Using Public Access Television for Health Promotion

State: CA Type: Model Practice Year: 2011

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Healthy for Life and Una Vida Saludable address the need for health information among members of the general public, and monolingual Spanish-speakers who are typically more heavily impacted by health problems and have fewer resources available to manage them. The shows provide a platform for getting information on current health problems, prevention and treatment methods, and community resources to the general public and Spanish-speaking community in a low-cost, timely manner. The shows have addressed a wide range of local health issues, including the leading causes of premature death in Santa Barbara county, H1N1, breast, cervical, prostate and colon cancers, HIV, tobacco, healthy and unhealthy (high sugar) drinks, responsible pet ownership, prenatal and post-partum care, immunization, getting the most out of medical visits, and diabetes.

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Santa Barbara County Public Health Department
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Using Public Access Television for Health Promotion
Healthy for Life and Una Vida Saludable address the need for health information among members of the general public, and monolingual Spanish-speakers who are typically more heavily impacted by health problems and have fewer resources available to manage them. The shows provide a platform for getting information on current health problems, prevention and treatment methods, and community resources to the general public and Spanish-speaking community in a low-cost, timely manner. The shows have addressed a wide range of local health issues, including the leading causes of premature death in Santa Barbara county, H1N1, breast, cervical, prostate and colon cancers, HIV, tobacco, healthy and unhealthy (high sugar) drinks, responsible pet ownership, prenatal and post-partum care, immunization, getting the most out of medical visits, and diabetes.
Public, education, and government (PEG) television stations are an underutilized tool for promoting public health. Nearly every mid-size and large city in the US has at least one PEG station with facilities for producing and broadcasting television programs at low-cost. The following is one example of the use of public access television to create and disseminate health education to mainstream and specialized audiences in engaging and effective formats. In collaboration with local public access television stations, the Santa Barbara County Public Health Department produces monthly health education television programs in English and Spanish, entitled, Healthy for Life and Una Vida Saludable. The 30-minute shows target two distinct audiences, monolingual Spanish speakers and the general English-speaking adult population of Santa Barbara County. The shows air 6-15 times/week on government and public access channels, and are seen by approximately 30,000 people or about 10% of the local adult population. The shows are also posted on the department’s website (http://www.countyofsb.org/phd/healthed.aspx?id=20746) and we are currently working with YouTube to have the shows available there. To date, 26 shows (13 English and 13 Spanish) have been produced, addressing a range of health issues, such as H1N1, cancer prevention, HIV, tobacco, healthy and unhealthy drinks, prenatal and post-partum care, immunization, and diabetes. The Spanish and English shows are tailored to the needs and characteristics of the target populations, with the Spanish language shows typically addressing the needs of lower-income, lower-literacy viewers, and the English shows primarily addressing middle-income, moderately-educated adults. The goal of the shows is to prevent health problems and promote healthy behavior. Key objectives include increasing understanding of health problems, increasing health promoting behaviors, and increasing use of local health resources. For example, recent shows on diabetes explain the types and causes of diabetes, demonstrate preventive eating and exercise behaviors, and list local diabetes treatment and prevention service sites and contact information. Healthy for Life and Una Vida Saludable began production in October, 2009 and have continued on a monthly basis since then. We have received significant feedback that indicates that the shows are meeting our objectives. We receive 10-15 phone calls and 30-40 comments each month from people who have seen the shows and want more information about the topics presented and related services. For example, after the tobacco prevention shows aired, our cessation program received triple the usual number of inquires about the program. Callers and other community members consistently praise the content and format of the shows. For example, after airing the show on HIV prevention that featured a woman with HIV, a caller said, ‘I cried while watching your show. That woman is so brave. Your show is a vital service to the community. Keep up the good work.’ The shows are successful because they are tailored to the target audiences, and provide a mix of health information, modeling of healthy behaviors, and tips for accessing health resources. In our second season we added segments demonstrating preparation of low-cost, healthy meals (Cooking for Life) and easy physical activities (Active for Life), and have received substantial positive feedback about the value of these components. Offering a free cookbook with recipes for low-cost, easy to prepare, healthy meals to viewers who request it has significantly increased the number of calls received, and likely increases our impact on viewer eating behavior. Nurses, health educators, and other professionals have requested copies of some shows to use with their client populations.
Agency Community RolesThe Santa Barbara County Public Health Department (PHD) produces monthly Healthy for Life and Una Vida Saludable television programs in English and Spanish. The PHD Director of Health Education writes, produces, and co-hosts the English language shows in collaboration with local health professionals who have expertise with the selected topics. Two PHD bilingual, bicultural health educators co-produce and co-host the Spanish language shows, addressing the same general topics as the English language shows, but tailoring them to the concerns, needs, and characteristics of the lower-income, Spanish-speaking population in Santa Barbara county. ImplementationThe first step in developing a health promotion public television show is to determine if sufficient funding and staffing are available. Many public stations allow free use of production facilities after staff or volunteers complete studio training. If adequate agency staffing is not available, rates to have station staff engineer the shows may be negotiated. We pay the station $400 to produce two related 30-minute shows in Spanish and English. This covers about 3 hours of in-studio time, and 1-2 hours of post-production. Public Health Department staff spend about 24 hours per month preparing the two show scripts, arranging guests, and recording the shows. The next step is to contact the local public television station and propose the show concept, negotiate rates, and make a shooting schedule. Health department staff should have control over show content, and select timely topics of interest to the target audience. Script development involves researching selected topics, identifying local experts and/or people with personal experience with the selected issue, and determining engaging ways to present key information visually (e.g., photos, onscreen text), and verbally (e.g., lecture, discussion, guests). Content should match the language level of the intended audience. Show hosts, experts and guests should be screened for knowledge, language ability, and their ability to relate to the audience. Local services and resources related to the selected topic should be researched and listed. Scripts should be reviewed and edited by members of the target audience. Shows produced for Spanish (or other language) speaking audiences should be edited for cultural appropriateness as well as translation. To promote healthy behaviors modeling of target behaviors should be included. This requires researching still or video samples through Google, YouTube, or other photo/video libraries, conducting field shoots, and/or planning live demonstrations and getting needed materials prior to studio taping. Recording multiple field shoots (e.g., cooking or activity demonstrations) at the same time can save time and money. Completed shows should be reviewed prior to airing to ensure accuracy and quality. Completed shows may be distributed to multiple public stations, and should be broadcast at times appropriate to the target audience. We begin planning each show about a month prior to the target recording date. Once we select the health topic, the executive producer spends about two weeks (10 hours) researching the topic, local resources and experts, possible guests, needed visuals, and modeling video, and drafting the script. During the following two weeks, the script is reviewed and edited by local experts, target audience members, and the Spanish language producers. The final scripts are sent to the hosts, guests, and station staff at least three days before the recording date. Occasionally we schedule a dry run/rehearsal a few days before the recording date. It takes station staff a few days to edit the shows after recording, and a day for the agency staff to review the shows. It typically takes the station a week or two to get new shows on the air.
The primary objective was to produce and broadcast 20 Healthy for Life and Una Vida Saludable television shows per year reaching large numbers of county residents at a cost of $4,000. The number and cost of shows produced, and the number of people reached, were the performance measures for this objective. Data was collected through tracking of the number and cost of shows produced, and through station estimates of the number of viewers. This objective was achieved as 22 shows were produced and broadcast during the first year of operation, at a cost of $4,400. Further, the Channels TV station estimates that approximately 30,000 people or about 10% of the local adult population see each program. Lessons learned include the realization that this model for producing low-cost health education television series utilizing local public access TV stations is achievable. At a cost of about $.05 per person reached, including staff time, public television is a highly cost-effective tool for producing and providing health education. The second objective of Healthy for Life and Una Vida Saludable was to increase viewer knowledge and understanding of health problems and related resources. Feedback from viewers and health professionals was the performance measure for this objective. Data on this was collected through personal, telephone, and email feedback about the shows from viewers, and input from local health professionals who reviewed each script. The impacts of television-based health education are difficult to assess. However, we have received feedback that indicates we are meeting this objective. Professionals who reviewed the scripts indicated that they contained valid information, and presentation methods that matched the target audiences. We receive 10-15 phone calls and 30-40 comments each month from people who have seen the shows and want more information about the topics presented and related services. For example, after the tobacco prevention shows aired, our cessation program received triple the usual number of inquires about the program. Callers and other community members consistently praise the content and format of the shows. For example, after airing the show on HIV prevention that featured a woman with HIV, a caller said, ‘I cried while watching your show. That woman is so brave. Your show is a vital service to the community. Keep up the good work.’ These and many other comments and calls suggest that viewer knowledge and understanding of the health issues presented increased. The third objective of Healthy for Life and Una Vida Saludable was to increase healthy behavior among viewers. Feedback from viewers was the performance measure for this objective. Data on this was collected through personal, telephone, and email feedback about the shows from viewers. The impacts of television-based health education on viewer behavior are very difficult to assess. However, we have received feedback that indicates we are meeting this objective. Of the 40-50 comments received each month, the feedback is overwhelmingly positive, and over 50% of the comments address behavioral impacts. For example, after a recent show on diabetes a viewer called to say she had prepared one of the meals demonstrated on the show and requested the cookbook used in the show. After showing a segment about a walking club started by the co-host of Una Vida Saludable, attendance at the walking club increased significantly. Similarly, several community members said they had gotten their flu shots after seeing the show on H1N1. Lessons learned have included shortening in-studio discussion and creating more segments that demonstrate the healthy behaviors we are trying to promote. Offering a free cookbook with recipes for healthy meals to viewers who request it has significantly increased the number of calls received, and likely increases our impact on viewer eating behavior. Further, nurses, health educators, and other profess
The Public Health Department’s commitment to maintaining the Healthy for Life/Una Vida Saludable TV shows is based on the community response to and apparent impacts of the shows. Personal, telephone, and email feedback about the shows from viewers, staff, and elected officials have consistently indicated that the shows are valuable in terms of increasing public awareness of health issues and performance of prevention measures. As indicated, we receive over 40 communications per show from diverse sources suggesting that the shows are being watched, that viewers are gaining information from the shows, and that the shows are effecting viewer behavior. This data, combined with the public relations benefits of getting and keeping health department programs and services in the public eye, and the cost-effectiveness of reaching 20-30,000 people for $400 per show, have solidified the department’s commitment to maintaining the program, even under dire financial conditions. County Supervisors like the show as it demonstrates positive actions taken by County staff. Program Managers like the show because it is a vehicle for promoting their services. Health educators like the show because it promotes healthier behavior. And the public likes the show because it has practical tips and resources for addressing health issues they are facing. We hope to ensure continuing commitment to the show by focusing on relevant health topics and presenting pragmatic health behaviors in an engaging format. Plans to sustain and improve the quality of the shows over time include: Increasing the efficiency of show production as staff experience with script development grows, and multiple shows and segments are recorded at the same time. Formally allocating staff time to show production, rather than having staff work on the shows as an extra duty not originally planned as part of their workload. We have recently redistributed staff time across grant and general fund programs to increase flexibility of staff time spent on show production and other health education tasks. Continuing to feature health department programs and staff in the shows. This assists these programs with marketing their services and maintains internal support for show production. Continuing to include community members in the shows. This increases viewership, buy-in, and modeling effects among target audience members, and maintains a personal connection with the community. The shows will assist with leveraging resources as almost every health issue and program addressed on the shows can benefit from mass exposure. This increases the reach and impact (‘bang-for-the-buck’) of most outreach and marketing efforts, and will be included in relevant grant proposals, program descriptions, and promotional materials.
 
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