"Soap operas as a platform for disseminating health information regarding ART and the use of 'reel' versus 'real' role models"
- Authors: Deiner, Catherine Anne
- Date: 2015
- Subjects: Isidingo (Television program) , Television soap operas -- South Africa , Health in mass media , Mass media in health education -- South Africa , Antiretroviral agents -- South Africa , Public health -- Moral and ethical aspects , HIV-positive women -- South Africa -- Grahamstown
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:3542 , http://hdl.handle.net/10962/d1017783
- Description: The media, through development communication and edutainment, plays a critical role in the transformation of societies. In line with this, this thesis discusses the extent to which commercially driven prosocial soap operas can provide a platform for public health messaging, in the context of the HIV/AIDS epidemic in South Africa, for antiretroviral treatment (ART) and for encouraging ART adherence to foster national development. Furthermore, this thesis examined the potential of celebrities as HIV/AIDS ambassadors and the potential of both fictional characters and ‘real-life’ celebrities to disseminate these health messages. Although the HIV/AIDS epidemic in South Africa is stabilising, this is not the time to relax the communication around the disease, particularly regarding adherence to ARVs, considering that South Africa has the largest ARV rollout in the world. The qualitative methodological approach taken for this thesis is a three-step approach examining the intended message, the text and the appropriated message by viewers. Firstly, a thematic content analysis of an episode of Isidingo, that illustrated Nandipha as HIV-positive and the side-effects that came with her ART adherence, and the 3Talk interview with Lesego Motsepe, where she announced that she was weaning herself off ART, was done in order to understand the intended health messaging in the soap opera and the health message disseminated by an HIV-positive actress with regards to ART. Thereafter interview responses by the production team as well as by HIV-positive viewers, using ARVs, were thematised. In addition media texts which provided commentary on the use of a celebrity as a HIV-positive role model were examined. In doing this, this thesis has offered up the meanings of how HIV-positive women taking ARVs and living in Makana experience and understand the media, particularly health messaging relating to ARVs. The findings of this study suggest that commercial soap operas are the perfect platform to address HIV/AIDS and that prosocial health messaging regarding ARV adherence is still necessary in this country. Soap operas have the potential to have an educational angle. Although, HIV-positive individuals serve as better role models as they are authentic; given human nature, fictional characters, such as Nandipha Matabane in Isidingo, may be more sustainable role models as their message can be scientifically-based and well-researched. Realistic characters serve as role models whose behaviour is to be emulated. Soap operas appeal to a wide audience and so storylines can be tailor-made according to the times and the needs in terms of health issues and messaging. Thus, soap operas are not a single platform but rather one which can be exploited to maximum advantage for public health messaging.
- Full Text:
- Authors: Deiner, Catherine Anne
- Date: 2015
- Subjects: Isidingo (Television program) , Television soap operas -- South Africa , Health in mass media , Mass media in health education -- South Africa , Antiretroviral agents -- South Africa , Public health -- Moral and ethical aspects , HIV-positive women -- South Africa -- Grahamstown
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:3542 , http://hdl.handle.net/10962/d1017783
- Description: The media, through development communication and edutainment, plays a critical role in the transformation of societies. In line with this, this thesis discusses the extent to which commercially driven prosocial soap operas can provide a platform for public health messaging, in the context of the HIV/AIDS epidemic in South Africa, for antiretroviral treatment (ART) and for encouraging ART adherence to foster national development. Furthermore, this thesis examined the potential of celebrities as HIV/AIDS ambassadors and the potential of both fictional characters and ‘real-life’ celebrities to disseminate these health messages. Although the HIV/AIDS epidemic in South Africa is stabilising, this is not the time to relax the communication around the disease, particularly regarding adherence to ARVs, considering that South Africa has the largest ARV rollout in the world. The qualitative methodological approach taken for this thesis is a three-step approach examining the intended message, the text and the appropriated message by viewers. Firstly, a thematic content analysis of an episode of Isidingo, that illustrated Nandipha as HIV-positive and the side-effects that came with her ART adherence, and the 3Talk interview with Lesego Motsepe, where she announced that she was weaning herself off ART, was done in order to understand the intended health messaging in the soap opera and the health message disseminated by an HIV-positive actress with regards to ART. Thereafter interview responses by the production team as well as by HIV-positive viewers, using ARVs, were thematised. In addition media texts which provided commentary on the use of a celebrity as a HIV-positive role model were examined. In doing this, this thesis has offered up the meanings of how HIV-positive women taking ARVs and living in Makana experience and understand the media, particularly health messaging relating to ARVs. The findings of this study suggest that commercial soap operas are the perfect platform to address HIV/AIDS and that prosocial health messaging regarding ARV adherence is still necessary in this country. Soap operas have the potential to have an educational angle. Although, HIV-positive individuals serve as better role models as they are authentic; given human nature, fictional characters, such as Nandipha Matabane in Isidingo, may be more sustainable role models as their message can be scientifically-based and well-researched. Realistic characters serve as role models whose behaviour is to be emulated. Soap operas appeal to a wide audience and so storylines can be tailor-made according to the times and the needs in terms of health issues and messaging. Thus, soap operas are not a single platform but rather one which can be exploited to maximum advantage for public health messaging.
- Full Text:
Illustrated medicines information for HIV/AIDS patients: influence on adherence,self-efficacy and health outcomes
- Authors: Barford, Kirsty-Lee
- Date: 2012
- Subjects: AIDS (Disease) -- Treatment -- South Africa , HIV infections -- Treatment -- South Africa , AIDS (Disease) -- Patients -- South Africa , HIV-positive persons -- South Africa , AIDS (Disease) -- Study and teaching -- South Africa , Antiretroviral agents -- South Africa , Communication in medicine -- South Africa , Communication in public health -- South Africa
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:3863 , http://hdl.handle.net/10962/d1015678
- Description: South Africa has an estimated 920 000 patients on antiretrovirals (ARVs), the largest number of patients in any country. ARV therapy demands adherence levels in excess of 95% to avoid development of drug resistance, but adherence to ARV therapy is estimated to be only between 50% and 70%. Poor medication adherence is acknowledged as a major public health problem, reducing the effectiveness of therapy and promoting resistance to ARVs. More than two thirds of the South African population have marginal reading skills and this significantly influences a patient’s ability to read and understand health-related information. Patient education materials tailored for the South African population could be a useful aid in facilitating communication with patients and perhaps impact positively on their medicine-taking behaviour. This behaviour is influenced by patient knowledge, beliefs, attitudes and expectations and includes self-management, self-efficacy and adherence. Self-efficacy, which refers to patient confidence in the ability to self-manage medicine taking, is a key factor influencing adherence. This study aimed to develop illustrated patient information leaflets (PILs) and medicine labels for all first-line ARV regimens used in the public health sector in South Africa and, using a randomised control study design, to investigate the impact of these illustrated information materials on knowledge, medication-taking behaviours and health outcomes in HIV/AIDS patients taking ARVs. To achieve this aim, the objectives were to assess HIV/AIDS and ARV-related knowledge, as well as self-efficacy and adherence to ARV therapy; to assess the influence of demographic variables on knowledge, adherence and self-efficacy; to assess the influence of the information materials on knowledge, self-efficacy and adherence and to assess the association of knowledge with health outcomes. Medicine labels and PILs, both English and isiXhosa, were developed for ARV regimens 1a, 1b, 1c and 1d. The 8-item Morisky Medication Adherence Scale (MMAS-8) and HIV Treatment Adherence Self Efficacy Scale (HIV-ASES) instruments for measuring respectively adherence and self-efficacy, were modified to optimize clarity, simplicity and cultural acceptability and were translated into isiXhosa using a multi-stage translation-back translation. The questions and the rating scales, for both the MMAS and HIV-ASES, underwent preliminary qualitative evaluation in focus group discussions. Patients were recruited from local Grahamstown clinics. A pilot study to evaluate applicability of the instruments was conducted in 16 isiXhosa AIDS patients on ARVs and the results from this study informed further modifications to the instruments. One hundred and seventeen patients were recruited for the randomised control trial and were randomly allocated to either control group (who received standard care) or experimental group (who received standard care as well as pictogram medicine labels and the illustrated PIL). Interviews were conducted at baseline and at one, three and six months. Data were analysed statistically using the t-test, chi-squared test and ANOVA (Analysis of Variance) at a 5% level of significance. Correlations were determined using Pearson and Spearman rho correlations. Approval was obtained from Rhodes University Ethical Standards Committee, Settlers Hospital Ethics Committee and the Eastern Cape Department of Health. The results of this research showed that illustrated PILs and medicine labels enhanced understanding of HIV/AIDS and ARV information, resulting in a mean overall knowledge score in the experimental group of 96%, which was significantly higher than the 75% measured in the control group. Variable knowledge scores were measured in three areas: baseline knowledge of general HIV/AIDS-related information was good at 87%, whereas knowledge scores relating to ARV-related information (60%) and side-effects (52%) were lower. These scores improved significantly in the experimental group over the 4 interviews during the 6 month trial duration, whereas in the control group, they fluctuated only slightly around the original baseline score. There was no significant influence of gender on knowledge score, whereas health literacy, education level and age tested (at one and three months) had a significant influence on knowledge. Self-efficacy and adherence results were high, indicating that the patients have confidence in their ability to adhere to the ARV therapy and to practice optimal self-care. Age, gender and education, in most cases, significantly influenced self-efficacy, but were found to have no effect on adherence. The CD4 count improved over the trial duration which may have been influenced by a number of factors, including better knowledge of ARVs and improved adherence. No significant parametric correlation was found between knowledge score and change in CD4 count, however, Spearman's rho showed significance (rs=0.498; p=0.022). Both patients and healthcare providers were highly enthusiastic about the illustrated labels and PILs, and indicated their desire for such materials to be routinely available to public sector HIV/AIDS patients. The isiXhosa version of the PIL was preferred by all the patients. These simple, easy-to-read leaflets and illustrated medication labels were shown to increase understanding and knowledge of ARVs and HIV/AIDS in low-literate patients, and their availability in the first-language of the patients was central to making them a highly useful information source.
- Full Text:
- Authors: Barford, Kirsty-Lee
- Date: 2012
- Subjects: AIDS (Disease) -- Treatment -- South Africa , HIV infections -- Treatment -- South Africa , AIDS (Disease) -- Patients -- South Africa , HIV-positive persons -- South Africa , AIDS (Disease) -- Study and teaching -- South Africa , Antiretroviral agents -- South Africa , Communication in medicine -- South Africa , Communication in public health -- South Africa
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:3863 , http://hdl.handle.net/10962/d1015678
- Description: South Africa has an estimated 920 000 patients on antiretrovirals (ARVs), the largest number of patients in any country. ARV therapy demands adherence levels in excess of 95% to avoid development of drug resistance, but adherence to ARV therapy is estimated to be only between 50% and 70%. Poor medication adherence is acknowledged as a major public health problem, reducing the effectiveness of therapy and promoting resistance to ARVs. More than two thirds of the South African population have marginal reading skills and this significantly influences a patient’s ability to read and understand health-related information. Patient education materials tailored for the South African population could be a useful aid in facilitating communication with patients and perhaps impact positively on their medicine-taking behaviour. This behaviour is influenced by patient knowledge, beliefs, attitudes and expectations and includes self-management, self-efficacy and adherence. Self-efficacy, which refers to patient confidence in the ability to self-manage medicine taking, is a key factor influencing adherence. This study aimed to develop illustrated patient information leaflets (PILs) and medicine labels for all first-line ARV regimens used in the public health sector in South Africa and, using a randomised control study design, to investigate the impact of these illustrated information materials on knowledge, medication-taking behaviours and health outcomes in HIV/AIDS patients taking ARVs. To achieve this aim, the objectives were to assess HIV/AIDS and ARV-related knowledge, as well as self-efficacy and adherence to ARV therapy; to assess the influence of demographic variables on knowledge, adherence and self-efficacy; to assess the influence of the information materials on knowledge, self-efficacy and adherence and to assess the association of knowledge with health outcomes. Medicine labels and PILs, both English and isiXhosa, were developed for ARV regimens 1a, 1b, 1c and 1d. The 8-item Morisky Medication Adherence Scale (MMAS-8) and HIV Treatment Adherence Self Efficacy Scale (HIV-ASES) instruments for measuring respectively adherence and self-efficacy, were modified to optimize clarity, simplicity and cultural acceptability and were translated into isiXhosa using a multi-stage translation-back translation. The questions and the rating scales, for both the MMAS and HIV-ASES, underwent preliminary qualitative evaluation in focus group discussions. Patients were recruited from local Grahamstown clinics. A pilot study to evaluate applicability of the instruments was conducted in 16 isiXhosa AIDS patients on ARVs and the results from this study informed further modifications to the instruments. One hundred and seventeen patients were recruited for the randomised control trial and were randomly allocated to either control group (who received standard care) or experimental group (who received standard care as well as pictogram medicine labels and the illustrated PIL). Interviews were conducted at baseline and at one, three and six months. Data were analysed statistically using the t-test, chi-squared test and ANOVA (Analysis of Variance) at a 5% level of significance. Correlations were determined using Pearson and Spearman rho correlations. Approval was obtained from Rhodes University Ethical Standards Committee, Settlers Hospital Ethics Committee and the Eastern Cape Department of Health. The results of this research showed that illustrated PILs and medicine labels enhanced understanding of HIV/AIDS and ARV information, resulting in a mean overall knowledge score in the experimental group of 96%, which was significantly higher than the 75% measured in the control group. Variable knowledge scores were measured in three areas: baseline knowledge of general HIV/AIDS-related information was good at 87%, whereas knowledge scores relating to ARV-related information (60%) and side-effects (52%) were lower. These scores improved significantly in the experimental group over the 4 interviews during the 6 month trial duration, whereas in the control group, they fluctuated only slightly around the original baseline score. There was no significant influence of gender on knowledge score, whereas health literacy, education level and age tested (at one and three months) had a significant influence on knowledge. Self-efficacy and adherence results were high, indicating that the patients have confidence in their ability to adhere to the ARV therapy and to practice optimal self-care. Age, gender and education, in most cases, significantly influenced self-efficacy, but were found to have no effect on adherence. The CD4 count improved over the trial duration which may have been influenced by a number of factors, including better knowledge of ARVs and improved adherence. No significant parametric correlation was found between knowledge score and change in CD4 count, however, Spearman's rho showed significance (rs=0.498; p=0.022). Both patients and healthcare providers were highly enthusiastic about the illustrated labels and PILs, and indicated their desire for such materials to be routinely available to public sector HIV/AIDS patients. The isiXhosa version of the PIL was preferred by all the patients. These simple, easy-to-read leaflets and illustrated medication labels were shown to increase understanding and knowledge of ARVs and HIV/AIDS in low-literate patients, and their availability in the first-language of the patients was central to making them a highly useful information source.
- Full Text:
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