The "Weight of the Nation in American Samoa: Studying a Mass Media Health Campaign's Reach and Effect and Developing Audience Segmentation Profiles in American Samoa"

Theoretical Background and research questions/hypothesis:  This 2015 health communications intervention research project in the South Pacific U.S. territory of American Samoa involved a public television broadcast of the HBO produced mass media health campaign, The Weight of the Nation (TWOTN), followed by a reach and effect and target audience segmentation survey. American Samoa suffers one of the highest levels of obesity and associated chronic disease in the world, and the problem continues to grow; yet no mass media health campaigns to combat this problem have yet been locally produced. The two overarching research questions are: 1) How useful (feasible, effective, and appropriate) is importing U.S. based health campaigns, such as TWOTN, to American Samoa; and 2) What social determinants and audience segmentations that would inform the design of future obesity health campaigns in American Samoa? The current sutdy is is informed by media reach and effect research, translation research, theory of action, and the health communications environment framework.

Methods:  The researcher partnered with American Samoa’s only public access television station, KVZK-TV, and sought and received permission from HBO for KVZK to broadcast the TWOTN series twice. A survey of a random representative sample of American Samoan households followed the second broadcast, assisted by American Samoan college students who were trained and organized into survey interview teams. The instrument was a bi-lingual questionnaire containing sixty four questions that sought quantitative and qualitative information on the broadcast’s reach and effect, demographic variables, people’s media behaviors, knowledge of obesity’s health risks, perceptions of their health status, lifestyle behaviors and effort levels and challenges to living healthfully in American Samoa. 

Results:  About 12% of American Samoa’s 55 thousand residents reported watching some part of the broadcast, which occurred during non prime time slots. All respondents reported a positive viewing experience and claimed healthy effects on their and their household’s behaviors (e.g. increasing fruit and vegetable consumption and physical activity). Most respondents understood most health risks associated with obesity, self-reported less than healthy lifestyles, and discussed their efforts and challenges to live healthfully in American Samoa. Barriers or challenges described include various socio-cultural practices and values, and the food and physical environment. The research also found that many American Samoans, particularly the poorer ones, do the healthy option of growing and/or fishing to fulfill some of their food needs. 

Conclusions:  U.S. based mass media television health campaigns, such as TWOTN, imported to American Samoa may reach and effect American Samoan audiences; but public local television in American Samoa prioritizes locally produced Samoan or bi-lingual programming. This study points to the need to invest, despite the resources required, in the development of strategic, evidence based, socially marketed, long term mass media campaigns in American Samoa that target its residents and government with appropriate messages and in appropriate language, to affect changes that will facilitate a reversal of American Samoa's obesity and NCD epidemics.

Implications for research and/or practice: More research, using focus groups, is needed to define the scope, themes, imagery, sounds, stories and messages that will comprise the strategic mass media health campaigns to combat American Samoa’s obesity epidemic.