Tell Me a Story

Philanthropy411 is currently covering the Communications Network and CommA Fall 2010 Conference in Los Angeles with the help of a blog team, which is part of the conference’s 2nd annual Gorilla Engagement Squad.  This is a guest post by Lucas Held, Director of Communications at the Wallace Foundation.  Follow the foundation on Twitter:  @WallaceFdn

by:  Lucas Held

For decades, automakers and soft drink companies have known that getting their product onto a TV show or a movie could help build exposure and even interest in their product. The theory is that viewers pay more attention to a product when it is lodged in a story (remember Elliott, ET and Reese’s Pieces) than in a separate ad.

But what would happen if a cause, of the sort that foundations cause about, was integrated into a TV show?

Well, now we know – and the results are pretty impressive.

On Thursday morning, Matt James, executive vice president of the Henry J. Kaiser Family Foundation, which for years has been an innovator in communicating about health to broad audiences, shared the stage with Neal Baer, M.D., the multi-talented Harvard-trained physician, who is former executive producer of the TV show ER (1994-2009), and now executive producer of Law & Order: Special Victims Unit.

First, if you thought folks don’t get information from TV dramas, think again. A survey conducted among ER viewers between 1997 and 2000 found that 53 percent learned about important health issues from the show, and 51 percent told others about what they heard. Big numbers. Nearly one-third (32 percent) used what they heard to make choices about health care, and 14 percent contacted a doctor or provider because of what they saw.

In other words, not only did the show build awareness, it met what’s usually the ultimate goal for foundation communications efforts: it inspired action.

Here is what happened with an episode on Human Papillomavirus. HPV is one of the most common sexually transmitted diseases and can be a precursor to cervical cancer. But awareness of the disease is low. According to a Kaiser report only about 40 percent of women 18 to 75 have heard of HPV, and only half of those (or about 20 percent of all women) know of its association to cancer.

So Baer, who marries a passion for TV drama with a passion for doing good, included in an episode a storyline involving a young girl who after having sex with several partners at a party, showed signs of the disease.

Most tests of advertising effectiveness involve pure recall – after seeing a spot, what did viewers remember? The better test is to do studies both before and after viewing. That’s what Baer and Kaiser did.

Before the ER episode, only 24 percent had heard of HPV. A week after the episode, awareness had doubled to 47 percent. Before the episode, 9 percent could correctly define HPV; a week after the episode, understanding (the next stage on the communications hierarchy) had tripled to 28 percent.

And the crucial cancer connection? Before the episode, 19 percent knew HPV was associated with cervical cancer; after, the figure had tripled to 60 percent.

I’m no public health expert. But this looks like strong evidence to me that the ER story was quite effective in building understanding about the disease.

It’s a long-held axiom of social marketing that unless messages are repeated across many channels, impact diminishes.  That was definitely the case here. After six weeks, the percentage of viewers recalling the association of HPV with cervical cancer fell from 60 percent to 38 percent – but that still represents an impressive doubling of awareness.

At the evening’s reception at the glass-walled Annenberg Community Beach House in Santa Monica, I spotted George Perlov, the thoughtful former executive vice president for research and innovation of the Ad Council who now runs his own consulting firm. I asked him how these results compared to the results of Public Service Announcements, like those run on buses or on radio. He said the results were better, but cautioned that when PSAs are evaluated, an entire target population is surveyed. Here, only actual viewers of the episode were surveyed. “It’s apples and oranges,” he said.

Even so, 9 million viewers (for ER’s final season) is pretty wide exposure.

And Baer has expanded his efforts by harnessing digital media. A recent episode of Law & Order: SVU focused on the horrifying epidemic of rape in the Democratic Republic of Congo. To promote the episode, Baer sent out a brief video using a bubbletweet (a brief video clip), and garnered previews in the Cheat Sheet of The Daily Beast, the Enough Project, and Human Rights Watch. News of the pending episode was tweeted to 1 million followers.

For an episode on the national backlog of tens of thousands rape kits whose samples have never been tested, promotion included an op-ed in The Huffington Post and an item on takepart.com. There were 6,000 retweets reaching well over a million followers. (By comparison, as of yesterday afternoon, my conference blog post was retweeted 20 times to 29,000 followers.)

Cleary an evangelist on the subject, Baer argued: “Drama can be a powerful conduit for focusing on public policy issues. Stories can make a difference. They can take cold, impersonal numbers and make them memorable in a way you will never forget.”

Story guru Andy Goodman would likely agree. Later in the day, he urged listeners to drop “inverted pyramid” stories (whether video or in print) where the lead tells all, in favor of narrative stories that build suspense.

So what does this imply? (My conclusions are solely my own.) First a few caveats. Baer is clearly unusual. A good story is not the same as a sound strategy. And without solid evidence behind them, stories are less meaningful for policymakers and practitioners. But in a networked age where “word of mouth” is one click away, Baer and James were pretty persuasive that under the right conditions, a good story can be pretty powerful medicine.

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