The Ecology of Prevention by unknow

Author:unknow
Language: eng
Format: epub
Publisher: Taylor & Francis Group
Published: 2013-08-15T00:00:00+00:00

Working Within the System

It must be noted that a shortcoming of most of the proposed strategies in this chapter is that they require the development of new programming (but see above, Sprafkin & Rubenstein), a costly endeavor, and a fight for access, a difficult fight, indeed. A martial arts metaphor quickly informs us that we cannot overcome superior force with force, but must work in the direction of that force. Some examples of working with current network fare and affiliates illustrate this principle.

Shows with high ratings, e.g., currently “Cagney and Lacey” and “Miami Vice,” have huge audiences. The depiction of the dilemmas of abortion on “Cagney and Lacey” may well have had significant impacts on that audience. Such risky efforts could be supported by letter writing campaigns to the network instigated by preventive interventionists in concert with various organizations.

An incredible public health opportunity was lost when the leading character, Sonny Crockett, on “Miami Vice” stopped smoking, but his cessation efforts and methods were not depicted on the program. Since part of the character's persona involved chainsmoking, showing how he stopped smoking, and hopefully, got over a relapse, could have been quite instructive and motivational.

These two examples indicate that with some redirection and external pressures and, hopefully, reinforcement, at least some current TV fare has considerable but largely untapped health promotion potential. The “Miami Vice” and “Cagney and Lacey” examples also indicate that health behavior change strategies and controversial health matters can be woven into a story line or become the central story of an episode or even series of episodes. These two programs, as well as a recent made-for-TV movie on a family's attempts to deal with AIDS, also illustrate commercial TV's ability to use virtually every effective element in Table 1, and format in Table 2 (positive behavior modeled and reinforced, negative behavior modeled but punished), while retaining dramatic appeal and reaching huge audiences. Such possibilities may also be magnified if a star (e.g., Bill Cosby) who has production control over a series becomes particularly interested in health promotion or other issues and can present information and strategies repeatedly within the program series.

Interventionists can attempt to exploit these seemingly “win-win” situations. For example, we can gather what is currently known about health behaviors and change strategies and have ideas on how these key points can be presented using effective elements and formats with potential program scenarios. The next step would require active collaboration with affiliate and/or network personnel.

Jason et al. (in press) have recently shown the viability of this approach. They worked with a local affiliate and community groups in Chicago on a smoking cessation media-based series. Apparently, the affiliate also benefitted from increased audience ratings and improved public relations. The Jason et al. project was able to involve over 40 worksites in this collaborative effort.

It would be incorrect to interpret this last section as suggesting that we drop our efforts at access and regulatory change. Commercial TV will not be radically transformed overnight, nor is it likely to ever reach the full potential suggested by this last section.

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