'Spyt kom te laat The development and evaluation of a health-related fotonovela about methamphetamine ('tik) use in the Western Cape and Northern Cape provinces of South Africa

[摘要] ENGLISH SUMMARY: The aim of this research project was to establish if and why fotonovelas can be an effective messaging tool to communicate the dangers associated with using methamphetamine ('tik) to Coloured communities in the Western Cape and Northern Cape provinces of South Africa and persuade them to avoid this drug. A health-related fotonovela about tik, 'Spyt kom te laat (Regret comes too late), was developed for this purpose using an entertainment-education approach involving a six-step production process, incorporating inputs from the target audience and subject field experts. Fear appeal characteristics were added to help improve the fotonovela's effectiveness. Two related studies were performed to evaluate the impact of the fotonovela.One study (N = 303) was a randomized controlled trial that compared the effects of three message conditions (a group who read the fotonovela, a group who read a traditional brochure, and a no message control group) in a between-groups experimental design. The results did not show knowledge gain in the fotonovela group to be significantly higher compared to the traditional brochure group. When compared to the control condition, both health documents did have a positive and significant effect, however, on knowledge level for those questions that did not show ceiling effects. The effects of the two health documents did not differ in terms of respondents' attitudes. Nonetheless, intention related to interpersonal discussions of tik health messages was found to be significantly higher for those respondents in the fotonovela condition compared to those respondents in the traditional brochure condition. The results did not show attitudes and intentions in the fotonovela and traditional brochure group to be significantly higher compared to the control group. The Extended Parallel Process Model (Witte, 1992, 1998), the Entertainment Overcoming Resistance Model (Moyer-Gusé, 2008), as well as theoretical assumptions about the arousal of emotions (fear, surprise, anger, sadness and compassion) from reading the fotonovela were applied to come up with explanations for differences in participants' attitudes and intentions. The fear appeal elements threat and self-efficacy showed promise for possibly affecting attitudes related to personal health behaviour, while the emotions sadness and compassion were significant and positive predictors of intentions and attitudes related to interpersonal discussions of tik health messages, respectively. In terms of message preference, about twice as many respondents said that they preferred reading health information about tik in fotonovela format over the traditional brochure, with a clear preference for the fotonovela in the 19 years and younger and in the 35 years and older age groups. The other study was explorative in nature. In this study, the fotonovela and traditional brochure were placed in the waiting room of a primary health care clinic to measure actual preference for either document as health communication tool. In performing this study – the first of this type ever – some instructive practical problems were experienced that could not all be solved. Nevertheless, there seem to be sufficient grounds to conclude that patients preferred to take home the fotonovela over the traditional health brochure. However, this preference will have to be put to the test again in follow-up studies. The appearance of the fotonovela was highlighted as the main motivating factor as to why patients decided to read the fotonovela, while patients who chose to read the traditional brochure did so mainly because they wanted to learn more about the health subject matter. Participants who read the fotonovela remembered aspects of the storyline best, whereas readers of the traditional brochure mainly recalled health information associated with tik.Based on the preference for the fotonovela over the traditional brochure found in both studies, and on the comparable knowledge and behavioural intentions that were identified after people had actually read the information in one of these formats, it is recommended that document designers consider using fotonovelas as a health communication tool dealing with tik or similar subjects. In order to help enhance the persuasiveness of such a fotonovela, adding fear appeal characteristics to such a health document and incorporating elements to try to arouse the emotions sadness and compassion can also be considered. Furthermore, it appears that combining fotonovelas with elements from traditional brochures may increase the chances of the included health messages reaching audiences. Therefore, further research is warranted into the efficacy of, and preferences for fotonovelas that incorporate features of traditional health brochures – or the other way around.

[发布机构] Stellenbosch University