Reel Talk: Using Storytelling to Improve Sexual Health In African American Girls

Background:  The goal of improving sexual health outcomes among African American youth is lofty but, with the proper tools, achievable. Though a number of effective sexual health programs exist their reach is limited. Crossing the divide between science and public practice can be aided by attaching health messages to emerging technologies favored by the target audience. Entertainment-Education (E-E) is a field that capitalizes on this notion by purposefully integrating health promotion messages into entertaining media content. The most effective E-E programs are accomplished in three steps: formative research/development, implementation, and evaluation. This study used a participatory approach during the formative phase to enhance the contextual relevance of material while simultaneously engaging participants to health promotion activities.  

Program background:  The Reel Talk program was the first phase of a pilot study that examined the usefulness of an E-E based HIV prevention web series targeting early adolescent African American girls. 

Evaluation Methods and Results:  Participants in Reel Talk were members of a community-based youth performing arts group in a southeastern urban city. A total of eight participants, ranging in age from 12 to 18, attended four focus groups. During the sessions, participants discussed teen sexual relationships, used storytelling to create positive and negative sexual relationship narratives, and considered how popular media informed their sexual and relationship expectations. A thematic analysis of the focus groups revealed that teens were highly attuned to media and looked to television shows to guide their sexual relationship expectations. Elements of positive relationships included mutually desired, drug-free sexual interactions, monogamy, respect, and family support. Negative relationships included drug use, intimate partner violence, and unfaithfulness. Consequences of both positive and negative relationships included pregnancy due to a low rate of condom use and emotional distress related to the end of the relationship.

Conclusions:  The storytelling process revealed social, familial and individual contexts that shaped sexual risk taking. The process of creating the story in a group resulted in a fluid narrative that changed in shape over time. This permitted participants to “try out” behaviors and immediately process their outcome. This resulted in realistic assessments of the benefits and consequences of adolescent sexual relationships. The participants reported being highly receptive to and influenced by entertaining media. However, they reported that there were very few examples of African American characters available. As a result, the participants frequently referenced syndicated shows that were originally broadcast up to fifteen years prior. This left a noticeable void in their media diets and they reported a desire to see characters and situations that could better prepare them for romantic relationships. 

Implications for research and/or practice:  Entertaining media successfully reaches teen audiences yet there is a lack of representative media for this target group. This leaves a gap that E-E strategies can fill. A participatory E-E approach can enrich newly developed media while simultaneously informing its participants of healthy behaviors. This loop, cycling from participatory content creation to targeted content consumption, may prove to be an effective tool for promoting healthy sexual behaviors among African American girls.