IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0209969.html
   My bibliography  Save this article

The effectiveness of using entertainment education narratives to promote safer sexual behaviors of youth: A meta-analysis, 1985-2017

Author

Listed:
  • Victor Orozco-Olvera
  • Fuyuan Shen
  • Lucie Cluver

Abstract

Background: Risky sexual behaviors are associated with the transmission of sexually transmitted infections (STIs) and unwanted pregnancies, both major health concerns for youth worldwide. This review studies the effectiveness of narrated mass media programs in promoting safer sexual practices among youth in developed and developing countries. Methods: Electronic and manual searches were conducted to identify experimental and quasi-experimental studies with robust counterfactual designs published between 1985 and the first quarter of 2017. Effect sizes were meta-analyzed using mixed-effects models. Results: Eight experimental and two quasi-experimental studies met our inclusion criteria. The aggregated sample size was 23,476 participants, with a median of 902 participants per study. Entertainment education narratives had small but significant effects for three sexual behaviors. It reduced the number of sexual partners [standardized mean difference, (SMD) = 0.17, 95% confidence interval (CI) = 0.02–0.33, three effect sizes], reduced unprotected sex (SMD = 0.08, 95% CI = 0.03–0.12, nine effect sizes), and increased testing and management for STIs (SMD = 0.29, 95% CI = 0.11–0.46, two effect sizes). The interventions were not effective in reducing inter-generational sex, measured through the age-gap with sexual partners (SMD = 0.06, 95% CI = -0.06–0.19, four effect sizes). Entertainment education had medium-size effects on knowledge outcomes (SMD = 0.67, 95% CI = 0.32–1.02, seven effect sizes), where a time-decay relationship is observed. No effects were found on attitudes. Conclusion: Although mass media entertainment had small effects in promoting safer sexual practices, its economies of scales over face-to-face interventions suggest its potential to be a cost-effective tool above an audience threshold. The use of study participants from the general youth population and the use of mostly effectiveness trials mitigate concerns regarding its scalability. The overall paucity of high-quality studies affirms the need for strengthening the evidence base of entertainment education. Future research should be undertaken to understand the moderator effects for different subgroups and intervention characteristics.

Suggested Citation

  • Victor Orozco-Olvera & Fuyuan Shen & Lucie Cluver, 2019. "The effectiveness of using entertainment education narratives to promote safer sexual behaviors of youth: A meta-analysis, 1985-2017," PLOS ONE, Public Library of Science, vol. 14(2), pages 1-14, February.
    • Handle: RePEc:plo:pone00:0209969
    DOI: 10.1371/journal.pone.0209969
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0209969
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0209969&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0209969?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Virginia A Fonner & Kevin S Armstrong & Caitlin E Kennedy & Kevin R O'Reilly & Michael D Sweat, 2014. "School Based Sex Education and HIV Prevention in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 9(3), pages 1-18, March.
    2. Pascaline Dupas, 2011. "Do Teenagers Respond to HIV Risk Information? Evidence from a Field Experiment in Kenya," American Economic Journal: Applied Economics, American Economic Association, vol. 3(1), pages 1-34, January.
    3. Stefano DellaVigna & Eliana La Ferrara, 2015. "Economic and Social Impacts of the Media," NBER Working Papers 21360, National Bureau of Economic Research, Inc.
    4. Abhijit V. Banerjee & Esther Duflo, 2009. "The Experimental Approach to Development Economics," Annual Review of Economics, Annual Reviews, vol. 1(1), pages 151-178, May.
    5. Eliana La Ferrara, 2016. "Mass Media and Social Change: Can We Use Television to Fight Poverty?," Journal of the European Economic Association, European Economic Association, vol. 14(4), pages 791-827.
    6. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
    7. de Walque, Damien & Dow, William H & Nathan, Rose & Abdul, Ramadhani & Abilahi, Faraji & Gong, Erick & Isdahl, Zachary & Jamison, Julian & Jullu, Boniphace & Krishnan, Suneeta & Majura, Albert & Migue, 2012. "Incentivising safe sex: a randomised trial of conditional cash transfers for HIV and sexually transmitted infection prevention in rural Tanzania," Department of Economics, Working Paper Series qt4vw984q0, Department of Economics, Institute for Business and Economic Research, UC Berkeley.
    8. Baird, Sarah & Gong, Erick & McIntosh, Craig & Özler, Berk, 2014. "The heterogeneous effects of HIV testing," Journal of Health Economics, Elsevier, vol. 37(C), pages 98-112.
    9. Melissa S. Kearney & Phillip B. Levine, 2015. "Media Influences on Social Outcomes: The Impact of MTV's 16 and Pregnant on Teen Childbearing," American Economic Review, American Economic Association, vol. 105(12), pages 3597-3632, December.
    10. Eliana La Ferrara, 2016. "Mass Media And Social Change: Can We Use Television To Fight Poverty?," Journal of the European Economic Association, European Economic Association, vol. 14(4), pages 791-827, August.
    11. Heckman, James, 2013. "Sample selection bias as a specification error," Applied Econometrics, Russian Presidential Academy of National Economy and Public Administration (RANEPA), vol. 31(3), pages 129-137.
    12. Cho, Yoon Y. & Kalomba, Davie & Mobarak, Ahmed Mushfiq & Orozco, Victor, 2013. "Gender Differences in the Effects of Vocational Training: Constraints on Women and Drop-Out Behavior," IZA Discussion Papers 7408, Institute of Labor Economics (IZA).
    13. Wang, H. & Singhal, A., 2016. "East Los High:Transmedia edutainment to promote the sexual and reproductive health of young Latina/o Americans," American Journal of Public Health, American Public Health Association, vol. 106(6), pages 1002-1010.
    14. Paluck, Elizabeth Levy & Green, Donald P., 2009. "Deference, Dissent, and Dispute Resolution: An Experimental Intervention Using Mass Media to Change Norms and Behavior in Rwanda," American Political Science Review, Cambridge University Press, vol. 103(4), pages 622-644, November.
    15. Legovini, Arianna & Di Maro, Vincenzo & Piza, Caio, 2015. "Impact evaluation helps deliver development projects," Policy Research Working Paper Series 7157, The World Bank.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Mayank Aggarwal & Anindya S. Chakrabarti & Chirantan Chatterjee, 2023. "Movies, stigma and choice: Evidence from the pharmaceutical industry," Health Economics, John Wiley & Sons, Ltd., vol. 32(5), pages 1019-1039, May.
    2. Donati,Dante & Orozco Olvera,Victor Hugo & Rao,Nandan Mark, 2022. "Using Social Media to Change Gender Norms : An Experiment within Facebook Messenger in India," Policy Research Working Paper Series 10199, The World Bank.
    3. W. Douglas Evans & Bonnie N Young & Michael A Johnson & Kirstie A. Jagoe & Dana Charron & Madeleine Rossanese & K Lloyd Morgan & Patricia Gichinga & Julie Ipe, 2019. "The Shamba Chef Educational Entertainment Program to Promote Modern Cookstoves in Kenya: Outcomes and Dose–Response Analysis," IJERPH, MDPI, vol. 17(1), pages 1-14, December.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Lubega, Patrick & Nakakawa, Frances & Narciso, Gaia & Newman, Carol & Kaaya, Archileo N. & Kityo, Cissy & Tumuhimbise, Gaston A., 2021. "Body and mind: Experimental evidence from women living with HIV," Journal of Development Economics, Elsevier, vol. 150(C).
    2. Banerjee,Abhijit & La Ferrara,Eliana & Orozco Olvera,Victor Hugo, 2019. "The Entertaining Way to Behavioral Change : Fighting HIV with MTV," Policy Research Working Paper Series 8998, The World Bank.
    3. Leonardo Bursztyn & Aakaash Rao & Christopher Roth & David Yanagizawa-Drott, 2020. "Misinformation During a Pandemic," Working Papers 2020-44, Becker Friedman Institute for Research In Economics.
    4. Patrick Lubega & Frances Nakakawa & Gaia Narciso & Carol Newman & Cissy Kityo, 2017. "Inspiring women: Experimental evidence on sharing entrepreneurial skills in Uganda," Trinity Economics Papers tep2017, Trinity College Dublin, Department of Economics.
    5. Bastien Michel & Samuel Kembou & Sonali Wayal & Joanna Murray, 2023. "Leveraging Mobile Phone Expansion in LMICs to Improve Parental Practices," Working Papers hal-03909663, HAL.
    6. Mayank Aggarwal & Anindya S. Chakrabarti & Chirantan Chatterjee, 2023. "Movies, stigma and choice: Evidence from the pharmaceutical industry," Health Economics, John Wiley & Sons, Ltd., vol. 32(5), pages 1019-1039, May.
    7. Jetter, Michael & Walker, Jay K., 2022. "News coverage and mass shootings in the US," European Economic Review, Elsevier, vol. 148(C).
    8. Leonardo Bursztyn & Ingar K. Haaland & Aakaash Rao & Christopher P. Roth, 2020. "Disguising Prejudice: Popular Rationales as Excuses for Intolerant Expression," NBER Working Papers 27288, National Bureau of Economic Research, Inc.
    9. Jetter, Michael & Walker, Jay K., 2018. "The Effect of Media Coverage on Mass Shootings," IZA Discussion Papers 11900, Institute of Labor Economics (IZA).
    10. Zhang, Shiying & Wang, Qing & Xiao, Yao & Zhang, Yilin, 2023. "Internet exposure during adolescence and age at first marriage," Journal of Asian Economics, Elsevier, vol. 84(C).
    11. Ganguli, Ina & Gaulé, Patrick & Čugalj, Danijela Vuletić, 2022. "Chasing the academic dream: Biased beliefs and scientific labor markets," Journal of Economic Behavior & Organization, Elsevier, vol. 202(C), pages 17-33.
    12. Ghada Barsoum & Bruno Crépon & Drew Gardiner & Bastien Michel & William Parienté, 2022. "Evaluating the Impact of Entrepreneurship Edutainment in Egypt: An Experimental Approach," Economica, London School of Economics and Political Science, vol. 89(353), pages 82-109, January.
    13. Alex Armand & Paul Atwell & Joseph F. Gomes & Yannik Schenk, 2023. "It’s a Bird, it’s a Plane, it’s Superman! Using Mass Media to fight Intolerance," LIDAM Discussion Papers IRES 2023012, Université catholique de Louvain, Institut de Recherches Economiques et Sociales (IRES).
    14. Mougin, Elisa, 2024. "TV in times of political uncertainty: Evidence from the 2017 elections in Kenya," Journal of Development Economics, Elsevier, vol. 166(C).
    15. Cassidy, Rachel & Groot Bruinderink, Marije & Janssens, Wendy & Morsink, Karlijn, 2021. "The power to protect: Household bargaining and female condom use," Journal of Development Economics, Elsevier, vol. 153(C).
    16. Leonardo Bursztyn & Aakaash Rao & Christopher Roth & David Yanagizawa-Drott, 2023. "Opinions as Facts," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 90(4), pages 1832-1864.
    17. Chadi, Adrian & Hoffmann, Manuel, 2021. "Television, Health, and Happiness: A Natural Experiment in West Germany," IZA Discussion Papers 14721, Institute of Labor Economics (IZA).
    18. Alan Manning & Paolo Masella, 2018. "Diffusion of Social Values Through the Lens of US Newspapers," CEP Discussion Papers dp1559, Centre for Economic Performance, LSE.
    19. David Mmopelwa & Oliver Morrissey & Trudy Owens, 2021. "HIV/AIDS and sexual behaviour in Botswana," Discussion Papers 2021-03, University of Nottingham, CREDIT.
    20. Ganguli, Ina & Gaule, Patrick & Čugalj, Danijela Vuletić, 2020. "Biased Beliefs and Entry into Scientific Careers," IZA Discussion Papers 13475, Institute of Labor Economics (IZA).

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0209969. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.