Entertainment as a Tool for Changing Healthcare Behavior – NPHR Blog


by Sapna Suresh

The radio soap opera Toma mi Mano, a 156-episode Spanish-language program broadcast across all 22 departments of Guatemala, features Ruth: a young woman who suffered years of sexual abuse at the hands of her uncle. Though for a while she believed he was completely out of her life, she returns to Guatemala and soon turns her attention to Ruth’s teenage sister. Marked by her own past abuses, Ruth tries to speak, but is quickly dissuaded by her mother. Despite the potential backlash, Ruth’s partner supports her decision to take a stand, prompting her to stop the cycle of abuse that is perpetuating. For many Guatemalans, this story has struck a personal chord. Several participants in a focus group of listeners expressed horror at Ruth’s mother’s indifference to her daughter’s grief and felt encouraged to take a more active role in parenting their children in order to build a more trusting relationship. The resonance of this plot is particularly plausible given the pervasiveness of male chauvinism, or machismo culture, in contemporary Guatemala – a problem that the radio play producers have intentionally tried to address with Ruth’s character arc. This plot and the other narratives featured in Toma mi Mano are typical examples of social behavior change interventions that seek to transmit knowledge, update attitudes and modify behaviors in order to facilitate better outcomes for health and well-being.

Toma mi Mano was developed by Population Media Center (PMC), a non-profit organization that promotes pro-social change in countries around the world through the production of “entertainment-education”. This type of communication campaign seeks to address a range of health-related issues, including sexual and gender-based violence, reproductive health, family planning and environmental sustainability, through the use of scientifically based approaches to behavior change. . In particular, when characters on PMC’s radio and television shows demonstrate the consequences of unwanted behavior and engage in behavior that subvert norms for a beneficial purpose, they increase the effectiveness of listeners and viewers in making such changes in their lives.

PMC programming uses several methods to reinforce the likelihood of persuasive effects on the audience. One technique they use is the presentation of the story over many sequential episodes to grab the audience’s attention, thus allowing their cognitive and emotional resources to fixate on the slowly advancing plot. Another approach involves the inclusion of positive, negative and transitional role models that highlight the consequences of different behavioral choices and provide different characters on whose experiences the audience can map their own. By virtue of both the serial format and the character identification process, the public is also able to develop parasocial relationships. Specifically, as the narrative progresses and the consumers of the show become more and more involved and invested in the lives of the people in the story, they develop connections with these characters who mimic interpersonal relationships. This process allows characters to build motivation within audience members by serving as friends, mentors, and ambitious figures.

The success of PMC’s programming in moving the needle on topics such as early marriage (Mai Sari Sunakhari, Nepal), substance abuse (East Los High, United States), nutrition (Pambazuko, Democratic Republic of the Congo), HIV / AIDS (last year, Latin America) and the rights of the disabled (Jolokoto, Nigeria) provides proof of the power of entertainment-education. Given theirs measurability, cost effectiveness, multidimensionality, And reproducibility, interventions such as those produced at the PMC demonstrate significant strength and potential in supporting global public health initiatives.

Sapna Suresh is a second-year PhD student at Northwestern University’s School of Communication. It conducts research on the many ways we can persuade people to change their attitudes and behaviors, including through the use of narratives and emotions. Her outreach work includes a previous internship at the Population Media Center, participation in the NPR SciCommers network, and service as a mentor for Northwestern college students focused on health communication.


Bandura, Albert. “Social cognitive theory for personal and social change by enabling the media”. Entertainment-education and social change. Routledge, 2003, 97-118.

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Horton, Donald and R. Richard Wohl. “Mass communication and shareholder interaction: remarks on remote intimacy”. Psychiatry 19.3 (1956): 215-229.


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