AJPH PERSPECTIVES East Los High:Transmedia Edutainment to Promote the Sexual and Reproductive Health of Young Latina/o Americans Hua Wang, PhD, and Arvind Singhal, PhD Latina/o Americans are at high risk for sexually transmitted infections and adolescent strategic design elements of East Los High’s pregnancies. Needed urgently are innovative health promotion approaches that are season 1 programming and we have reported engaging and culturally sensitive. East Los High is a transmedia edutainment program the research methods used for program aimed at young Latina/o Americans. It embeds educational messages in entertainment evaluation along with a discussion about the fi narratives across digital platforms to promote sexual and reproductive health. We key ndings and implications for designing sexual and reproductive health interventions employed online analytics tracking (2013–2014), an online viewer survey (2013), and for Latina/o youths. a laboratory experiment (El Paso, TX, 2014) for season 1 program evaluation. We found that East Los High had a wide audience reach, strong viewer engagement, and a positive cognitive, emotional, and social impact on sexual and reproductive health communi- cation and education. Culturally sensitive transmedia edutainment programs are a promising health promotion strategy for minority populations and warrant further LITERATURE REVIEW Although storytelling has served as a ve- investigation. (Am J Public Health. 2016;106:1002–1010. doi:10.2105/AJPH.2016. hicle for recreation, instruction, and trans- 303072) formation for thousands of years, only in recent decades has it been used in enter- tainment media for health promotion— atina/os are the largest and fastest- Latina/o youths.4 Current interventions a field of scholarship and practice known as Lgrowing racial/ethnic minority in the are targeted predominantly at African “entertainment–education” or “edutain- United States.1 Per US Census Bureau pro- Americans and tied largely to school-based ment.”9,10 Edutainment programs in- jections, 25% of American adolescents will programs, and their effectiveness is limited.3 creasingly supplement and complement be Latina/o by 2020.2 These changing de- Innovative and culturally sensitive health traditional public health interventions. In the mographics have significant implications for promotion approaches for Latina/o youths early days of edutainment, radio and televi- public health. Although risky sexual behav- are urgently needed.4,8 East Los High is such sion dramatic serials were designed and iors among American youths have declined a sexual and reproductive health intervention. broadcast in Latin America, Asia, and Africa since 1990, Latina/o youths have higher rates Incorporating an online drama series and to entertain and educate on a variety of 9,10 of sexually transmitted infections and un- several narrative extensions across multiple topics. Using fictional melodramatic intended pregnancies than do other racial/ digital platforms, East Los High followed the narratives, they educated audiences about 3,4 – ethnic groups. One in 3 Latina adolescents principles of entertainment education and contraceptive methods and modeled positive become pregnant before age 20 years—1.5 transmedia storytelling to reach, engage, sexual attitudes and behaviors; thus, they have fl times the national average.2 This is not sur- and in uence young Latina/o Americans improved the sexual and reproductive health 9,10 prising considering that only about half of regarding adolescent pregnancy prevention of millions in developing countries. sexually active Latina/o adolescents reported and better sexual and reproductive health. However, edutainment programs in using a condom during their last sexual in- We set up the context of this project after North America and Europe face stiff com- a review of transmedia edutainment, in- petition in their media-saturated environ- tercourse, and only 1 in 7 used birth control 11 5 cluding its theoretical foundations in narrative pills or other contraceptives. Latina adoles- ments. To earn audience ratings, sexual engagement and persuasion. We analyzed the content on commercial channels is usually cent mothers bear the greatest burden of higher order and rapid repeat pregnancies.6 Poverty, school dropout, and limited health ABOUT THE AUTHORS Hua Wang is with the Department of Communication and the Department of Community Health and Health Behavior, care access also affect young Latina/o University at Buffalo, The State University of New York. Arvind Singhal is with the Department of Communication, The Americans, exacerbating disparities in sexual University of Texas at El Paso, and the Faculty of Business Administration, Hedmark University College, Rena, Norway. and reproductive health.7 Correspondence should be sent to Hua Wang, 359 Baldy Hall, Department of Communication, University at Buffalo, Buffalo, NY 14260 (e-mail: [email protected]). Reprints can be ordered at http://www.ajph.org by clicking the “Reprints” link. Despite the high risks, there is a dearth This article was accepted January 7, 2016. of effective health interventions tailored to doi: 10.2105/AJPH.2016.303072 1002 Perspectives From The Social Sciences Peer Reviewed Wang and Singhal AJPH June 2016, Vol 106, No. 6 AJPH PERSPECTIVES highly explicit, often inaccurate, and com- space.18 In addition, narratives resonate par- Among the main characters are Jacob, monly devoid of discussion about risks and ticularly well with audience members when a graduating senior and popular football associated consequences.12 To overcome they perceive the stories to be realistic and can player; Jessie, an intelligent, attractive junior these challenges, several institutions (e.g., identify with the characters on the basis who secretly admires Jacob and is new to Hollywood Health & Society in the United of existing similarities or desirable attri- the school’s Bomb Squad dance team; Maya, States) have given creative writers and pro- butes.16,19,20 Furthermore, theories of cul- Jessie’s cousin, a troubled runaway who ducers the knowhow to accurately portray turecentric health promotion emphasize that takes refuge in Jessie’s home and quickly critical health information in the popular narratives built with familiar cultural markers becomes Jacob’s heartthrob; Ceci, a lead 10 media. are especially effective when targeting mi- dancer in the Bomb Squad, who is sexually Transmedia storytelling is an innovative nority populations.8,21 active, becomes pregnant, and finds her life 10 media programming trend. Instead of tell- Recent meta-analyses have demonstrated turned upside-down; and Vanessa, captain of ing the story in a single medium, narrative the advantages of using narratives in health the Bomb Squad, who trades sex for favors elements are creatively coordinated across interventions. Narratives have a sizably sig- and discovers she is HIV positive. The plot “ different media platforms (hence trans- nificant impact on combined changes in at- simmers when Jessie, a member of the ” “ ” media ) to build a story world, engage titudes, intention, and behavior, even though virgin club, is forced to disclose her secret a broader spectrum of audience, and provide they have a relatively small effect size in in- as things get hot between her and Jacob. them an enriching experience beyond pure dividual outcomes. Narratives are powerful Maya, scarred by a past rape, rebuilds her 13,14 entertainment. Inspired by the com- interventional tools for eliciting affective life through work in a restaurant owned by ’ mercial success of transmedia in entertain- audience response, and evidence suggests that Jacob s father. Ceci, deserted by her boyfriend ment franchises such as Star Wars, some those delivered through audio and video are when she becomes pregnant, considers transmedia producers are now collaborating more effective than are those delivered abortion but decides to keep her child. with nongovernmental organizations 22,23 Vanessa, jealous and vengeful, orchestrates through print. Moreover, empirical (NGOs) and public health professionals to Jessie’s seduction and repents as she copes studies show that narrative-based in- create prosocial programs. For young audi- with HIV. terventions effectively reduce health dispar- ence members, who are savvy entertainment Furthermore, East Los High is the first ities for racial/ethnic minority groups.24 consumers and can easily navigate multiple transmedia program purposefully designed Narrative persuasion theories guided East Los digital platforms, transmedia edutainment as edutainment to tackle sexual and re- High program development in terms of holds promise as a health promotion and productive health issues. Some commercial character building and content production education interventional tool.10 franchises created such transmedia experi- and its program evaluation in terms of ences for their audience members. A notable choosing key measures and hypotheses. example was The Matrix, in which the overarching storyline was conveyed through THEORETICAL FOUNDATIONS the movie trilogy and a series of animations, 14 Edutainment programs are grounded in EAST LOS HIGH PROGRAM comic books, and a video game tie-ins. theories of narrative persuasion that explain The interwoven transmedia tapestry made the factors and processes that facilitate changes DEVELOPMENT a richer story world, deepening the audience’s in audience members’ knowledge, attitudes, At least 3 aspects of East Los High set it apart relationship with the characters,