1,2 By 2020, as per Census projections, 25% of American teens will be Latina/o.
3These changing demographics hold significant implications for public health. Although risky sexual behaviors among American youth have declined since 1990, Latina/o youth have higher rates of sexually transmitted infections (STIs) and unintended pregnancies than other racial/ethnic groups. [4][5][6] One in 3 Latina teens become pregnant before the age of 20, 1.5 times the national average. 3 This is not surprising as only about half of sexually active Latina/o teens reported using a condom during their last intercourse, and only 1 in 7 used birth control pills or other contraceptives. 7 Latina teen mothers bear the greatest burden of higher order and rapid repeat pregnancies. Edutainment programs are also grounded in social cognitive theory, an agentic framework of psychosocial change with a dual path of influence: direct exposure to media models and indirect social learning through interpersonal discussions. 27 The transportation-imagery model posits that narratives can be highly immersive, prompting 6 the audience to pay attention, generate mental imagery of a prospective potentiality, and transport them into a world of different time and space. 28 In addition, narratives resonate particularly well with the audience when they perceive the stories to be realistic and can identify with the characters based on existing similarities or desirable attributes. 26,29,30 Further, theories of culture-centric health promotion emphasize that narratives built with familiar cultural markers are especially effective when targeting minority populations.
12,31Recent meta-analyses have demonstrated the advantages of using narratives in health interventions: Narratives have a sizable significant impact on combined changes in attitudes, intention, and behavior, even if they have a relatively small effect size in individual outcomes. Narratives are powerful interventional tools for eliciting affective audience response; and evidence suggests that those delivered through audio and video are more effective than print. [32][33][34] Moreover, empirical studies show supporting evidence of narrative-based interventions for racial/ethnic minority groups to reduce disparities.
35-37Narrative persuasion theories guided the ELH program development (in terms of character building and content production) and its program evaluation (in terms of choosing key measures and hypotheses).
ELH PROGRAM DEVELOPMENTAt least 3 unique aspects of ELH set it apart from popular series such as Degrassi completed the study. They were randomly assigned to 1 of the following conditions. Condition 1 (n=30) was a true control group without any intervention. Condition 2 (n=21) was a non-dramatic text version of ELH presented as a newspaper story.Condition 3 (n=21) was a dramatic text version, presented as an ELH script. Condition 4 (n=32) was an online drama, presented as an abbreviated version of ELH Hulu series.Condition 5 (n=32) was a transmedia version, presented as the online dra...