Television and Population Health

Dimensions of family life have changed tremendously in the past several decades. For example, in many parts of the world, age at marriage has risen dramatically, children’s involvement in mate selection has increased, parental authority has declined, premarital sex has increased, contraceptive use has become widespread, and fertility has declined. Both structural and ideational explanations of family change emphasize television as an important mechanism responsible for these changes. Additionally, television is increasingly used worldwide as an intervention tool to change family attitudes and behaviors. Government and non-government organizations, including the WHO, USAID, CDC, UNFPA, and the BBC World Trust invest billions of dollars annually on television campaigns promoting contraceptive use and safe sex practices.
Although observational studies report significant differences in family attitudes and behaviors between viewers and non-viewers, the meaning of these findings remains unclear. Because viewers self-select to watch, and self-select what and how much to watch, they are different from non-viewers in ways that predispose them to think and act differently to health messages. Therefore, we are uncertain whether observational study results indicate that television impacts attitudes and behaviors (causation) or whether background characteristics differentiating viewers from non-viewers are responsible for the observed findings (selection). To permit valid assessment of television’s causal impacts, this study will employ an experimental design in which 14 remote, rural, unelectrified villages will be stratified into 7 matched pairs, with one village in each pair randomly selected for the introduction of television. Baseline data will be collected using mutually reinforcing qualitative (family and community ethnographies) and quantitative (survey interviews, content analysis) techniques. Two principal research questions will be addressed:

  • Does television have a causal impact on each one of a set of family attitudes and behaviors?
  • Where television does show effects, through which mechanisms do these effects operate?
This research is highly significant as it will deliver the most rigorous assessments to date on television’s causal impacts on familial attitudes and behaviors. It is highly innovative in its reliance on an experimental design, its focus on the pathways through which effects might occur, its integration of multiple quantitative and qualitative data collection approaches (e.g., ethnography, survey research, content analysis, geographic information analysis), and its international and interdisciplinary research team. This large experiment has sufficient statistical power to detect potential effects (14 villages with approximately 4,000 respondents) and will advance our understanding on the causes of family change and the social impacts of mass media.

Principal Investigator: Rukmalie Jayakody, Penn State.  Investigators:  Vi Van An, Vietnam Museum of Ethnology; Jane Brown, University of North Carolina-Chapel Hill; John Casterline, Ohio State University;  Wayne Osgood, Penn State; Arland Thornton, University of Michigan; Tom Weisner, UCLA