Telenovela Style Educational Video to Promote Medicare's Drug Benefit Subsidy Program Among the Hispanic Population

Background: How to effectively inform Hispanic seniors and their influential familial caregivers about Medicare’s Low Income Subsidy (LIS) program was a unique challenge for the Centers for Medicare & Medicaid Services (CMS). Largely an immigrant population, many Hispanics ages 65 and older face cultural and language barriers. U.S. Census data show that an estimated 65 percent speak English less than “very well,” and almost 20 percent live in poverty. Many live with—and often rely on—relatives for health information needs.

Program background: Audio-visual formats with identifiable characters and cultural appeal have proven to be effective tools to educate Hispanic seniors on important issues. However, the cost of TV advertisements in national Hispanic media has skyrocketed. As a solution, the telenovela style educational video project was developed as part of a Spanish-language multi-media and educational campaign to encourage Hispanic seniors to enroll in the LIS program.

Evaluation Methods and Results: To identify the key message(s) that would affect the target audiences’ behaviors and lead them to take action regarding the LIS benefit, focus group testing with both Hispanic seniors and caregivers was conducted. Two messages/concepts tested were ranked as the preferred motivators. However, all four tested relatively positive for different reasons. The focus group findings confirmed that the target audiences prefer an audiovisual format, particularly novelas (soap-operas) style. The findings also showed that many Hispanic seniors tend to go to community centers and hospitals for help in understanding their health insurance needs. Telephone interviews were conducted with community-based organizations and Promotoras/es (community health workers) serving Hispanic seniors to better understand how they could support the project and help achieve its objectives.  Based on these findings, CMS created an 8-minute novela type Spanish- language video addressing the focus-group-tested messages in an appealing and culturally sensitive story format, which was well-received by both seniors and caregivers. The video tells the story of how the García family (fictional but typical) learned about the extra help they could receive in paying for their prescription drugs through the LIS program and how to enroll. The story shows how the family is affected by changing health care costs. The project included public screenings of the video at educational events and/or information sessions held in partnership with CBOs in heavily Spanish-speaking communities, and where CMS outreach specialists and their partners could support. Through these events, attendance and applications were tracked. Other promotional activities included customizable print media ads featuring the video’s main characters, a 60-second video trailer posted on the CMS website primarily for Internet-savvy caregivers, and concurrent/parallel e-mail and telephone campaigns in other cities with a high concentration of Hispanic seniors.

Conclusions: The telenovela style educational video was a success because of the careful research done to understand the target audience, a well-crafted dissemination plan and its rapid implementation, bilingual/bicultural expertise, and its high production value.

Implications for research and/or practice: These considerations need to be taken into account for multi-media and outreach campaigns targeted to future Hispanic Medicare beneficiaries--who will grow in numbers as "baby boomers" age into Medicare and have different demographic and lifestyle characteristics.