I was totally there! : understanding engagement in entertainment-ducation narratives

<strong>Summary</strong> <strong>I was totally there!: Understanding engagement in entertainment-education narratives</strong> <strong>By Lonneke van Leeuwen</strong> <strong>Introduction</strong> Narratives have the power to influence their recipients’ health behaviors. With the entertainment-education (E-E) strategy, health organizations turn this narrative power to good account by employing narratives in their health promoting campaigns. E-E programs, mostly in the form of televised narratives, have been shown to effectively encourage a variety of health-related behaviors. Because of these positive results, the E-E strategy is considered a promising communication strategy to encourage healthy behaviors. One quality of E-E narratives that has been shown to be crucial for narrative impact is the ability of E-E narratives to engage target recipients. Engaged recipients may experience four dimensions of narrative engagement (NE): narrative understanding, attentional focus, emotional engagement, and narrative presence. Although evidence is growing that NE plays a role in E-E narratives’ impact (hereafter: E-E impact), little is known about how NE leads to E-E impact and about how NE emerges in recipients of narratives. <strong>Objective</strong> The objective of this dissertation is to provide a better understanding of NE in E-E narratives, by investigating how NE is associated with E-E narratives’ impact, and by investigating the processes that contribute to experiencing NE. <strong>Context</strong> The studies described in this dissertation are conducted within the context of NE in E-E narratives aiming to discourage alcohol (binge) drinking among adolescents and young adults. In 2008, the televised E-E drama series <em>Roes</em> (<em>High</em> in English) was broadcast on national television. <em>Roes</em> consists of 11 case stories (25 minutes each) portraying negative experiences and outcomes of adolescent protagonist(s) drinking alcohol and/or using other drugs. <strong>Research questions</strong> Three research questions are addressed in this dissertation: RQ1: Does <em>Roes</em> discourage alcohol (binge) drinking in E-E narrative recipients? RQ2a: Are NE dimensions associated with E-E impact on alcohol (binge) drinking? And, if so: RQ2b: Do negative and positive thoughts about alcohol (binge) drinking mediate associations between NE dimensions and E-E impact on alcohol (binge) drinking? RQ3: Which psychological processes experienced during narrative reception contribute to experiencing NE dimensions? <strong>Main findings</strong> This dissertation has shown that <em>Roes</em> discouraged alcohol (binge) drinking. Viewing multiple episodes of <em>Roes</em> positively predicted a decrease in alcoholic drinks consumed per occasion, an increase in the intention to decrease alcohol use, and an increase in perceived normative pressure. One year after exposure, the impact on the intention to decrease alcohol use was still present. One of the <em>Roes</em> episodes, <em>Verliefd</em> (<em>In love</em> in English), was further examined. After the participants had viewed this episode, their beliefs relating to the negative outcomes of alcohol binge drinking (BD) were more contra-BD as compared to their beliefs prior to viewing the episode. Attitudes towards BD and willingness to engage in BD also became more contra-BD. Then, the roles of the NE dimensions attentional focus, narrative understanding, emotional engagement, and narrative presence in E-E impact were investigated. It was shown that the NE dimensions attentional focus, emotional engagement, and narrative presence were positively associated with E-E impact. Attentional focus was associated both with stronger beliefs about the severity of the negative outcomes of BD and with a lowered intention to engage in BD. Emotional engagement and narrative presence were associated with stronger beliefs that BD leads to negative outcomes (negative outcome beliefs), and with stronger beliefs about being vulnerable to these negative outcomes (vulnerability beliefs). Surprisingly, the NE dimension narrative understanding was associated with increased willingness to engage in BD. No evidence was found that negative thoughts about BD mediated associations between NE dimensions and E-E impact. Relations between NE dimensions, positive thoughts about BD, and E-E impact could not be investigated: only one participant reported a positive thought about BD in response to Verliefd. Based on these findings we conclude that attentional focus, emotional engagement, and narrative presence are important for E-E impact, and that thoughts about BD do not play a role therein. Because NE dimensions were found to be associated with E-E impact, it was investigated which psychological processes contribute to NE dimensions. Negative thoughts about the perceptual persuasiveness of <em>Verliefd</em> negatively associated with emotional engagement and narrative presence. Furthermore, it was shown that enjoyment of <em>Verliefd</em> was a strong contributor to NE, mainly through contributing to attentional focus. Another strong contributor to NE was narrative realism, mainly through contributing to narrative understanding. Finally, personal relevance, character involvement, and perceived severity contributed mainly through emotional engagement. This dissertation shows that E-E narratives can be an effective health communication strategy to discourage alcohol (binge) drinking in young people. Furthermore, this dissertation provides health communication researchers and media psychologists with insights into the role of NE in E-E impact, and offers E-E developers practical recommendations about how to create engaging and impactful E-E narratives.