Understanding the Effectiveness of the Entertainment-Education Strategy: An Investigation of How Audience Involvement, Message Processing, and Message Design Influence Health Information Recall

Abstract

A growing body of evidence suggests that entertainment-education (EE) is a promising health communication strategy. The purpose of this study was to identify some of the factors that facilitate and hinder audience involvement with EE messages. Using confirmatory factor analysis, the authors introduce a construct they call experiential involvement, which describes the experience of being cognitively and emotionally involved with EE messages and is a product of transportation into an EE text and identification with EE characters. Using an experimental design, the authors also investigated how reports of experiential involvement and health information recall varied depending on the degree to which the educational content was well integrated with the narrative content in EE messages. Findings indicated that integration significantly influenced health information recall. Results indicated that experiential involvement and the perception that the health topic in EE messages was personally relevant predicted participants' systematic processing of the information in EE messages. Contrary to expectation, personal relevance did not predict experiential involvement, and systematic message processing was negatively related to health information recall. Implications for the construction of EE messages and the study of the EE strategy are discussed.

Acknowledgments

The first author thanks David Tewskbury, John Caughlin, and Jeremiah Johnson for their contributions to this article.

Notes

*Statistically significant at p = .05. There was a significant difference (a) in the number of people who were native English speakers across message conditions and (b) in the reports of racial identification across experimental conditions.

¹Health recall items for the avian flu condition: According to the Fast Facts brochure/story you read, how do birds transmit the avian flu to humans? How do birds transmit the avian flu to other birds? When and where was the first case of a human infection of the avian flu reported? How might it be possible for you to catch the avian flu? What are some of the symptoms of avian flu? How are humans infected with the avian flu treated for the illness? What are the conditions for a global pandemic? What type of birds are the most common carriers of the avian flu? Of those who have been infected with the avian flu, how many died from the illness? When did the most serious avian flu pandemic occur and how many people did it kill?

Health recall items for the chlamydia condition: According to the Fast Facts brochure/story you read, what are some common symptoms of chlamydia? Who is most likely to report having chlamydia? What are the three ways you can protect yourself against chlamydia? Approximately how many people are affected by chlamydia each in the U.S.? What two tests are used to detect chlamydia? For both males and females, what age group is most at risk for contracting chlamydia? How is chlamydia treated? What is the most common symptom for men who are infected with chlamydia? What are the long term risks for women who contract chlamydia?.

²The Experiential Involvement Scale consists of five items from Green and Brock's (2000) transportation scale: (a) “While I was reading the story, I could easily picture the events in it taking place”; (b) “While I was reading the narrative, activity going on in the room around me was on my mind”; (c) “I could picture myself in the scenes of events described in the story”; (d) “I was mentally involved in the story while reading it”; and (e) “I found my mind wandering while reading the story”; and six items from Cohen's (2001) identification scale: (a) “I tend to understand the reasons why the main character does what he/she does”; (b) “While reading the story, I could feel the emotions the main character portrayed”; (c) “While reading, I felt I could really get into the main character's head”; (d) “At key moments in the story, I felt I knew exactly what the main character was going through”; (e) “While reading this story, I wanted the main character to succeed in achieving his/her goal”; (f) “When the main character succeed, I felt joy but when he/she failed, I was sad.”.

*p < .05. **p < .01.

³An 11-item survey was administered to 49 participants to evaluate the extent to which the low- and high-integration stories differed with respect to message interest, realism, entertainment, and audience enjoyment. Participants were randomly assigned to two of the four message conditions. After reading the stories, they completed an Audience Evaluation Scale using a 7-point Likert-type scale and answered the following questions: How much did you enjoy this story? How enjoyable do you find the subject matter? How enjoyable do you find this type of story? How interesting did you find this story? How interesting did you find the characters in this story? How interesting did you find the subject matter? How entertaining did you find this story? How realistic did you find this story? How realistic did you find the characters in this story? How realistic did you find the writing style of this story? Would you recommend this story to a friend? Cronbach's alpha (α = .92) demonstrated that the Audience Evaluation Scale had strong internal consistency. Results indicated that there were no significant differences across the four story conditions, F(3, 95) = .219, p = .88. The analyses also indicated that there were no significant differences across the four stories with respect to each subscale of the Audience Evaluation Scale including enjoyment (α = .86), F(3, 85) = .41, p = .75; interest (α = .86), F(3, 95) = .59, p = .63; realism (α = .68), F(3, 95) = 1.17, p = .33; and entertainment (single-item), F(3, 95) = .13, p = .94.