analysis of Netflix series 13 Reasons Why controversy in mainstream news coverage

Background

Mental health conditions and psychiatric disorders are among the leading causes of illness, disability, and death among young people around the globe. In the United States, teen suicide has increased by about 30% in the last decade. Raising awareness of warning signs and promoting access to mental health resources can help reduce suicide rates for at-risk youth. However, death by suicide remains a taboo topic for public discourse and societal intervention. An unconventional approach to address taboo topics in society is the use of popular media.

Method

We conducted a quantitative content analysis of mainstream news reporting on the controversial Netflix series 13 Reasons Why Season 1. Using a combination of top-down and bottom-up search strategies, our final sample consisted of 97 articles published between March 31 and May 31, 2017, from 16 media outlets in 3,150 sentences. We systematically examined the news framing in these articles in terms of content and valence, the salience of health/social issue related frames, and their compliance with the WHO guidelines.

Results

Nearly a third of the content directly addressed issues of our interest: 61.6% was about suicide and 38.4% was about depression, bullying, sexual assault, and other related health/social issues; it was more negative (42.8%) than positive (17.4%). The criticism focused on the risk of suicide contagion, glamorizing teen suicide, and the portrayal of parents and educators as indifferent and incompetent. The praise was about the show raising awareness of real and difficult issues young people struggle with in their everyday life and serving as a conversation starter to spur meaningful discussions. Our evaluation of WHO guideline compliance for reporting on suicide yielded mixed results. Although we found recommended practices across all major categories, they were minimal and could be improved.

Conclusion

Despite their well intentions and best efforts, the 13 Reasons Why production team missed several critical opportunities to be better prepared and more effective in creating social impact entertainment and fostering difficult dialogs. There is an urgent need to train news reporters about established health communication guidelines and promote best practices in media reporting on sensitive topics such as suicide.

Utilizing Television Clips for Graduate Medical Education Anti-racist Curricula: An Acceptability Study

Introduction Racism is a pervasive social problem that influences medicine, highlighting the need for interventions. One promising educational technique, referred to as edutainment, utilizes clips from television shows as an instructive strategy. The objective of this study was to examine the acceptability of edutainment around anti-racist curricula for residents. Methods We conducted a survey of underrepresented in medicine (URM) medical faculty to inform content for subsequent focus groups with medicine, psychiatry, and pediatrics residents. For the survey, URM faculty were randomly assigned to view four of eight clips and responded to close- and open-ended items. Focus group participants viewed selected clips and provided feedback. All study procedures occurred in 2020-2021. We calculated descriptive statistics for close-ended survey items and employed thematic analysis for open-ended items and focus group transcripts. Results Twelve URM faculty completed the survey. Feedback was uniformly positive so we included all eight clips in the resident focus groups. For each of the three participating specialties, we conducted two focus groups (2-11 participants each, total n=25) with participants viewing four of the eight clips. Analysis of focus group transcripts found that participants were receptive to the edutainment approach. Feedback as to the realism and acceptability of certain clips differed by specialty. Triangulation of survey and focus group results found differences in the acceptability of specific clips between residents and faculty. Conclusion Edutainment with medical television shows may be a promising avenue for anti-racist curricular content for residents. The educational methods described here are being incorporated into a multi-pronged, hospital system wide graduate medical education anti-racist curriculum.

Viewer Reactions to EVALI Storylines on Popular Medical Dramas: A Thematic Analysis of Twitter Messages

Previous research has found an association between awareness of e-cigarette, or vaping, product-use associated lung injury (EVALI) and lower intention to use e-cigarettes among young people. This study utilized Twitter data to evaluate if the January 2020 depiction of EVALI on New Amsterdam, Chicago Med, and Grey's Anatomy-three popular primetime medical dramas-could be a potential innovative avenue to raise awareness of EVALI. We obtained tweets containing e-cigarette-related search strings from 1/21/2020 to 02/18/2020 and filtered these with storyline-specific keywords, resulting in 1,493 tweets for qualitative coding by two trained human coders. Content codes were informed by prior research, theories of narrative influence, and e-cigarette related outcomes. Of 641 (42.9%) relevant tweets, the most frequent content codes were perceived realism (n = 292, 45.6%) and negative response (n = 264, 41.2%). A common theme among these tweets was that storylines were unrealistic because none of the characters with EVALI used THC-containing products. Approximately 12% of tweets (n = 78) mentioned e-cigarette knowledge and 28 (4.4%) mentioned behavior, including quitting e-cigarettes because of viewing the storylines. Implications for health communication research utilizing social media data and maximizing the achievement of positive health-related outcomes for storylines depicting current health topics are discussed.