(p. 284) Broadcast Media–Based Approaches to Positive Parenting
A public health approach to parenting support requires an effective media and communication strategy to engage parents and increase the reach of evidence-based parenting programs. Efforts to apply a public health approach that enhances access to parenting supports have led to increased use of mass communication that aims to normalize and destigmatize participation in parenting programs and to impart positive parenting information directly to parents. Mass media communication strategies, such as television, radio, and streaming services, have considerable potential to increase the reach of parenting interventions, particularly for hard-to-reach, vulnerable, or disadvantaged parents. This chapter examines how Triple P has used television and other mass media formats as a means to promote positive parenting on a large scale. This chapter explores how mass media communication strategies can be used to reach and engage parents, promote acquisition of parenting knowledge and parenting skills, and complement a broader system of parenting supports.
Why a Media-Based Approach?
A population-level mass media communication strategy has considerable potential to encourage parents to participate in parenting programs and to affect their parenting practices directly. The mass media exert a substantial influence over attitudes, beliefs, awareness, and behavior and potentially provide powerful teaching in today’s society. The mass media have long been (p. 285) an important source of health information for the general public and have often been used to reduce health risk behaviors (e.g., substance abuse, HIV risk behaviors) and promote positive health behaviors (physical activity, nutrition; Abroms & Maibach, 2008; Wakefield, Loken, & Hornik, 2010). The application of a mass media approach to positive parenting is relatively new, however.
For the most part, broadcast media have generally been used to promote parents’ awareness of, engagement in, and demand for parenting programs (e.g., Sanders, Calam, Durand, Liversidge, & Carmont, 2008). In addition, however, well-crafted mass media messages may also be an effective and attractive method for imparting positive parenting information that can complement clinic- or center-based programs, as they have good capacity for reaching a wide target audience, can potentially overcome barriers to attendance at parenting groups, can help to destigmatize and normalize parenting assistance, and can affect community norms regarding standards of care for children (Sanders & Prinz, 2008). In this way, mass media messages have potential for changing parents’ parenting cognitions, affect, and practices.
The Pervasiveness and Reach of Mass Media
Broadcast media approaches potentially offer an efficient and affordable format for providing families with quality information about parenting. A primary advantage of a broadcast media approach is its capacity to dramatically increase the reach of evidence-based parenting supports, compared to traditional parent education methods, which rely on parents attending individual or group sessions on parenting. Of course, some families will require the more intensive support that a clinical intervention provides, but in a public health framework, mass media strategies are a critical part of a larger system of supports to families. Media approaches complement more intensive professional services and supports and enable parenting programs to reach families who might not otherwise be reached. Even modest effects of a wide-reaching program can translate into meaningful societal benefits when multiplied across all those affected.
Several studies have shown that television and online programming are parents’ two most preferred methods for obtaining information about parenting (e.g., Metzler, Sanders, Rusby, & Crowley, 2012). This is not surprising, as watching television and accessing online resources are major leisure activities for most adults and the way that people most commonly acquire new knowledge and information (Brown, Steele, & Walsh-Childers, 2002). Virtually all US households have at least one television (96%); in 2014, the average adult aged 18-49 watched over 4 hours of content on the television screen per day and an additional 30 minutes (approximately) watching digital video on a computer or smartphone (Nielsen, 2014). The televised media and online networks are forums where parents are increasingly accessing both information and entertainment.
The Power of Video-Based Messages for Promoting Behavior Change
One important advantage of video-based broadcast media messages is that they can harness the power of video-based modeling and observational learning. There is extensive research on the (p. 286) value of observational learning and video-based modeling in promoting behavior change (e.g., Bandura, 1986; Flay & Burton, 1990; Harwood & Weissberg, 1987). Video examples that demonstrate to parents practical ways of handling common child behavior problems increase the likelihood that a parent can actually enact the demonstrated behaviors. Video modeling stimulates multiple sensory inputs, which increases attention to the message, recall of the message, and motivation to change behavior. In addition, witnessing a model successfully enact a behavior improves viewers’ self-efficacy (Bandura, 1986; Maibach & Cotton, 1995). Furthermore, the social influence model (Cialdini, 2001) underscores the important social validation that modeling provides: Individuals are more likely to enact a behavior when they perceive that others like them are engaging in that behavior.
Examples of Mass Media Approaches: A Changing Landscape
Over the past 20 years, there has been a major transformation in the types of mass media communication opportunities available to promote behavior change. The increase in the number of television channels has reduced audience sizes for any given show, but the growth of subscription television, the Internet, streaming services, and social media has created many more opportunities for interventionists to directly reach a target audience (Lupis, 2017). The types of communication options available has expanded exponentially in a relatively short period of time.
The range of mass media communication options that could be deployed to support positive parenting include live and subscription television programming (infotainment, reality-based documentary-style coach shows, scripted fiction), radio programming, paid commercials, public service announcements, webcasts and webinars, podcasts, on-demand video and audio streaming, social media for video/audio streaming and sharing, embedding parenting tips into relevant news stories, and “hot topics” news interviews. Technology-assisted approaches, such as apps for mobile devices and parenting websites, can also provide video/audio content, downloadable information (e.g., tip sheets for parents), interactive programming, social networking connectivity with other users, and cell phone messaging (e.g., Triple P Online; Sanders, Baker, & Turner, 2012). It is clear that rapid changes in the media landscape and the growth of the Internet and social networking platforms has transformed our capacity to reach parents with different types of media messages in a variety of formats. It has also resulted in increased competition for parents’ attention as they are bombarded with many more messages designed to influence them.
Brief Review of Efficacy
Mass communications have long been an important source of health information to the general public and used to promote positive health behavior change (Abroms & Maibach, 2008; Wakefield et al., 2010). It is only within the past several years that these strategies have been applied to promoting effective parenting skills. Triple P provides some excellent examples of this broadcast media format.
(p. 287) Television Programs
Television is a popular vehicle for getting messages to large segments of the population. As noted, Metzler et al. (2012) found that television was parents’ most preferred vehicle for accessing information about parenting. The capacity for reaching large segments of the population has to be balanced against the costs of production, limited control over program content, style of production, and scheduling. Nevertheless, several television productions on parenting have shown that television programming can be effective in improving parenting practices and child behavior outcomes.
As applied to parenting, this style of programming seeks to engage, entertain, and inform viewers about how to tackle common everyday parenting concerns using principles of positive parenting. Sanders, Montgomery, and Brechman-Toussaint (2000) evaluated the effects of an infotainment-style 12-episode television series, Families, which was broadcast in prime time on commercial television in New Zealand. This program provided parents with information and advice on a wide variety of parenting and family issues, and a 5- to 7-minute Triple P segment embedded in each 30-minute episode allowed parents to complete a 12-session Triple P intervention at home. Compared to wait-list controls who showed no change, mothers of children with conduct problems who viewed videotapes of the broadcast series and read accompanying informational tip sheets reported a greater reduction in disruptive child behavior, from 43% of children in the clinically elevated range prior to viewing the program to 14% following the program. Mothers who viewed the program also reported an increase in their own sense of parenting competence. These effects were maintained at a 6-month follow-up.
The Triple P Video Series is another example of an infotainment-style program. The Triple P Video Series consists of 10 episodes, with each episode lasting 12 to 15 minutes. The 10 episodes cover all content in Level 4 Triple P. Although designed for broadcast, the Video Series was evaluated in a randomized controlled trial (RCT) against a wait-list control, in which parents watched two episodes per week on DVD at home. Compared to controls, those who viewed the Video Series reported reductions in child problem behaviors and dysfunctional parenting practices and improvements in child positive behaviors, parents’ use of positive parenting strategies, and observed parent—child interactions (Metzler, Rusby, Sanders, & Crowley, 2017). Examples of feedback from parents about the Video Series are provided in Box 25.1.
—Parents’ comments, Oregon, USA
Reality-Based, Documentary-Style Coaching
Reality shows have been popular in television programming for some time. This genre includes “coached” shows, in which experts help individuals overcome challenges and improve their health, skills, and daily functioning. These shows typically have strong audience engagement; audiences appear interested in information and entertainment about how other people handle problems and challenges (McAlister & Fernandez, 2002). Parenting-related coaching shows such as Supernanny, and Nanny 911, in the United States and House of Tiny Tearaways and Little Angels in the United Kingdom had mixed reviews from professionals, but they attracted strong viewing audiences and were popular with parents because they seemed to capture the realities of (p. 288) struggling to manage difficult children. In a survey of viewers of Supernanny, parents reported finding the program useful and being influenced to try the parenting techniques presented (Ganeshasundaram & Henley, 2009).
Triple P was evaluated as the subject of a six-episode documentary series on British television with additional online resources (Sanders, Calam, et al., 2008). Driving Mum and Dad Mad was broadcast on ITV (the largest commercial network in the United Kingdom), attracting a peak audience of 5.9 million viewers and an average weekly audience of over 4.2 million viewers. It covered the experiences of five families with children who had severe conduct problems; these families participated in eight-session Level 4 Group Triple P. The show displayed emotional and engaging footage, with highly distressed but relatable families. The families were shown trying the targeted positive parenting strategies and making substantial improvements in their families’ and children’s lives.
This series was tested in an RCT comparing two viewing conditions (standard vs. enhanced). Families in the standard condition watched the series and had access to online written informational tip sheets on the ITV website. Families in the enhanced condition watched the series and received additional individually tailored support through a 10-session self-paced workbook and access to a specially designed website. The website had downloadable tip sheets for each episode, e-mail reminders to watch the show, text message prompts to implement program tips, audio- and video-streamed positive parenting messages and demonstrations of the parenting techniques, and e-mail support from trained Triple P providers. Both conditions showed significant reductions in child conduct problems, coercive parenting, depression, anxiety, and stress and greater parental self-efficacy. The enhanced condition showed greater improvements in child behavior and parenting and parental adjustment, reduced marital conflict, and higher consumer satisfaction.
Calam, Sanders, Miller, Sadhnani, and Carmont (2008) showed that families with more severe child behavior problems were more likely to watch the entire series than families with fewer problems, and that problem severity at baseline did not predict outcomes.
These findings show that a mass media-based parenting intervention can have the power not only to increase awareness but also to change both parents’ and children’s behavior, even among high-risk families.
(p. 289) Radio Programs
Radio programs are another source of broadcast media that can reach parents. The Australian Broadcasting Corporation (ABC), the national broadcaster in Australia, produced a regular 10-minute Triple P segment on positive parenting that was broadcast live to ABC listeners and then podcast. Between January 2008 and December 2011, there were 171 podcasts produced dealing with a diverse array of topics, ranging from issues concerning the development of babies to those involving adult children. Each segment dealt with a specific parenting issue or problem. The parenting expert was interviewed by the presenter about the topic and typically covered issues such as what the problem is, why it is a problem, and how the problem can be prevented or managed. An RCT evaluated the effects of listening to seven podcasted segments relevant to parenting toddlers and preschool-aged children with early onset conduct problems (Morawska, Tometzki, & Sanders, 2014). Postintervention, parents in the podcast condition reported significantly lower levels of child disruptive behavior and more positive parenting practices and self-efficacy than parents in the wait-list control condition.
Special Challenges in Working with the Media
Changing Nature of Broadcast Media
As stated previously, the media landscape is constantly changing and has shifted dramatically in just the past few years (Lupis, 2017; Nielson, 2014). This underscores the importance of those working with the media to stay abreast of new platforms and formats and the opportunities and challenges they represent. As consumption of live broadcasts, traditional TV and radio, and DVDs slowly and steadily declines, especially among young adults (Lupis, 2017), new opportunities are created through the steadily increasing consumption of streamed, web-delivered programming (e.g., digital video and podcasts) and social media sharing. It is important to remain nimble and flexible in the development of media assets, so that as technology advances and platforms, formats, and distribution channels shift, media assets created for an older platform or distribution channel can be repurposed for a new platform or distribution channel. This flexibility and adaptation to the “new media” are essential to staying relevant and reaching the target audience of parents.
Need for Involvement of Media Experts and Media Training for Key Personnel
Most parenting practitioners are not trained to work with the media, and many are wary of the prospect of being interviewed by the media. In addition, a successful media strategy requires parenting professionals to be informed about media outlets’ different requirements, interests, priorities, and target audience demographics (Sanders & Prinz, 2008). Large-scale, population-level interventions benefit from having dedicated staff with media training to develop relationships with and work with media personnel. For example, a large-scale public health rollout of a parenting intervention will benefit from having one or more identified spokespersons to deal (p. 290) with media inquiries. The Every Family rollout (Sanders, Ralph, et al., 2008) and Triple P system trial (Prinz, Sanders, Shapiro, Whitaker, & Lutzker, 2009) had trained media consultants work with the implementation teams to achieve media coverage for the project. In addition, some media training for practitioners themselves can help practitioners be prepared and reduce their anxiety and therefore perform more effectively with the media. Developing clear, concise ways of conveying information makes it easier to get key messages accurately communicated.
Risks and Cautions
Protecting Families’ Privacy
Working with the media industry can be a rewarding experience, and stories can be produced that are positive, entertaining, and helpful to parents. Having a media liaison to negotiate the conditions under which visual footage is provided of real families is helpful. There are potential risks that professionals should be aware of, however. Steps must be taken to ensure that children are protected from any harm or exploitation that might arise from their appearance in a parenting program. Parents must be provided information about the potential risks and benefits of their involvement and give fully informed consent. It is recommended that the professional working with the family be available to provide support regarding any concerns that may arise as a consequence of the public viewing their footage. In addition, when parents consent to their family being filmed or interviewed, they are often unaware that their video footage will be cataloged and stored in the archives of the station or producer. Their footage will be classified and, in the case of problem behavior, may be cataloged as an “example of bad behavior in supermarket.” Requesting that the footage be tagged by the journalist or producer as “not to be used with any other story” reduces but does not entirely eliminate the risk that the same footage will be used by another journalist or producer for a different story, removed from its original context. Parents and professionals who are asked to identify families who may be interested in participating in a story should be made aware of this risk. It is always advisable to discuss with the producer or journalist whether the station, network, or production company has procedures to protect or restrict further use of the footage.
Avoid Using Media Strategies in Isolation From Other Interventions
Mass communication coverage designed to promote parental awareness of parenting programs requires a trained workforce ready to deliver parenting interventions. Creating demand for programs without ensuring that there is capacity to meet the increased demand can lead to frustration on the part of parents and practitioners alike. The Every Family initiative (Sanders, Ralph, et al., 2008) provided workforce training for a wide variety of practitioners to deliver evidence-based parenting programs while the media strategy was being implemented.
Implications and Future Directions
Mass communication programs can be a valuable element of a larger system of family supports, complementing more intensive supports for high-risk families, reaching those who might not (p. 291) otherwise be reached, and providing a sufficient level of intervention for many parents. Mass communication strategies can raise awareness, destigmatize and normalize parenting assistance, and encourage engagement in parenting programs. In addition, self-help media-based approaches to providing parenting supports can be effective in actually changing parenting practices by realistically showing parents implementing parenting skills and techniques to manage specific problem behaviors or parenting situations.
To effectively implement a large-scale, population-based parenting strategy requires a sustained media and communication effort that is dynamic, built around key relationships between professionals and the local media, and is responsive to media inquiries in a timely manner. Building a respectful and collaborative relationship with the media takes time. It is through the building of personal contacts and relationships with journalists that more opportunities can be created for positive media coverage for an intervention. For example, during the Every Family (Sanders, Ralph, et al., 2008) initiative, Channel 9’s Extra Program in Australia produced a number of stories dealing with the prevention or management of a wide range of common behavioral issues. These editorial stories were filmed to discuss a common problem, to understand the causes, and then to depict a solution to the problem.
We contend that all parents can benefit from receiving information and guidance on effective parenting, and that media communication offers a useful mechanism for providing this information. As mass communication about parenting grows and the information explosion on parenting advice continues, parents who can learn effective parenting skills and handle their children’s problem behaviors themselves with minimal assistance will do so, and as a result, practitioners in the future may be more likely to be working with more complex and change-resistant families who have already tried and failed with the self-help approach.
The changing media landscape will continue to offer new opportunities and challenges. There will continue to be a role for traditional broadcast media, where infotainment programming, reality-based documentary-style coaching, and scripted fiction (e.g., parent characters in a fictional series) remain popular. Web-based streaming services will likely provide an increasingly popular venue for distribution of programming. Growth in social media will provide new opportunities for professionals to share media messages with parents and for parents to share media messages with each other. Even virtual reality may one day allow parents to practice strategies for handling difficult situations (shopping or driving with misbehaving child) in a “safe” virtual environment. And, of course, future developments in technology and media platforms will create new opportunities for reaching parents in ways we cannot currently foresee.
Population-level communication strategies are a potentially powerful means of increasing the reach and impact of parenting programs to improve the well-being of children. A variety of broadcast communication strategies, including television programs, radio programs, streaming services, and social media, can be used to foster positive parenting. Studies to date have shown that parents are able to improve their parenting skills through mass communication approaches, and children have benefitted as a result. A carefully planned, theoretically informed, and evidence-based communication strategy that integrates messages about parenting with (p. 292) program supports available in the community holds great potential to strengthen population-based approaches to parenting support. The overall media approach can include specific strategies to increase parental awareness of and engagement in programs, promote public support for the parenting initiative, disseminate new research findings, and impart positive parenting guidance directly to parents.
• With their wide reach and powerful messaging, broadcast media–based approaches have considerable potential for encouraging parents to participate in parenting programs, as well as directly affecting parents’ childrearing practices and community norms.
• Mass media options that can be deployed to support positive parenting include television programming and advertising, radio programming and advertising, video and audio streaming services, podcasts, social media, and embedding parenting into news stories.
• Media-based parenting programs, such as the Triple P examples described here, have shown both strong capacity to engage parents and positive effects on improving parents’ parenting practices, children’s behavior, and family functioning.
• There are many important considerations for media approaches, including providing protection for families’ privacy, having media-trained individuals on staff, developing relationships with media outlets and being informed about their requirements and interests, and embedding the media strategy in a larger system of community supports for parents.
• The constantly evolving media landscape provides many new opportunities for reaching parents and challenges us to remain flexible and adapt to new media platforms and formats to stay relevant and continue reaching our target audience of parents.
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