UNIT 5 POSITIVE INFLUENCE OF MEDIA* Positive Influence of

Media

Structure

5.0 Introduction
5.1 Media’s Role in Health Communication
5.1.1 Why is Health Communication important?
5.1.2 Approaches to Health Communication

5.2 Media’s Role in Health Education

5.2.1 Health Education and the Mass Media
5.2.2 Why is Health Education important?
5.2.3 Health Education in India

5.3 Media’s Role in Destigmatization

5.3.1 What is Destigmatization?
5.3.2 Role of Media in Stigmatization
5.3.3 Media’s Role in Destigmatization

5.4 Case Studies: How Media Campaign Help Disseminate Information?

5.5 Summary
5.6 Keywords
5.7 Review Questions
5.8 References and Suggested Reading
5.9 Additional Online Resources

Learning Objectives

After reading this unit, you will be able to:

· explain media’s role in health communication and increasing health

awareness,
· discuss the role of media in health education, and
· elucidate media’s role in destigmatization.

5.0 INTRODUCTION
By now, you must be able to comprehend the intricacies of media
psychology, the role it plays in the field of psychology, in our lives, and the
way it has been studied and researched over the years. Apart from the fact
that it was recognized as a proper field of study after a lot of effort, it is also
clear that more attention was given to the negative effects it had on human
psychology and cognition.

*
Dr Shivantika Sharad, Department of Applied Psychology, Vivekananda College,
University of Delhi, New Delhi. 105
Persuasion and This is not surprising. We all know that psychology at large was obsessed
Influence of Media
with investigating negative aspects of human functioning for several decades,
before the advent of the Positive Psychology movement. In 1998, Martin
Seligman, then president of the American Psychological Association, chose
positive psychology as the theme during his presidency. This was a
monumental step towards the rise in focus on human strengths and virtues,
and not just their frailties and weaknesses.

So, how exactly does media fit into positive psychology? Ask yourself this,
why do you think psychologists or researchers wanted to study media effects
in the first place? Because they were concerned with the impact, it had on
human behaviour and cognition. Scholars believed that what people heard,
read, and/or saw through the means of media had major influence on them.
Such hypotheses were tested and researched upon rigorously. Many studies
established how media affects people’s thoughts, feelings and actions.

However, as we said earlier, the attention was mainly on the negative effects
it had. What would happen if the situation was reversed? What could be the
positive effects of media? Logic would suggest, if people were acquiring
violence from watching aggressive content, they could also learn altruistic
behaviour if they engaged in content that promoted altruism. This provided
an interesting point of view that researchers had not considered earlier. Thus
arose the field of Positive Media Psychology, which deals with the positive
cognitive, emotional and behavioural impact of media use. The positive
impact of media in health communication, health education, and
destigmatization forms the focus of this unit.

5.1 MEDIA’S ROLE IN HEALTH

COMMUNICATION
Media plays a dominating role in communicating information. The field of
health communication deals with the study and use of communication
strategies and approaches through which the public can be informed about
different health issues. Mass media is used to publicize useful health
information, increase public awareness about the importance of health in
development and the negative consequences of unhealthy habits and lifestyle.
Health communication also helps in maintaining important health issues on
the public agenda. The use of the multiple mass media and other
technological innovations to broadcast relevant health information to the
public, increases public awareness of individual and collective health aspects
and underscore the importance of health in development (WHO, 1996).

Health communication is not restricted to communication between the doctor

and the patient; it includes the larger aim of keeping the public aware of
various health practices. If there is a health emergency, it is important to
communicate the same in a way that everyone can understand and thus,
follow necessary precautions. Let us look at some of the health
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communication that took place during the COVID-19 pandemic. The baritone Positive Influence of
Media
voice of Bollywood super star Amitabh Bachchan was used as the caller tune
to raise awareness about coronavirus. “Do gaz doori, mask hai zaruri”
(maintaining distance of 2 feet and using mask is essential) became a popular
jingle of the time.

Figure 5.1 Health-care Behaviour during COVID-19

Source: https://commons.wikimedia.org/wiki/File:WHO_EN_HealthyAtHome-Physical-
activity_if_you_are_at_home_during_COVID-19_outbreak.png

The images (Figure 5.2) have been taken from e-book created for young
children by Public Health Foundation of India, Ministry of Health and Family
Welfare, Government of India. The e-book, available in five different
languages, has been created to empower children with practical information
that would equip them to cope with Corona virus pandemic.

Such kind of health communication exists all around us, and was essential
especially during a pandemic like, Corona virus when a lot of misinformation
was being spread through the social media. According to USA’s Healthy
People 2010, health communication is a way of using effective
communication strategies to influence people’s behaviour in taking decisions
to improve their health conditions. Health communications influence the
individual as well as the collective decisions about enhancing health.

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Persuasion and
Influence of Media

Figure 5.2 Images from an e-book on Coping with COID-19 pandemic

Source: https://phfi.org/covid19/covid-resources/

Health communication happens through campaigns that are run with the help
of traditional and contemporary modes of communication, which we will
discuss shortly. The communication about health can take place at multiple
levels as is shown in Figure 5.3. Greater the level at which health
communication works, more is its reach and hence greater is the success.

Figure 5.3 Multiple levels of health communication

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Health communication makes individuals more aware, and as a result, the Positive Influence of
Media
community more knowledgeable about various important health-care
behaviours.This helps in creating a healthier and more developed society.
Effective communication in health communication can:

· Putting health on public agenda and improve health outcomes: By

influencing, supporting and engaging individuals, communities, healthcare
professionals, policymakers, and the public to follow certain behavioural
practices, health communication eventually improve health outcomes (for
example, India’s pulse polio campaign to ensure every child below the age
of five takes polio drops, helped in the near eradication of the disease from
the country).

· Reduce the impact of socio-economic, racial, disease specific factors:

Health communications are designed in such a manner that they are
accessible to all, irrespective of their socio-economic status, race or other
factors (for example, doctors using more simplified language, pamphlets
and brochures, using easy to understand language so that people from
different backgrounds can understand better).

· Improve prevention and promotion of healthy behaviours: Prevention

is better than cure, and hence health communication promotes healthy
lifestyles and safety behaviours. WHO, for instance, is promoting active
lifestyle during the lockdown (Figure 5.1) Other examples include the
promotion for the use of various birth control methods, and campaigns run
regularly on non-smoking, so people are more cautious of their actions.

· Helps in demystifying diseases and provide accurate information in

the era of infodemic: Health communication helps simplify knowledge
about diseases into clear and ‘actionable’ messages. We live in an era of
infodemic, where there is plenty of information – some right, some wrong
mostly being spread through social media (WHO, 2020). This makes
making health enhancing decisions difficult for people. Health
communication is necessary to mitigate misinformation and myths.

5.1.1 Why is Health Communication important?

According to CRICO Strategies National CBS Report (2015), ineffective
communication has been a cause for 1,744 deaths and over $1.7 billion in
malpractices in a period of five years. This alone is enough to stress on the
importance of having better health communication practices in place. The
purpose of health communication is, not just preventing certain diseases, but
also promoting behaviours that are more health conscious. Groups that are
marginalized in society like sex workers, or people with low or no literacy,
stigmatized groups, like those suffering from HIV/AIDS or mental illnesses
etc. are reached through health communication. Increased numbers of health
professionals are focussing on health communication as a speciality. They are
learning from various other fields such as psychology, communication
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Persuasion and theories, and from marketing studies in order to attain better and more
Influence of Media
effective communication skills.

Figure 5.4 Attributes of Effective Health Communication

Effective health communication needs to be:

· accurate (the message should be valid and factually correct)

· accessible to the targeted audience

· balanced (with both benefits and risks of potential actions being

presented)

· consistent (content should be consistent with information from other

sources)

· culturally appropriate (that is it should take into consideration ethnic,

racial and linguistic diversity)

· evidence based (content of communication is scientific and based on

research)

· Wide reach (so that the message is available to the largest possible
number of targeted population)

· Reliable (the source of the health communication content is credible)

· Understandable and repeated (the content is repeatedly delivered or

available, like the COVID-19 ring tone)
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5.1.2 Approaches to Health Communication Positive Influence of
Media
Communication is a process of sharing information. However, without the
means to share that data, it will remain more or less a secret. If a person
comes up with a certain idea, s/he shares it with people with the help of
proper communication channels. Similarly, when it comes to health
communication, we require certain medium to allow health related
information to reach as many people as possible. According to Thomas
(2006), there are some traditional and some contemporary approaches
through which health communication takes place. The shift from an emphasis
on communicating with the “masses’’ to one on communication with specific
segments of the market has led to new and different approaches to
communication. Traditional approaches to health communication include
distribution of print materials (brochures, self-help guides, health education
material etc.), health fair, information and referrals (through e-mails,
telephone etc.), public service announcements, non-paid types of promotions
on radio, television, newspapers, press releases, featured stories on different
media etc. Contemporary approaches to health communication are influenced
by the technological innovations in the field of communication. These
include direct-to-customer marketing, electronic information distribution, e-
marketing, and social media marketing.

Use of multiple communication channels, like radio, television, newspaper,

flyers, brochures, internet and social media tools (i.e., Twitter, Facebook, and
YouTube) can allow health messages to be communicated to people. Health
communication strategies aim to change people's knowledge, attitudes, and/or
behaviours, that includes increase risk perception, reinforcing positive
behaviours, influence social norms, increase availability of support and
needed services and empower individuals to change or improve their health
conditions. It includes many areas including edutainment or enter-education
(education through entertainment), health journalism, interpersonal
communication, media advocacy, organizational communication, risk
communication (communication based on fear appeals), social
communication and social marketing. It can take many forms from mass and
multi-media communications to traditional and culture-specific
communication such as story-telling, puppet shows and street-plays. Soap
operas and movies are also often used to disseminate health information.

Let us discuss the various channels of dissemination of health communication

briefly.

1) Entertainment Media: How often have you seen a movie or a television

series and wished to be a part of it? How often did you see a character
similar to you on the movie screen, because of which, you felt more
confident in your own skin? Or simply, how often do you watch Harry
Potter or Narnia and wish you had a wand or a magic closet? Movies,
television series, fictional characters, they can invoke emotions in us that
normally might not come out as easily. We have read in previous units 111
Persuasion and how media can influence us, and how it is becoming a very regular part
Influence of Media
of everyone’s lives. Thus, when it comes to communicating about health,
entertainment media has been extremely useful.

To give an example let us go back to the year 2007 when ‘Taare Zameen
Par’, a Bollywood film was released, that highlighted a child’s dyslexia.
The movie was a critical as well as a box office success, and was one
that carried a strong message. The movie revolves around a child who
was suffering from a learning disorder known as dyslexia, which made
studying academics in a normal fashion hard for him to fathom. His
parents, unaware and ignorant of their child’s disability, send him to a
boarding school thinking it would help him. It was not until an
unconventional teacher appears that things start to get better for the
child. The movie was praised by not just critics but also by the general
audience and scholars (Rao and Krishna, 2008).

Education-entertainment programs incorporate health-promoting

messages and storylines in entertainment programs. Entertainment media
can undoubtedly promote health communication and healthy lifestyle in
a very effective way. We will further discuss this effect in detail in the
case study at the end of this unit.

Digital Marketing: With the invention of internet, the world became an

infinitely smaller place to reside in. People from different parts of the
world were able to connect with each other, their cultures, their
education, etc. Considering the dependence of people on the internet, it is
only wise to use such mediums to connect with people to promote
healthy behaviours. Traditional media such as television and radio has
become less popular means for obtaining health information. Rather,
internet and social media are increasingly being used for the same. Most
consumers of online health information access user-generated health
information as it provides tailored information for the users, that suits
them personally. Health communication using social media has shifted
from being unidirectional (as in mass media campaigns which were top-
down communication) to multidirectional where consumers generate
(bottom-up communication), seek as well as share (horizontal
communication) information. Given this change, the field of health
communication and thus health education also had to undergo a change.

Diverse digital marketing strategies exist to promote health

communication. There exist a number of websites providing people with
relevant and helpful information. There are chat-bots, which allow
people to have short conversations regarding health, social media
accounts that people follow to get updates about how they can keep
themselves healthy and social media influencers who help run campaigns
that promote health communication, thereby endorsing and encouraging
people to adapt to healthy behaviours.
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 Social Media Marketing: Shares health messages through online social Positive Influence of
Media
media platforms, which include social networks like Facebook,
information-disseminating platforms like YouTube, and microblogging
services like Twitter. The advantage of social media health campaign is
its enormity, breadth of reach, and immediacy of social media platforms
apart from being cost-effective. Social media campaigns are more
effective in successfully converting health-related knowledge and
information into web-based discussions. Studies on effectiveness of
social media campaigns report positive behavioural changes being
elicited. Social media platforms were used during the COVID-19
pandemic to spread information about the pandemic and reducing fear
and anxiety among the public. Healthcare institutions are increasingly
using social media as a channel to communicate with their customers.

An Indian social media campaign on Youtube by Mahindra Rise in

association with Cancer Patients Aid Association, titled, “Sehat Ka
Batua” creatively used the habit of women putting their purse (batua)
inside their blouses as a reminder for personally examining their breasts
to protect them from breast cancer. You can watch this campaign here
https://www.youtube.com/watch?v=zu_55piVrJU (A Unique CSR
Initiative of Mahindra, for Self-Diagnosis of Breast Cancer in India).

2) Advertising: Another major strategy in health communication is

advertising. Huge investments are made on traditional public health
advertisements annually to promote preventive health behaviours.
According to Schevitz (2010), educational campaign is essentially a
selling campaign, the article we offer for sale being health. The central
idea of commercial advertisements as well as health advertisements is to
change behaviours of the target audience. Therefore, the underlying
principles of product advertising (commercial advertising) and
advertising for health promotion are the same. These principles and steps
have been elaborated in Unit 7.

3) Interpersonal Communication: This is the most important form of

communication as it involves the interaction between the health care
provider and the patient itself. A person is most likely to take his/her
doctor’s word of mouth very easily, considering they place a lot of their
trust in them. This is another reason why while educating heath care
professionals, emphasis is now made also, on how they communicate the
information. It ought to be in a manner the patients are able to grasp and
follow.

The role of media is paramount as it is not just there to disseminate data

and information, but also to influence people into following the advices.
Thus, it is important to, not just spread the message to as many people as
possible, but to have enough value in the message so that people are
compelled to abide by them. We would later see how the Pulse Polio
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Persuasion and campaign by Mr Amitabh Bachchan was extremely successful in
Influence of Media
drawing people to the polio booth.

Behaviour in humans is not a one-time change. Rather, it is a continuous

process, which requires regular maintenance. For instance, if you are
trying to convince someone to start exercising, it is very likely that they
will not agree in one go. You might have to talk to them about exercising
and its benefits, why they should engage in it, etc. on a continual basis. It
is only after a certain point, will they agree to start with the
recommended habit.

The process is similar in health behaviour change. Communicators

must repeatedly engage with the audience in an effective way so that
they end up taking up the mentioned advice. Health communication
falls under the umbrella term of health education. Let us discuss the
latter, how it is different from the former, and how media has contributed
in its advancement.

Print media ads (i.e. Newspapers, Magazines, leaflets, brochures etc.)

play an important role in informing and educating the people about
important events related to their daily life. Sharma (2005) further
suggests that newspapers are among the most important sources of health
related around the world. The print media provide detailed information
on almost every topic related to health. By informing the important
things about the health-related issues, media help bringing the
behavioural changes among the people. These changes may be related to
change in the previous unhealthy habits, or wrong beliefs, or may be
related to preoccupied attitudes or aimed at reinforcing the existing
beliefs of habits.
Check Your Progress 1

Answer true or false:

1) The larger aim of health communication is to keep the public aware of
various health practices.
2) Entertainment media is not a channel for spreading health
communication
3) In infodemic, there is very less information.
4) For effective health communication, it is not necessary that the
information is culturally appropriate.
5) Social network is one of the levels at which health communication can
work.

5.2 MEDIA’S ROLE IN HEALTH EDUCATION

Health education has the primary aim of informing people about health.
According to the World Health Organisation, “health education is any
combination of learning experiences designed to help individuals and
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communities improve their health, by increasing their knowledge or Positive Influence of
Media
influencing their attitudes” (WHO, 1998). The WHO definition lays
emphasison a) dissemination of health-related information, b) inspiring and
motivating the population for, c) taking necessary action, d) to improve
health and e) maintain healthy behaviour / lifestyle.

Health education is a social science that is a hybrid field drawing from the
biological, environmental, psychological, physical and medical sciences. It is
a core public health discipline. Its aim is to promote health and prevent
disease, disability and premature death through education-driven voluntary
behaviour change activities. These change activities target the knowledge,
attitudes, skills and behaviour of the individual, group, institutions or
community as a whole. The purpose of health education is to positively
influence the health behaviour of individuals and communities as well as the
living and working conditions that influence their health.

Box 5.1Reflect!

After knowing both their definitions, can you differentiate between health
education and health communication?

Reading in one go, one might think twice to notice the distinctions between
health communication and health education, due to the similarities they share.
However, the reason why they share certain qualities is that health
communication is a part of health education. Nevertheless, health education
is not just about imbibing healthy behaviour or quality. It is concerned with
motivating, building skills and confidence (self-efficacy) in people so they
are motivated to switch to healthier behaviours.

There are different health education strategies that operate at three

different levels. At these levels, the methods for imparting ideas and
information to develop knowledge, attitude and skills are also varied. The
individual methods include direct face-to-face communication like home
visits. Such communication is interactive and permits a two-way flow of
information. Thus, the client (a layperson or a patient) can ask questions and
get clarifications from a health educator (a nurse or a health care worker for
example). Because of limited resources (of time, availability of health
educators, cost etc.), health education cannot always be done individually.
Health education can be imparted to small groups. Group methods include
demonstrations, role-play, street-play, panel discussion, group discussion,
seminar, lecture, workshop, etc. These methods are comparatively less
interactive. However, they allow for feedback. The group is usually
homogenous in nature, for example all patients of osteoporosis or newly
married adults on the use of contraceptives. Mass method is the method of
mass media. To reach maximum number of people who are diverse and
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Persuasion and geographically dispersed, mass methods are used. It does not allow for two-
Influence of Media
way communication. These methods comprise exhibitions, lectures and
health promotion campaigns on mass media including radio, TV, newspaper,
magazines, bill-boards etc.

Figure 5.5 Health Education Programme

5.2.1 Health Education and the Mass Media

Health education aims at helping individuals and communities to have
improved control over their health, by increasing their knowledge and
influencing their attitude towards health. But the aim of health education is
not limited to just the cerebral level. It aims at motivating people to take
appropriate actions to improve their health. People need to know about the
variety of factors that affect health, including social, economic and
environmental conditions, apart from the individual risk factors and the
facilities and utilities of the health care system.

Gupta & Sharma (2015) suggest that mass media impart necessary health
information in our daily life, enabling common people to take appropriate
decision about the different aspects of their lives especially about health.
Evidences suggest that mass media play a central role in informing and
education people about important events / changes happening around the
world. Especially because media connect the audience to the world beyond
their immediate reach. In other words, media bring the world closer to the
audience and increase their reach and access. Mass media is one such
institution which has the ability and potential to influence every individual’s
life in a big way. We see that media has ability to influence, our behaviour,
our culture and even it can affect our thinking and attitudes towards different
issues in our daily life (Gupta, 2006).
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Use of social media can enhance communication strategies for health Positive Influence of
Media
education and provides new opportunities for public health. Health educators
and professionals are now relying on social media tools for being visible and
viable. More research needs to be conducted on use social media
technologies by health educators and its impact.

Box 5.2 Health Education and Health

Health education: It is a part of the discipline of Public health. It involves:

· conducting research and assessments

· planning mass media and health communications campaigns
· implementing mass media and health communications campaigns to help
change attitudes and behaviors, and imparting knowledge and teaching
skills to achieve health
· evaluation of these programs for continuous program improvement.
· health advocacy (for healthy lifestyles, policies, and environments)
· providing training to individuals, health advisors, other professionals,
and policymakers
(Auld, Radius, Galer-Unti, Hinman, Gotsch, & Mail, 2011)

Health communication: It is a part of the discipline of communication

studies, in which communicating promotional health information (like public
health campaigns, health education, doctor and patient interaction) is
examined and practiced. The focus is on different communication strategies
that can be utilized to inform and influence choice and behaviour of the
targeted population. It is majorly dissemination of health information (like
ways to enhance health or avoid risk to health) and is a part of health
education. It improves health literacy of people, which is one of the goals of
health education.

Health promotion: Health promotion is defined as the process of enabling

people to increase control over, and to improve one’s health (Health
Promotion Glossary, 1998). As part of the public health movement around
the world in the 1980s, World Health Organization initiated a number of
programmes towards achieving “Health for All”.

Media have wide reach and access to influence millions of audiences, and
geographically scattered, the reasons why media are so intensively used in
health education programmes. Through the right mix of message and media,
desired behavioural change amongst the target audience can be obtained.
Thus, media plays an extremely important role of change agent. It influences
the knowledge, attitude, beliefs, choices and eventually behaviour of people
about health and healthy behaviours.

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Persuasion and 5.2.2 Why is Health Education important?
Influence of Media
In absence of healthy individuals, a community, let alone a country, cannot
thrive. When the health of the citizens of a country deteriorates, so does the
economy. To put things into perspective, let us look at the following example
from history.

During 1347 to 1351 CE, the black plague had spread all across Europe,
killing 30 to 60% of Europe’s population. Around 75 to 200 million
individuals met their death due to this plague, and the consequences of the
same were, with little surprise, enormous (Dunham, 2008). A sense of fear
was generated among everyone alive. More and more people started staying
in the safety of their homes rather than deciding to go to work. This
eventually turned into an economic crisis at the top of a health crisis. The
government, since was not very helpful, was now threatened by the public,
which further made it a state of uncertainty and instability. There were
religious repercussions to this as well, but that is irrelevant in this context.
What is relevant, however, is how a health crisis can make things extremely
difficult, if not managed properly at the right time.

In today’s time, things have obviously changed for the better. Medical
technology has advanced beyond imagination since the 1300s. However,
diseases and health deterioration are not something humans can get rid of, it
comes with being a mortal being. Nevertheless, that does not mean people
cannot take precautions to ensure safety about their health. The Corona virus
pandemic is an important case in point.

The purpose of health education is to educate people so they choose healthy

behaviours. It enhances quality of life of individuals and creates a healthy
society.

Box 5.3 Activity

Think about the COVID-19 pandemic and reflect on how health education
played a role in curbing the spread of the virus.

5.2.3 Health Education in India

There are about 260 million people living in India who are unable to read and
write, according to the 2011 census. Considering the amount of illiteracy, one
can imagine the complexity of reaching these people with the idea of health
education. Moreover, there are more rural than urban areas in the country.It is
a highly diverse country, and traits such as these require proper attention
when a plan for health education is generated.

Central Health Education Bureau (Ministry of Health & Family Welfare,

Government of India) is the apex institution in India for health education
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(https://dghs.gov.in/content/1408_3_httpchebnicin.aspx). It has the following Positive Influence of
Media
five divisions to ensure health education. All these division together help
provide valuable information to people related to health. They are responsible
for devising a plan that takes into consideration the various intricacies to
ensure the effectiveness of the various health education promotion
campaigns. The seven divisions are:

· Training division
· Media and Editorial
· Health promotion and education services
· School health education division
· Administrative division

While all these divisions work together to improve and provide health
education, let us try to understand the role of media in a little detail. The
media division, in particular, takes up various activities in order to promote
health education. It uses scientific ways of disseminating the latest and
correct information to the people about health and prevention of diseases. It
ensures exhibitions on several health-related topics, and celebrates days such
as World Health Day, World Mental Health Day, No Tobacco Day, and
Worlds AIDS Day, to name just a few. Not just this, but the editorial division
also brings out periodicals namely Swasth Hind (English monthly) Arogya
Sandesh (Hindi monthly), and Swasthya Shiksha Samachar (Hindi quarterly)
to disseminate health education information (Sharma, 2005).

The Bureau provides media services to all National Health Programmes and
Technical Divisions of the Directorate General of Health Services. It prepares
scripts for All India Radio and Doordarshan Kendras on health issues of
public health interest.

Check Your Progress 2

1) Differentiate between health education and health communication.

…………………………………………………………………………….

…………………………………………………………………………….

…………………………………………………………………………….

2) Identify the methods to promote health education programmes.

…………………………………………………………………………….

…………………………………………………………………………….

…………………………………………………………………………….

…………………………………………………………………………….

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Persuasion and
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5.3 MEDIA’S ROLE IN DESTIGMATIZATION

Box 5.4 Reflect!

Have you ever been treated differently because you behaved in a way, which
is not generally accepted norm? (For example, a girl who speaks loudly may
be frowned upon by people for not speaking softly. Or a man being called
names because of him being effeminate).

“Stigma is a perceived negative attribute that causes someone to devalue or

think less of the whole person. It is a preconceived idea or stereotype that
causes someone to devalue or think less of the person in question. People
tend to distance themselves from individuals in stigmatized groups, to blame
individuals in these groups for negative actions and to discriminate against
the stigmatized individuals” (Salters-Pedneault, 2020).

In simpler terms, stigma is a certain quality or trait attached to a set of people

(perceived to be negative or different) in order to distinguish them from
others as compared to more socially accepted forms of behaviours. For
example, in India, girls and boys are expected to behave in a specific way,
such as men are expected to have masculine characteristics and women, with
more feminine characteristics. Thus, when a girl or a boy fails to abide by
these ‘normal’ forms of behaviours, they are stigmatized, and may often face
discrimination by the society. Further more, the behaviour society considers
to be unusual, becomes the whole identity of that individual. For example, if
a man is effeminate, the society may deem him as “the effeminate man”,
thereby ignoring all the other qualities that make him a separate individual.

Other example could be of a person suffering from a mental illness. In India,

mental illness is still a taboo and people choose to not talk about it openly,
fearing how others might respond. Thus, many a times, families choose not to
disclose to the society if they or any of their family member is suffering from
any mental illness for the fear of social stigma.

Erving Goffman, one of the most influential sociologists of the 20th century,
defines stigma as a phenomenon where an individual is rejected by the
society due to a certain quality that is considered strange. The individual’s
reaction to stigma can be divided into the following three ways:

· The Stigmatized: Includes people who have the trait deemed

undesirable by the public
· The Normals: Includes people who do not bear the stigma
· The Wise: Includes people among the normal who accept and are more
open to the stigmatized

Gerhard Falk (2001), another sociologist and historian, stated how

stigmatization would always remain a part of human civilization with one
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group stigmatizing the other. That is because of the concept of ‘insiders’ and Positive Influence of
Media
‘outsiders’, and people’s need to feel belonged to one group. Falk concluded
that, “we and all societies will always stigmatize some condition and some
behaviour because doing so provides for group solidarity by delineating
'outsiders' from 'insiders’.

Box 5.5 Reflect!

Now that you know what stigmatization means, how would you define
destigmatization? What are the ways you think can help in reducing stigma?

5.3.1 What is Destigmatization?

The process of attempting to remove stigma, and to thereby, normalise
qualities that are considered unusual through different means is known as
destigmatization. In other words, to remove negative associations from what
is regarded as shameful by society. Stigma can be reduced by the help of
education, which can be in the following terms:

· Making people aware of the facts (like, men can be effeminate;

females can be masculine, etc.)
· Empowering the stigmatized groups (by encouraging people to be
more open and accepting of their differences)
· Choosing to speak more cautiously (not using degrading languages for
pointing out certain differences among people)
· Focussing on the positive (by asking the people to pay attention to the
diversity and freedom acceptance of differences would bring)
· Creating a more inclusive society (a society where there is acceptance
and celebration of difference)
Box 5.6 Reflect!
Have you ever had stigmas about someone or a particular group or a
concept? How did you overcome it?

There are numerous individuals who grow up stigmatizing because they do

not know any better. However, many people get out of this bubble by
educating themselves about unfamiliar concepts. This can take place due to a
personal experience or due to some other reason. A major contributor to
reducing stigma can be with the help of media. Considering its reach and the
people who are affected by it, media can play a pivotal role in
destigmatization. Let us understand how it can help in further detail.

5.3.2 Role of Media in Stigmatization

In 2015, the hashtag “#Oscars So White” was initiated by an activist, and to
this day, it continues to hold importance. Eventually, numerous known and 121
Persuasion and respected actors came forward to join the movement and boycotted the
Influence of Media
Oscars, an award that is notably the biggest honour an actor can be bestowed
upon for their skills. Why was this? Simply due to the lack of black
representation and a more diverse set of nominees. How did this hashtag
become so popular? It was with the help of social media platforms, where
people were quick to respond to the issue with their support.

This scenario lead people to take a second look at, not just the nominees, but
movies in general. People began to ask themselves questions such as, are our
movies diverse? Are there people from different ethnicity who get
representation? The answer is a big and simple no. Hollywood movies have
usually revolved around white or male lead characters. Moreover, if there are
characters of different ethnicity to be portrayed, they are often played by
popular actors instead of those who would actually fit the criteria. In India
also, we hardly have actors from the north-east India playing characters from
the north-east. The bio-pic ‘Mary Kom’ is a pertinent example, where the
lead Mary Kom was played by the mainstream actress Priyanka Chopra and
not an actress from north-east India.

Movies play an important role in people’s lives; these fictional stories include
characters that become role models to many people. Thus, the lack of
diversity in movies can play a direct effect on the society. The representation
is not just limited to black actors, but it called for better representation of
women, LGBTQ+ community, and individuals belonging to different
ethnicities, etc.

How movies portray characters can help people make judgements about
them, they can know and read about it to educate themselves further. In the
absence of any representation, however, this is unlikely to happen. By
portraying black characters as gangsters, Asian characters as highly
conservative, etc, these will imbibe and promote the already existing stigmas.
This is where media can act more maturely while portraying stigmatized or
underrepresented characters. A large part of media has already begun
ensuring representing people and other concepts (such as mental health,
HIV/AIDS, etc.) to reduce the stigmas.

What do you thing foreigners think of when they think of India? Is it an

image of poverty? Over population? A land of snake charmers?

Ask yourself this, is India limited to such characteristics? Not in the slightest.
Nevertheless, what people outside of India know of the country is through its
portrayal in the movies, TV series, and books. Moreover, it is not a mystery
that Indian characters are not often seen on the international screen. When
they are, however, they are stigmatized and a stereotypical view of them is
highlighted.

It is not just an issue in international media, however, when it comes to

Indian cinema, there is hardly any diversity. Female characters are portrayed
122 mainly as love interest to the male lead, LGBTQ+ characters are included for
comical purposes, mental illness is hardly mentioned and can also be seen Positive Influence of
Media
poked fun at on various television series. In short, there is a long way to go.
What is portrayed in the movies, play a direct role in influencing the minds of
people who are in continuous touch with media’s various forms.

In today’s time, when majority of the population engages with media, it is

clear there is a need for a positive role that media can play in educating
people, and in many cases, it has begun doing that. You will understand how
media can promote health education and communication better after going
through the case study mentioned in the end of this unit. However, let us go
through another topic of importance, destigmatization, in which media can
also play a pivotal role.

5.3.3 Media’s Role in Destigmatization

Box 5.7 Activity

When you want to know about something, what do you do to know more
about it:

a) Go to the library
b) Google the information
c) Watch Documentaries
d) Watch Movies/TV Series based on the topic, if any
e) Read Newspaper cuttings of the information
f) All or a mixture of all the above

Chances are you would take a combination of the actions mentioned above.
The point of the above exercise was to make you understand how much
media plays a role in each of our lives. There are many concepts and issues
that people are not aware of and one movie, media campaign, newspaper
article has the power to generate enough stir among the public that they
would be compelled to know more about the topic.

For instance, we discussed, how the release of ‘Taare Zameen Par’ pushed
people, schools to raise awareness on the topic of learning disabilities.
Similarly, media can play a pivotal role in influencing and spreading public
awareness. It can help in normalising behaviours that are stigmatized by
educating people in an effective manner.

For instance, mostly the qualities associated with women in movies are that
they are emotional, caring, and those who will keep the house and the family
together. While there is no issue in empowering women who run households,
it is also important to represent the other section of women in a positive light.
In recent years, viewers of Indian film and television have witnessed a shift
from portrayals of females as innocent and subordinate in nature, into
independent sexual beings. This has already begun with more movies coming
that highlight a woman’s character as being more than just a love interest.
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Persuasion and With movies such as Kahaani, Queen, Dear Zindagi, Padmaavat etc. things
Influence of Media
are surely taking a positive turn.

Thus, media can play a significant role in offering newer narratives in the
public domain. They help in reducing the prevalent stereotypes, prejudices
and discriminatory practices. They bring discourses of ‘deviance’ into
discourse on ‘normalcy’ or ‘alternative ways of being’. Silent candle-light
protests by the public, at India Gate was a virtually unknown concept until
the 2005 blockbuster Rang De Basanti brought it alive.

Mental illness is a taboo in India, but the circumstances are slowly changing.
This is possible because of the increase in the number of people who are
willing to talk about the issue in public. India recently also decriminalised
suicide as a criminal activity, a step that acknowledged mental health issues
as more than a criminal behaviour. Movies like Hichki, Pa, Taare Zameen
Par brought new discussions on different psychological disorders.

Popular channels and social media also have a lot to do with imparting
awareness on various mental health related issues. It gives people the space
to communicate the issues they are going through. What this does is that it
makes people conscious of many others suffering from similar situations. It
creates a community where people can be of help to one another. Bollywood
actor, Deepika Padukone, openly came out about her depression. She talked
about her battle with depression while her professional career was booming.
She emphasised on the importance of making this issue as public as possible
and released a video “Not Ashamed” on the popular channel, YouTube,
where she shared her personal struggle while going through that phase.

Deepika Padukone, a popular Bollywood actress, openly talking about her battle with
depression in a You Tube Video

If we take an example of representation of LGBTQ+ community, it is evident

that there is little representation. Furthermore, when it is, it is often portrayed
in a comical role. However, media has been playing a positive role in making
people aware by including characters that belong to this community.
Thereby, leading to an effort to reduce stigmatization of LGBTQ+
community. More TV series, movies now include characters belonging to the
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LGBTQ+ community. These characters are given quality role and importance Positive Influence of
Media
in the series’ plot. One recent example could be of the movie Kapoor and
Sons, where one of the lead characters in the movie was gay. The character
was not poked fun at for his sexuality and it was depicted in a very realistic
manner, thereby, putting the existence of the community in front of the
public.

We have continuously read and gone through researches that proved media’s
influence on public. It, however, is understood that people’s behaviours and
cognitions are not changed due to exposure to one strong media message. It
takes constant effort to imbibe positive messages into the public. Media’s
reach can fasten this process, and its effectiveness is the reason why it is used
to disseminate information.

In the next section, let us look at case studies to understand how media
helped in promoting health communication, education and destigmatization
for HIV/AIDS campaigns.

Check Your Progress 3

1) Define destigmatization.
……………………………………………………………………….
……………………………………………………………………….
……………………………………………………………………….
2) Cite some examples where media has played a role to destigmatize
people’s behaviours.
……………………………………………………………………….
……………………………………………………………………….
……………………………………………………………………….
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Persuasion and
Influence of Media
5.4 CASE STUDIES: HOW MEDIA CAMPAIGN
HELP DISSEMINATE INFORMATION?
Case study 1: Mass Media Campaign on HIV/AIDS (Sood, Shefner-
Rogers, & Sengupta, 2007)

HIV/AIDS is a virus that damages one’s immune system and makes one
more prone to getting sick. It is contagious and can spread from one person to
another through sexual intercourse. It cannot be cured but can be prevented.
Those who suffer from it can lead a normal life, however they must take
precautions so it does not spread further.

It is not easy due to the lack of enough education and awareness about the
disease. A lot of misinformation, stigmas, and false opinions are prevalent
about AIDS. This can make life harder for those who are suffering from the
disease. The fear of stigma can even convince some not to seek help from
health care professionals. This is extremely dangerous for the person
suffering as well as for others who might get in contact with them.

India saw its first case of AIDS in 1986, and since then it has spread to a
large part of the country. It is imperative that people are more aware of this,
and actions are taken to ensure it does not spread further. As per the HIV
estimates report (2019), Government of India, there are around 23.49 lakh
people living with HIV/AIDS (PLHIV) in 2019, and the estimated new HIV
infections declining by 37% between 2010 to 2019.

HIV/AIDS is transmitted mainly because of engaging in sex. Sex, itself, is a

taboo in India and is not talked about, which explains why the disease spread
to such a large number. Even though times may be changing, at least in some
metropolitan areas, stigma and discrimination are still a major hindrance to
prevention, care, and treatment (UNICEF, 2004).

Entertainment-Education Strategy to combat AIDS in India: Strategy to

involve entertainment media was taken in the attempt to influence knowledge
and behaviour change towards AIDS in India. The entertainment-education
strategy is based on the Social Cognitive Theory by Albert Bandura, which
concluded that people’s behaviours are influenced by what they observe, and
they tend to behave in a manner similar to how their role models act.

The BBC World Service Trust Partnership Campaign: To increase

awareness of HIV/AIDS in India, a campaign was launched by the BBC
World Service Trust (BBC WST), India’s National Aids Control
Organisation (NACO), Doordarshan (national television service), and All
India Radio. The purpose behind the campaigns was:

· to increase accurate knowledge about the modes of HIV transmission,

· to increase knowledge about the means of preventing HIV infection,
· to promote interpersonal communication about HIV/AIDS, and;
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· to promote interpersonal communication about condoms and condom Positive Influence of
Media
use.

‘Jasoos Vijay’, a TV series, was the basis of the campaign where the
protagonist, Vijay, was HIV positive. It was through his experiences the
audience learns about the discrimination people suffering from HIV face, the
care and treatment for the virus, the importance of condom use and other
means through which it can be prevented.

Jasoos Vijay, a TV series with the aim to spread awareness about HIV/AIDS
Image Source: IMDB

‘Haath se Haath Mila’ was another reality show that went out in the streets to
spread awareness about HIV/AIDS. Each episode consisted of real-life youth
dilemmas, comedy skits, popular music segments, and contests that generated
public discussion about sexual health issues. In addition to these, nine one-
minute television spots, which were repeatedly shown and carried
information regarding:

· the myths and misconceptions regarding routes of HIV transmission,

· the mistaken beliefs about people living with HIV/AIDS,
· methods for preventing HIV infection (for example, using condoms), and
· the need for open discussion about sexual norms and practices.

Six one-minute radio spots were also created and were tailored as per the
local audience, with special emphasis on male audience members. These
spots carried knowledge regarding how HIV infection is transmitted, and
how condom usage can help prevent it.

Results of the Media Campaigns: These campaigns did a lot for changing
the perspective about HIV. Furthermore, results clearly showed that
individuals who were exposed to the campaigns were more likely:

· to be aware of STIs, HIV/AIDS, and condoms,

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Persuasion and · to know about the routes of HIV transmission,
Influence of Media
· to have fewer misconceptions about HIV transmission, and
· to talk to others about STIs, HIV/AIDS, and condoms than those who
were not exposed to the campaign messages.

The case study establishes how much media can contribute in providing
people with helpful information. Furthermore, in this situation, it fulfilled the
objectives.

Case Study 2: The Bachchan Effect: Do Boond Zindagi Ke (Case study

on India’s Pulse Polio Mission)

In 2002, India witnessed a massive outbreak of Polio. Northern India had a

major share of infections from UP and Bihar which comprised more than
95% of total cases. But there was huge resistance in the rural public towards
immunization. The Ministry of Health and Family Welfare and UNICEF had
to employ advertising company (then) Ogilvy and Mather to lead the mass
communication for the Pulse Polio program in India. Their major challenge
was to persuade the rural mothers to visit the vaccination camps and get their
child the polio drops.

To overcome the resistance and motivate women to get their child

immunized, Mr Amitabh Bachchan was made the brand ambassador for the
Polio Eradication Campaign in 2002. Mr Bachchan is very popular in north
India and has great respect and credibility. His image of an angry young man
(a role that he played in many popular Hindi movies) was capitalized by the
advertising agency. In the television ad, he roared “Dhikkar hai hum par,
Polio ke booth par itne kam log?” His powerful voice echoed on every TV
set and radio station in the early 2000s and resulted in mothers getting their
children to the polio booths and receive ‘Do Boond Zindagi Ke’.

When these mothers were asked about the reason for coming to the camp that
held little or no importance for them initially, their response was that
“Amitabh Bachchan has become angry!’Research also established the
effectiveness of Amitabh Bachchan media spots. TV ads were slightly more
influential than radio ads in drawing people to the polio booths. The use of
emotional appeal in the campaign did the magic. Even UNICEF recognized
Mr Bachchan’s effort as a UNICEF Good will Ambassador
(https://www.unicef.org/india/our-partners/celebrities/amitabh-bachchan).

Eradication efforts coupled with effective use of mass media for the ‘Pulse
Polio’ campaign was met with measurable success. India recorded just 66
cases in 2005, down from 135 cases reported in 2004, 225 in 2003, and 1,600
in 2002.

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 Positive Influence of
Media

Every Bachchan ad about Polio

awareness would end with the
actor raising two fingers with
the message- ‘Pulse Polio
Immunization- Two drops of
Life’.
Source:
https://www.socialsamosa.com
/2020/03/brand-saga-pulse-
polio-campaign/

The door-to-door communication strategy was coupled with posters,

campaigns, exhibitions, interpersonal communication, village seminars, wall
paintings, health camps (swasthya mela), folk drama and community
meetings which lead to polio eradication from India.

5.5 SUMMARY
Let us review what we have learnt in this unit.

· When media channels started to gain popularity, the positive aspects

were well ignored. Its negative effects were soon rigorously studied and
declared, not much attention was given to what good it can do to the
human society.

· However, with the emergence of positive psychology, media’s

importance to help people in various ways was paid attention to and
given importance. How media helped in prosocial and other positive
behaviours started to gain wider acceptance. It is still in the process of
becoming a large phenomenon. However, the foundation has been set.

· Media play a significant role in health in health communication, health

education , stigmatization and destigmatization social taboos.

· Through the case study, we learnt how different media channels helped
raise awareness about HIV/AIDS. Not just that but it was effective in
reducing stigmas attached to it, and helped those suffering from it seek
help and take further precautions. Another case study demonstrated the
129
Persuasion and result of effective mass media campaign for polio immunization. Clearly,
Influence of Media
when a proper strategy is in place, media can provide extreme value to
the society and can thus, contribute massively in developing the society
further.

5.6 KEYWORDS
Destigmatization The process of attempting to remove stigma and to
normalise qualities that are considered unusual through different means

Health Communication Communicating health information, like public

health campaigns, health education, doctor and patient interaction, which is
examined and practiced

Health Education Aims is to promote health and prevent disease, disability

and premature death through education-driven voluntary behaviour change
activities

Health Promotion Process of enabling people to increase control over, and

to improve one’s health

Infodemic When there is plenty of information – some right, some wrong –

mostly being spread through social media

Positive Media Psychology Sub-field of Psychology that deals with the

positive cognitive, emotional and behavioural impact of media use

Stigma A perceived attribute or trait that causes someone to devalue or think

less of the whole person

5.7 REVIEW QUESTIONS

1) Discuss the role of mass media in health education.
2) Explain the significance of health education for a developing society.
3) How does mass media campaign help in disseminating information to
reduce stigma and bring about behavioural changes? Support your
answer with relevant case studies.
4) Elucidate the main attributes for effective health communication.
5) Describe the various channels of disseminating health communication.

5.8 REFERENCES AND SUGGESTED READING

Auld, M. E., Radius, S. M., Galer-Unti, R., Hinman, J. M., Gotsch, A. R., &
Mail, P. D. (2011). Distinguishing between health education and health
information dissemination. American journal of public health, 101(3), 390–
392. https://doi.org/10.2105/AJPH.2010.300037

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CRICO Strategies National CBS Report. (2015). Malpractice Risks in Positive Influence of
Media
communication failures. Retrieved from
https://www.rmf.harvard.edu/Malpractice-Data/Annual-Benchmark-
Reports/Risks-in-Communication-Failures

Dunham, (29th January 2008). Black death 'discriminated' between victims.

Retrieved from
http://www.abc.net.au/science/articles/2008/01/29/2149185.htm
Falk, G. (2001). STIGMA: How We Treat Outsiders. Prometheus Books.
Rao, T. S. Sathyanarayana; Krishna, V. S. T. (2008). "Wake up call from
'Stars on the Ground'". Indian Journal of Psychiatry. 50 (1): 2–4.
doi:10.4103/0019-5545.39749.
Schevitz J. (2010). Advertising as a force in public health education.
1915. American journal of public health, 100(7), 1202–1204.
https://doi.org/10.2105/ajph.100.7.1202
Sharma, M. (2005). Health Education in India: A Strengths, Weaknesses,
Opportunities, and Threats (SWOT). The International Electronic Journal of
Health Education, 8, 80-85

Salters-Pedneault, K. (2020). Understanding Stigma When You Have BPD.

Retrieved from https://www.verywellmind.com/stigma-a-definition-of-
stigma-425329
Sood, S., Shefner-Rogers, C.L. & Sengupta, M. (2007). The Impact of a
Mass Media Campaign on HIV/AIDS Knowledge and Behavior Change in
North India: Results from a Longitudinal Study. Asian Journal of
Communication, 16(3), 231-250.
Thomas, R. K. (2006) Introduction to Health Communication. In: Health
Communication. Springer, Boston, MA .https://doi.org/10.1007/0-387-
26116-8_1
US Office of Disease Prevention and Promotion. (2004). Health
communication, Healthy People 2010 (Vol. 1). Retrieved from http://healthy
people.gov/Document/HTML/volume1/ 11HealthCom.htm# edn4.

World Health Organisation. (2021) Infodemic Management –

Infodemiology. Ad-Hoc Technical Consultation on Managing the COVID-19
Infodemic. Available online at: https://www.who.int/teams/risk-
communication/infodemic-management (accessed July 7–8, 2021).
WHO (1996).Communication, Education and Participation: A Framework
and Guide to Action. WHO (AMRO/PAHO), Washington, 1996
WHO (1998). https://www.who.int/healthpromotion/about/HPR%20Glossary
%201998.pdf (WHO definition)
https://www.frontiersin.org/articles/10.3389/fpubh.2020.573397/full#B2
education-entertainment campaigns in COVID-19:
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Persuasion and https://www.tandfonline.com/doi/full/10.1080/10410236.2020.1847451
Influence of Media
https://npin.cdc.gov/pages/health-communication-strategies
Popular social media health-promotion campaigns:
https://www.bangthetable.com/blog/public-health-social-media-campaigns/
Health education in India:https://files.eric.ed.gov/fulltext/EJ794068.pdf
https://dghs.gov.in/content/1408_3_httpchebnicin.aspx

5.9 ADDITIONAL ONLINE RESOURCES

· Effective use of social media platforms for promotion of mental health
awareness (nih.gov)
· 3 Effective Marketing Campaigns Promoting Mental Health Wellness 3
Effective Marketing Campaigns Pro (digitalmediasolutions.com)
· Social Media as an Educational Tool to Promote Health
(uniteforsight.org)
· EMRPUB_2012_EN_1362.pdf (who.int)
· http://www.emcdda.europa.eu/attachements.cfm/att_94034_EN_Effectiv
eness%20of%20Mass%20Media%20campaigns%20HDA.pdf
· Prof. Melanie A. Wakefield, PhD, Prof. Barbara Loken, PhD, and Prof.
Robert C. Hornik, PhD (2010). Use of mass media campaigns to change
health behaviour (nih.gov).

Answers to Check Your Progress 1: True or False

(1) True (2) False (3) False (4) False (5) True

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