Potential Positive Effects of Health-Related Storylines in Fictional Television Programs

Abstract

Integrating health-promoting messages within the storylines of fictional television programs may provide the opportunities for a captured audience, for in-depth education and for positive behavioural modelling. This thesis reports the results of three studies on this topic. The first study employed a randomised experimental design to examine the impact of an alcohol poisoning storyline in the television program, ER, on viewers’ alcohol-related beliefs, attitudes, intentions and behaviours. The second study employed a prospective observational design, including both viewers and non-viewers, to examine the impact of the same storyline. The findings of the first two studies provide support for the potential of a storyline in a fictional television program to have a positive impact on viewers’ drinking-related outcome expectations, attitudes and intentions. Short-term changes in behaviour, however, were not found at 4 to 14 days post-viewing. One potential explanation is that the more subtle nature of narrative may not be sufficiently explicit to stimulate behavioural change. A complementary public service announcement placed after the episode may prompt viewers to reflect on the health message in the story, enhance perceived accuracy of the health-related content and serve as a cue for behavioural action. Consequently, the third study in this thesis employed a randomised between-subjects experimental design to investigate the effects of a complementary public service announcement. Overall, an organ donation episode with a complementary public service announcement had a significantly greater impact on perceived learning, intention to discuss one’s organ donor wishes, and actual discussion behaviour, than each of the standalone viewing conditions. Self-referencing of organ donation to one’s own life was the most substantial mediator of these effects, which suggests that the complementary public service announcement may have served as a prompt for viewers to relate the preceding program’s storyline and fundamental health message to their own life and, in turn, stimulated behavioural action. To conclude, the findings of the final study suggest that complementary public service announcements are a promising post-production strategy for substantially enhancing the positive impact of health-related storylines in fictional television programs. The findings may be practically implemented in New Zealand and other countries around the world to promote positive health behaviour change at a population-based level.