1 National HIV and AIDS Communication Survey 2006 Impact of the Television Drama Tsha Tsha D. Lawrence Kincaid Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA November 6-10 2006 Johns Hopkins Health and Education in South Africa (JHHESA) 2 (No Transcript) 3 Tsha Tsha
Weekly television drama series for
youth in the Nguni language with
Produced by CADRE in partnership
with Curious Pictures
With funding by SABC Education
and PEPFAR through USAID and
the Health Communication
Set in Lubusi a fictional rural village in the Eastern Cape.
In the dusty streets of this impoverished rural town the series follows the lives of four 20-somethings as they negotiate a bumpy course along the path to adulthood dealing with HIV and AIDS relationships sex and poverty.
4 National HIV and AIDS Communication Survey 2006 Research Team South Africa CADRE Warren Parker Benjamin Makhubele Helen Hajiyiannis Pumla Ntlabati Cathy Connolly (MRC) HDA Saul Johnson Gill Schierhout Zethu Matebeni SOUL CITY Sue Goldstein Esca Scheepers JHHESA Patrick Coleman USA JHSPH D. Lawrence Kincaid 5 Survey Research Methodology
National sample survey of men and women ages 15 to 65
Multi-stage stratified probability sample of 7006 plus a supplementary sample of 1501 in 5 local communities served by the Khomanani program.
Face-to-face interviews in each household with electronic data entry.
Data collected by AC Nielsen with funding by PEPFAR through USAID and the Health Communication Partnership and the NDoH through Health Development Africa (HDA).
Same sampling frame as the National HSRC 2005 AIDS Survey 6 Series methodology
Entertainment Education focusing on creative insightful and collaborative problem-solving in limit-situations.
Based more on deepening understanding of issues than provision of information or delivery of messages.
Educational themes or lessons are embedded in the story and encountered
in contexts of dramatic events.
The complexities of problem situations and problem solving unfold in a gradual realistic way.
7 Series methodology
A ball-room dancing club provides a metaphoric background for exploring relationships and intimacy.
Fantasy humor and entertaining secondary characters provide dramatic relief and entertainment value.
Drama promotes reflection and psychological insight as characters discover their shadows and struggle to find meaningful ways of engaging with the world.
8 HIV and AIDS ISSUES EMPHASIZED IN THE DRAMA
Community support for PLWAs
Challenges of young people
Caring for sick parents
9 Viwe spoiled relatively wealthy arrogant discovers she is HIV positive and learns to face the challenges this brings. Boniswa introspective bookish but whose heart and mind dont always follow the same path. DJ brash immature city boy exiled in Lubusi and out of tune with a world he gradually embraces. Andile struggling to care for Mother sick with AIDS and little sister talented but reluctant dancer. 10 TSHA TSHA 2-MINUTEVIDEO CLIP HERE 11 CREDITS Rolie Nikiwe Co-Director David Jammy Executive Producer Curious Pictures Johan Neethling Executive Producer SABC-Education Harriet Gavshon Executive Producer Head Script Writer Curious Pictures 12 CREDITS Warren Parker (shown) Kevin Kelly CADRE Larry Kincaid Patrick Coleman Research Senior Advisor Johns Hopkins University BSPH Health Communication Program Pumla Ntlabati CADRE 13 Research Objectives
Determine the reach and nature of the audience that watched Tsha Tsha on TV
Estimate the direct effects of exposure to the drama on HIV and AIDS Attitudes
Estimate the effects of exposure to the drama on AIDS related behavior.
Estimate the indirect effects of watching the drama on AIDS attitudes and behaviour through the identification with characters in the drama
14 Exposure to the Tsha Tsha TV Drama Percent N 7006 (15-65 years) weighted population 14137024 of 29366512 15 Number of Tsha Tsha Episodes Watched Percent Number of Episodes Watched N 7006 (15-65 years) 30 percent (weighted) 8686438 16 Number of Tsha Tsha Episodes Watched by Sex Percent Number of Episodes Watched N 7006 (15-65 years) Population (weighted) 29366512 17 Number of Tsha Tsha Episodes Watched by Youth Ages 15-24 Years Percent Number of Episodes Watched N 2814 (15-24 years) Half or more (weighted) 3983263 18 Number of Tsha Tsha Episodes Watched by Sex among Youth 15-24 Years Percent Number of Episodes Watched N 2814 (15-24 years) Population (weighted) 9518968 19 Percent who watched Tsha Tsha in the last 12 months by province N 7006 weighted 20 Percent who watched Tsha Tsha in the last 12 months by province N 7006 weighted 21 Percent who watched Tsha Tsha in the last 12 months by sex and level of education Percent Level of Education N 7006 (15-65 years) Population (weighted) 29335442 22 Measuring Prevention Behavior
Have you ever had sex before 83 (5826)
Have you had sex in the past 12 mo 83 (4844)
With the person you most recently
had sex with did you do anything
to prevent HIV infection 49 (2372)
What did you do to prevent getting
DO NOT PROMPT. MULTIPLE RESPONSE
Nothing used condoms faithful to partner
N 7006 23 Condom use to prevent HIV by sex and level of exposure to Tsha Tsha Percent Number of Episodes Watched N 4844 (15-65 years) Population (weighted) 20565661 24 Condom use to prevent HIV among youth by sex and level of exposure to Tsha Tsha Percent Number of Episodes Watched N 1610 (15-24 years) Population (weighted) 5412941 25 Percent condom use with non-regular partner last time by sex and level of exposure to Tsha Tsha Percent Number of Episodes Watched N 2385 (15-65 years) Population (weighted) 9693241 26
3. Single vs. ever married
4. Level of education
5. No children for whom youre guardian
6. Level of Living Standard (Household Items)
Poverty Lack of fuel clean water medicine food
Owns one or more television sets
9. Frequency of watching television
10. Frequency of listening to radio
11. Listens to local community radio
12. Frequency of reading newspapers
13. Frequency of reading magazines
14. Frequency of internet use
15. Currently employed or a student
16. Geotype rural urban informal formal
List of socio-economic control variables used to estimate adjusted impact of watching Tsha Tsha 27 PROPENSITY SCORE ANALYSIS Propensity score is a means to balance the treatment and control units by combining a set of predictors of being exposed into a single variable by means of multivariate logistic regression. (Rosenbaum and Rubin 1983) The propensity score is the probability of recalling the messages of a campaign as predicted by the regression of recall on a set of all possible determinants of exposure. (our 17 socio-demographic control variables) Approximates the conditions of a randomized experimental design by constructing a matched control group that is statistically equivalent to the treatment group (viewers) in terms of the probability (propensity) of watching the drama. What would have happened. . . The counter-factual condition 28 Percent using condoms to prevent HIV by any level of exposure to Tsha Tsha N 4844 4844 who have had sex in last 12 months p 29 Percent using condoms to prevent HIV by exposure to Tsha Tsha and marital status N 4844 who have had sex in last 12 months p 30 Impact of Watching Tsha Tsha Talking to others about getting an HIV test N 4844 who have had sex in last 12 months p 31 Impact of Watching Tsha Tsha Getting an HIV test N 4844 who have had sex in last 12 months p 32 Impact of Watching Tsha Tsha Knowledge of ARV treatment N 7006 p 33 Impact of Watching Tsha Tsha Caring for someone living with HIV and AIDS N 7006 p 34 Items Used to Measure Attitudes towards People Living with HIV and AIDS (Reversed Stigma)
1. Getting aids is the result of sinning.
2. It is a waste of money to train/educate someone who is HIV positive.
People who know they are HIV positive should not have sex.
I would be embarrassed to be seen with someone who everyone knows has HIV and AIDS.
When you learn that you have HIV your life is over
People with HIV will soon lose their friends.
Strongly agree (1) to strongly disagree (4) Reliability a .61 35 Median Split Low High 36 Impact of Watching Tsha Tsha Positive attitude towards PLHA (reversed stigma) N 7006 p 37 Impact of Watching Tsha Tsha AIDS telephone help services N 4844 who have had sex in last 12 months p 38 Knowledge and use of other methods to prevent getting HIV After controlling for all socio-demographic variables and the other 17 AIDS communication programs watching Tsha Tsha had no statistically significant effects on abstinence sticking to one partner and faithfulness to your partner. 39 Estimation of the cost-effectiveness of Tsha Tsha on condom use to prevent HIV 1 Joint funding by SABC-Education and USAID broadcast costs are not included but are presumed to be offset by commercial advertising. 40 Summary
Tsha Tsha was watched by almost 50 of the population ages 15-65 years 14 million viewers.
After controlling for 17 socio-economic control variables and all the other AIDS communication program Tsha Tsha was sound to have significant impact on seven important attitudes and behaviors related to HIV and AIDS.
The estimated cost of reaching each person in the Tsha Tsha audience was R1.04 and the estimated cost of each additional condom user was R16.05.
41 THANK YOU
HEALTH COMMUNICATION PARTNERSHIP
JOHNS HOPKINS HEALTH AND EDUCATION IN SOUTH AFRICA
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