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Using Media to Maintain Sexual Health: A Focus on Adolescent Girls

Using Media to Maintain Sexual Health: A Focus on Adolescent Girls. Jane D. Brown, PhD Sarah N. Keller, MS. School of Journalism & Mass Communication, UNC-Chapel Hill. Overview. Adolescents Sexual health Special risk for teen girls Media Sexual content

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Using Media to Maintain Sexual Health: A Focus on Adolescent Girls

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  1. Using Media to Maintain Sexual Health:A Focus on Adolescent Girls Jane D. Brown, PhD Sarah N. Keller, MS School of Journalism & Mass Communication, UNC-Chapel Hill

  2. Overview • Adolescents • Sexual health • Special risk for teen girls • Media • Sexual content • Effects on sexual identity & behavior • Potential to promote sexual health • Lessons learned: How to use media to promote sexual health?

  3. Defining the problem: Adolescent sexual health • 73% of boys and 56% girls have sexual intercourse by age 18 • Estimated 4 in 10 get pregnant by age 20 • 2/3 all STD cases acquired by age 25 • 75% teen pregnancies unintended AGI, 1994. McCauley A,. Meeting the needs of young people. Popul Rpts 1995; series J, no.41. Eng TR, Butler WT. Institute of Medicine. The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Washington: National Academy Press, 1996.

  4. Use of contraceptives • 72% sexually active girls ages 15-17 use contraception • Fewer than half (44%) of girls who use contraception use condoms • Girls, on average, delay 1 year after first sex before contracepting • Estimated four in 10 get pregnant by age 20 AGI, 1994. McCauley A,. Meeting the needs of young people. Popul Rpts 1995; series J, no.41.

  5. STD rates • Youth under 25 have one-half world’s HIV infections • 12 million STD cases a year in U.S. • 3 million in teens • Girls age 15-19 have highest rates of gonorrhea in U.S.; chlamydia rates growing Eng TR, Butler WT. Institute of Medicine. The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Washington: National Academy Press, 1996.

  6. STD knowledge • 42% U.S. teenagers can’t name an STD other than HIV • Only 3% know of chlamydia -- the fastest growing STD in U.S. • Fewer than half (44%) of sexually active women talk to partners about HIV-- only 27% discuss other STDs American Social Health Association. Gallup Study: Teenagers Know More than Adults about STDs. Research Triangle Park, NC: 1996. Glamour, et al. Survey of Women about their Knowledge, Attitudes, and Practices Regarding their Reproductive Health. Menlo Park, CA: Kaiser Family Foundation, 1997.

  7. Media’s potential as an educator • Media can be powerful • Media are not being used to their full potential • In Western Europe, 3/4 of population learns about STDs from TV, books or magazines • In U.S., 1/4 learn about STDs from media ASHA, 1996.

  8. TV videos in Nigeria related to increased family planning • Contraceptive use by Nigerian women in 1993 who had seen music videos and TV dramas to promote family planning in 1989-92 Westoff C, Rodriguez G, Bankole A. Family Planning and Mass Media Effects. Chapel Hill: The Evaluation Project, 1996.

  9. PSAs promote condoms in Portland, Oregon 1992-94 • Teens who used condoms in last month increased from 32% to 40% • Teens who used condoms with casual partners rose from 72% to 90% • Teens who planned to discuss condoms with next partners rose from 53% to 80% Blair J. PSI/Project ACTION: Improving Teen Risk Reduction. Washington: Population Services International, 1995.

  10. Define Target Audience, Focus Message & Choose Media • Start with audience • Define who they are: • media use • personal identity - what they care about • risk level • Gear message to fit • Choose appropriate media

  11. Selecting target audience: Teen girls • Girls twice as likely as boys to get STDs. • Asymptomatic infections harder to diagnose • Long-term complications more serious • Young women have special risk: • thinner cervical mucus • multiple partners • Less negotiating power in relationships CDC. HIV/AIDS Surveillance Report 1994; 5:1-36. Germain A, Wasserheit J, eds. Reproductive Tract Infections: Global Impact and Priorities for Women’s Reproductive Health. New York: Plenum Press, 1992.

  12. Formative research: Media use • TV: 2 hours, 43 minutes per day • Music: 3 - 4 hours per day • Movies: First R-rated film at age 12.5 • Magazines: Girls ages 11-13 start with Seventeen, move to Glamour • Internet: Girls constitute 40% of CD-Rom Myst users American Psychological Association, 1993.

  13. Media diets vary by race & gender • Not all teenagers tune into the same kind of media • Girls prefer softer music and soap operas • Boys prefer action flicks and harder, louder music • African-Americans and children from single-parent households watch more TV Steele JR, Brown JD. Adolescent room culture: Studying media in the context of everyday life. J Adolesc Hth 1995; 24(5).

  14. Media diets vary by personal identity, too • Even within race & class categories, teenagers’ media use vary dramatically • Teens define themselves by their identities • Girls’ sense of selves may be particularly transitory & vulnerable to media influence Pipher M. Reviving Ophelia. New York: Ballantine Books, 1994. Thompson S. Going All the Way. New York: Hill and Wang, 1995.

  15. All teens get a lot of “sex”… • TV: 8 sexual messages per hour on prime-time • Movies: More explicit than TV • Music: 3/4 lyrics about love and sex • Magazines: Seventeen, Young Miss, Glamour & Cosmopolitan • Internet: ?

  16. Sex on TV • TV family hour 8-9 pm: • 3/4 network programming contain sexual content • only 9% of scenes mention responsibilities, risks, protection or consequences Advocates for Youth. Talking with TV. Washington: Advocates for Youth, 1996. Dale K, et al. Sexual Messages on Family Hour TV: Content and Context. Santa Barbara: Children Now, Kaiser Family Foundation, 1996.

  17. Sex on TV (cont’d) • Sexual interactions on family hour TV shows has steadily increased over the past two decades

  18. Sex education on TV? • Condoms, STDs & pregnancy are mentioned in fewer than 1 in 10 sex-related scenes on family hour TV

  19. What effect? • Studies are few • Sex on TV increases perception that peers are having sex • Teens unlikely to learn safe sex from TV • Aggressive sex on TV increases acceptance of rape & sexual abuse Advocates for Youth, 1996. ASHA, 1996.

  20. TV violence studies show that violent programming teaches: behavior modeling (cool people are violent) social norms (guns are powerful) desensitization (killing people isn’t so bad) Same effects may occur with sex on TV: behavior modeling (stars have risky sex) social norms (premarital sex is OK) desensitization (violent sex won’t really hurt) What effect? (cont’d)

  21. When Oprah Winfrey recommends a book, it sells! • Thousands of books in print before & after selection by Oprah • The Deep End of the Ocean, Jaquelyn Mitchard • Song of Soloman, Toni Morrison • The Book of Ruth, Jane Hamilton Thigpen DE. Winfrey’s winners. Time Magazine, Dec. 2, 1996

  22. Define target audience Find out who they are: Media use Personal identity Risk level Focus message Choose media Use media channel & message style that audience uses Speak to relationship identity & sexual scripts Gear health messages to reach different categories of risk Lessons learned

  23. Gearing messages to fit • Speaking to teen identities may be key to influencing behavior • Identity -- a person’s self-perception & tastes in fashion, music & friends -- may determine sexual practice

  24. Project ACTION • Social marketing to promote teenage condom use in Portland, Oregon by Population Services International 1992-94 • Community mobilization • Condom vending machines • Peer skill-building workshops • Motivational media campaign • Evaluation research

  25. Project ACTION: Tailoring the message • Target audience: At-risk teens ages 12-21 • Focus groups subdivided into boys, girls & African-Americans • Different PSAs designed to match sexual scripts of each subgroup • PSA for girls: romantic flowers • PSA for boys: pretty girls • PSA for African-Americans: passionate glance

  26. Applying TV violence lessons to safe sex campaigns • PSAs can be more effective • Segment audience • Show negative, realistic consequences • Present alternatives to unwanted behavior • Illustrate behaviors that lead to safe sex • Use non-celebrity adolescent voices • Avoid lengthy sponsor announcements UC-Santa Barbara, 1997.

  27. Cues to action Give constructive suggestions to improve behavior Link to services: Tell where to go for condoms, STD counseling, treatment or more information Community mobilization Use media to set agenda Involve youth & opinion leaders Foster support for new behavior Work with different sectors Other lessons learned Blair J, 1995.

  28. Active audience • Teens don’t accept media messages wholesale • Media use depends on identity • Identity shaped partly by media • Cyclical process Brown, 1995. Pipher, 1994.

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