Health Belief Messages about Alcohol Consumption in Network Television
Entertainment
Programs:
A Preliminary Report
by
Janet A. Bridges
Associate Professor of Communication
University of Southwestern Louisiana
Lafayette LA 70504-3650
318-482-6142
with Christine M. Price and Terri R. Breaux
Graduate Students
Department of Communication
University of Southwestern Louisiana
Lafayette LA 70504-3650
Submitted to the Mass Communication and Society Division of the Association for
Education
in Journalism and Mass Communication, annual meeting, Washington DC,
August 1995
The author wishes to thank Jung-Sook Lee and the late Robert E. Simmons for
their comments
when this project was conceptualized.
An Abstract
Health Belief Messages about Alcohol Consumption in Network Television
Entertainment
Programs:
A Preliminary Report
by
Janet A. Bridges
Associate Professor of Communication
University of Southwestern Louisiana
with Christine M. Price and Terri R. Breaux
Graduate Students
Department of Communication
University of Southwestern Louisiana
Messages about expectations from alcohol use in 103 television entertainment
programs
indicated that alcohol use is most frequently portrayed as
affecting social enhancement;
second most frequently alcohol is associated with relaxation, and
thirdly with a
ssertiveness.
Soaps and nonsoap evening programs were not different in associating social
enhancement
and assertiveness with alcohol, but nonsoap evening programs
had many more messages
associating alcohol use with relaxation.Evening nonsoap programs
associate alcohol with
aggression more often than the soaps.
Submitted to the Mass Communication and Society Division of the Association for
Education
in Journalism and Mass Communication, annual meeting, Washington DC,
August 1995
Health Belief Messages about Alcohol Consumption in Network Television
Entertainment
Programs:
A Preliminary Report
_______________________________
Health Belief Messages about Alcohol Consumption in Network Television
Entertainment
Programs:
A Preliminary Report
The social costs of alcoholism in the United States have been estimated at more
than $116
billion yearly (Carroll, 1989; Harwood, 1984; Blume, 1984,
1981). Alcoholism, the
nation's third largest health problem, affects approximately 25 percent
of the homes
(Carroll, 1989; National Council on Alcoholism, 1987).
Research in the health fields has attempted to identify, if not causes of
alcohol abuse,
at least correlates of increasing consumption of alcoholic
beverages, as well as methods
of treatment. Biological factors have been studied, but recent
studies have focused on the
individual's environment as a possible predictor of that individual's alcohol
use.
Entertainment television, an integral part of most individuals'
environments, can provide
subtle messages about appropriate behavior and consequences of
behavior in terms of
beliefs about the effects of alcohol.
Alcohol Use in Media Content: The cues in television programs about alcohol use
are
myriad. A recent report picked up in the news media suggests
that "a child will watch
someone take a drink on TV an average of 100,000 times by the time
he turns 18." The
report said some characters in late prime-time programs will take a
drink on the average
of once every 20 minutes (American Health and Psychology Today
Service, 1989).
Signorielli (1987) said National Opinion Research Center (NORC) data on whether
an
individual uses alcohol was modestly and negatively (r= -.05)
correlated with television
use. Controlling for sex, age, education, income and race made the
relationship positive
(r= .028). Both correlations were very low, but statistically
significant. Signorielli
noted that through 1985 the proportion of entertainment programs
referring to alcohol in
one form or another increased linearly, as did the proportion of
programs mentioning the
harmful effects of alcohol.
A study of adolescents concluded that drinking on popular television programs
was done by
"good guys," sending a message to teenagers that drinking is a
desirable behavior
(Smoking Taboo, 1991).
Lowry (1981) found 30 "negative short-term consequences" of drinking in 120
hours of 1979
prime-time television programs, but 14 of these were comic intoxication. Only
four
"negative long-term consequences" were noted. Lowry found an
average of 3.38 drinking
acts per hour.
The National Institute of Mental Health's report on Television and Behavior
(Gerbner,
Morgan and Signorielli, 1982) indicated that during evening
hours alcohol use averages no
less than one and one-half acts per program, increasing to no less
than three drinking
acts in the later prime-time hours. For the daytime soap operas, at
least 6 drinking
incidents per hour are the norm. Thirty-six percent of the major
characters are drinking
(Gerbner, et al., 1982). Wallack, et al., (1990) found that
evening soap operas averaged
13.3 acts of alcohol drinking per hour.
Signorielli (1990) said early studies on daytime soap operas found more women
than men
characters are problem drinkers, and these drinkers are upper
rather than lower class.
Her own research found that in prime time problem drinkers were more
likely to be men. A
case study with one of the daytime soaps (Wallack, et al., 1985)
found "several good role
models for social drinking and abstinence" and "negative
reinforcement for heavier or high
risk drinking." The NIMH study found that 48 percent of the women in
adventure/crime
programs are drinking (Gerbner, et al., 1982).
Media Content and Alcohol Use: No direct evidence links drinking behavior on
entertainment television to drinking behavior in real life, but research
evidence suggests
that the mass media, especially television, provide an indirect learning
environment for
heavy viewers, who tend to perceive life and the world more like the
world as shown on
television than like real life itself . (For a discussion of
possible effects of heavy
viewing, see Gerbner, et al., 1986; Morgan and Signorielli, 1990;
Ball-Rokeach and
DeFleur, 1979; or DeFleur and Ball-Rokeach, 1989. McQuail (1987)
presents a good
discussion of unintentional media effects.) In a face-to-face situation,
Caudill and
Marlatt's (1975) experiment found that modeling behavior, long
considered an indirect
effect of television viewing, was associated with drinking behavior.
Subjects in their
study with a heavy drinking model drank significantly more in a
social situation than
subjects with a model who drank little or who didn't drink.
Health Beliefs: There is little research that seeks to identify specific belief
dimensions
that underlie specific behaviors, such as decisions to use alcohol and other
substances.
However, there is some support in health communication and other behavioral
literature t
o support a linkage, first, between mass media use and
belief-formation and, second,
between beliefs and the formation of intentions to perform behaviors
(Fishbein & Ajzen,
1975).
Brown and her colleagues linked six expectancies about alcohol, defined as
"anticipated
consequences of alcohol use," to alcohol behavior (Brown,
Goldman, Inn and Anderson,
1980). Although directional causality cannot be determined, they said
"global" factors
were related to less alcohol consumption while "increased
expectation of sexual and
aggressive behavior (two separate expectancies)" were associated with
heavier drinking.
A more recent study identifies nine different expectancies about alcohol use as
part of
development of a "Drinking Expectancy Questionnaire" (Young
and Knight, 1989). The
authors' analysis of a large number of possible expectancies about
alcohol use identified
assertiveness, affective change, sexual enhancement, social
enhancement, relaxation,
cognitive impairment, dependence, carelessness, and aggression as
underlying dimensions.
The authors did not attempt to link these expectancies with media
behavior.
The research documenting the amount of drinking on television entertainment
programs
suggests that underlying messages about expectancies about
alcohol -- the health beliefs--
in entertainment-television drinking behavior should be examined. This study
examines
health- belief messages about alcohol use embedded in continuing
entertainment programs
broadcast on prime time and in afternoon soap operas to try to
determine whether a pattern
of alcohol-belief information is reaching the television audience for these
programs.
METHOD
Analysis of the health belief messages was based on coding of 56 half hours of
prime-time
continuing programs and 47 half hours of daytime soaps. The
weeks were selected to avoid
sweeps, with the intent to acquire "average" or nonspecial content.
The number of programs
coded and the weeks selected were limited by resources.[1] Programs were taped
during one
week in the spring 1993 season and one week in the fall 1993 season.
Because we are interested in the implications of continuing messages rather than
a
description of one time period, programs selected for prime time
were those with live
characters in the top-rated programs for each season , selected from
combined ratings
provided by two networks. Excluded were talk shows, news magazines,
sports and movies.
Talk shows, news magazines and sports do not provide intercharacter
messages, and this
study was not examining commercial messages. Movies were excluded
because they do not have
the potential for continuing messages.
For the soap operas, which air every day, broadcasts of each program were
selected by
random number. Because we were gathering character information
as well, a coder familiar
with continuing characters was assigned the familiar program in
order to make character
information more accurate. [For example, in the soaps, marital
status may not be obvious
from one half hours' viewing. Those who follow a particular soap can
provide more
information.] Other program assignment was random.
Although a week or program selected randomly from the entire season would have
more
generalizability to the television season as a whole, the week
selected here avoids the
special content usually included in prime time when the season
begins and ends and during
sweeps and should be more representative of the season as a whole
than these special
weeks.
In order to cover the widest diversity of programs and to make comparisons
without
weighting, coding was limited to one half hour of each taped
program.For both the
prime-time programs and the soaps, if any program was a full-hour
broadcast the full hour
was taped and the actual half hour coded for the program was selected randomly
, unless
drinking occurred in one half hour only. Coders were instructed to
view both half hours.
Because we were looking for behaviors associated with alcohol use
rather than just a count
of alcohol use, if alcohol use occurred in only one of these half hours, the
time with
alcohol use was coded because that was the activity of interest. If
alcohol use occurred
in both half hours, the coder was instructed to code the original
assignment.
Coding Procedures: Each half hour was double coded. Programs were first coded by
graduate
students in a beginning research methods course. Then the
student coding was verified by
one of two trained coders assigned to the project. Each student was
assigned 3 half hours
of prime time and 3 half hours of afternoon soaps and was provided a
detailed set of
directions, sample code sheets and coding examples, and required to
attend a training
session.
As a reliability check, twenty half-hour programs were double coded by each of
the
supervising coders. An additional random sample of 6 half hours was
verified by both
coders, in effect providing a triple code. On the health beliefs, no
disagreements were
found.
Codes and coding procedures were developed through a pretest of a preliminary
program set.
The pretest coded by time, determining drinking behavior of each character per
half hour.
The preliminary coding indicated that drinking, even for the same character,
varied
considerably by scene; therefore an alternative to time or
character was needed.
Coding: Coding was conducted in two stages. First general scene information was
recorded.
Instructions for the scene information relied heavily on Wallack's "TV Coder's
Manual"
for coding drinking acts (Wallack, et al., 1990). For each
scene, the type of alcohol
behavior and the setting (place, time of day, number of men and number
of women present,
type of people [e.g., business, romantic,etc.] , and mood of the
scene) were coded. In
addition, presence or absence of examples of the Young and Knight
(1989) nine
alcohol-related health beliefs were coded. The type of program was also
recorded.
The second phase of the study, which is not reported here, focused on individual
characters. Perceived demographic information about each character,
the character's role
in the scene, the character's drinking behavior and reason for
drinking, consequences of
this drinking behavior and any cautions mentioned about drinking
were coded.
Because this report is concerned with health belief messages in programs,
relevant is type
of program and Wallack's definition of use of alcohol, or a "drinking act." If
a
character actually ingested a drink or prepared to take a drink,
the scene was recorded
as having drinking behavior. In addition, references to alcohol or
visual alcohol
artifacts were included as drinking behavior. Whether a character
actually drinks a
beverage, orders a drink, or discusses intent to drink, certain
messages about alcohol
beliefs may be communicated, and those beliefs are of interest here.
Seven types of programs, based on identification in TV Guide, were identified:
daytime
soaps, comedy, drama, crime drama, evening soaps, mysteries,
and "other." Coders were
instructed to use the TV Guide identification.
Scene was chosen as the unit of analysis. Time as a unit wasn't giving us
overall
background in the pretest and and had the additional problem of
repetition. For example,
one person could have several drinks in a one scene and be sending
only one message. And
as already mentioned, characters tended to appear in more than one
scene. Scene analysis
allowed us to identify the different messages being sent in
different situations. Because
a scene has a start and finish, scene as the unit of analysis
allowed us to assess the
situation as a whole. Determination of a "scene" followed the
definitions provided for
broadcast script writers (see Armer, 1993, and Miller,1980, for
example). For this
analysis, an abrupt change of time or place constituted a change of
scene.
Coding Health Beliefs: The nine alcohol-related health beliefs were identified
as "alcohol
reinforcement domains" by Young and Knight's (1989) factor analysis of a list
of alcohol
expectancies. Young and Knight had reported three representative items for each
belief.
The items reflected both positive and negative expectancies.
Coders were provided the list as well as the underlying domain. They were
instructed to
circle any item that applied to the scene being viewed. Coders
could circle as many as
applied to that scene. If any of the three items for a domain was
marked, the scene was
considered to indicate the overriding belief.
The domains, or beliefs, and the representative items are listed below.
Assertiveness:
If I'm drinking it's easier to express my feelings.
Drinking makes me feel outgoing and friendly.
I have more self-confidence when I'm drinking.
Affective Change:
I am more sullen and depressed when drinking alcohol.
Drinking makes me happy and content.
Drinking helps me put my life on the right track.
Sexual Enhancement:
I am more romantic when I drink.
Drinking makes me more sexually responsive.
Drinking alcohol makes me think more about sex.
Social Enhancement:
Social activities are more boring if alcohol is involved.
When I'm drinking I avoid people or situations for fear of embarrassment.
Drinking adds a certain warmth to social occasions.
Relaxation:
I do not drink alcohol to help me unwind after a hard day's or week's work.
Drinking makes me feel calm.
Drinking alcohol helps me unwind after a hard day's or week's work.
Drinking enables me to fall asleep more easily.
Cognitive Impairment:
I think less clearly when drinking.
I get better ideas when I am drinking.
When I drink alcohol I get more easily confused.
Dependence:
Drinking alcohol is usually associated with other activities.
I am powerless in the face of alcohol.
I feel powerful when I drink: as if I can really influence others to do what I
want.
Carelessness:
I am less concerned about my actions when I'm drinking.
I am more aware of what I say and do if I'm drinking alcohol.
When I'm drinking I take extra care of myself and my possessions.
Aggression:
I control my temper more easily when drinking alcohol.
Little things annoy me less when I'm drinking.
Drinking increases my aggressiveness.
RESULTS
The coding included half hours of 56 soaps,32 comedy programs, 5 dramas, 4 crime
dramas, 4
evening soaps, and 2 mysteries. Drinking behavior varied; only two programs
did not have
at least one scene without drinking. In other words, 98 percent of the programs
had at
least one scene without drinking behavior. The actual number
of scenes per program that
did not include drinking behavior ranged from 1 to 16; the mean
number of scenes without
alcohol use was 5.7 across the sample. But because the number of
scenes varied from
program to program, figures based on the number of scenes should be
interpreted with
caution.
As already noted, because the interest was in continuing messages and therefore
continuing
programs, no movies were coded. There were no programs in the "other" category;
all fit
into one of the other six established TV Guide categories.
Although some programs were
coded in both time frames (once in fall and once in spring) and each
afternoon soap was
coded more than once, each half hour represents a different program
broadcast (a different
time) and will be referred to as a "program."
At least one scene of each of the health beliefs was present in the collective
programs.
As indicated in Table 1, the most frequently identified health
belief (or expectancy about
alcohol) was that alcohol is perceived as affecting social enhancement; 38
percent of the
programs sent messages that alcohol use is associated with changes a social
situation.
The second greatest health message sent was that alcohol use is associated with
relaxation
(26 percent), and the third association was with assertiveness (21 percent).
Following
these were: affective change (19 percent), sexual enhancement
(16.5 percent), dependence
(15.5 percent), carelessness (14 percent), cognitive impairment (12
percent), and
aggression (11 percent).
__________________
Table 1 about here
__________________
Beliefs by Program Type: The next question was whether these beliefs are common
across
program types or whether specific program types presented
special health beliefs.
Two analyses were done. Chi square analyses were run to determine whether the
presence or
absence of the health beliefs in at least one scene differed
by program type. Analyses of
variance and t-tests were conducted by program type on the mean
number of scenes including
each health belief.
Although examining the distribution of health beliefs over the six categories as
a whole
was interesting, the small number of evening programs in most
of the categories made
comparisons difficult and required that we collapse the categories for
meaningful
analysis. Because we are interested in soaps as a category, evening soaps
were included
with afternoon soaps as a broad "soaps" category; all other evening
programs were
collapsed into a group of other nonsoap prime-time programs.
Differences across Program Types: As indicated in both Tables 1 and 2,
regardless of the
type of analysis, there was no difference at the .05 level
between soaps and nonsoap
evening programs in presence of five of the health beliefs: messages
indicating that
alcohol expectations included social enhancement, assertiveness,
affective change,
dependence, and carelessness were present in as many soaps as in the
nonsoaps.
__________________
Table 2 about here
__________________
Chi square analysis indicated that 39.5 percent of the nonsoap evening programs
had at
least one scene showing alcohol beliefs dealing with
relaxation, nearly twice as many as
the soaps, 17 percent (chi square = 6.77, df = 1, p = .009). This
difference was even
larger with aggression; 21 percent of the nonsoap evening programs
associated alcohol use
with aggression, compared to 3 percent of the soaps (chi square =
8.13, df = 1, p = .004).
With the other two beliefs, sexual enhancement and cognitive impairment, there
was no
difference in the number of programs including at least one
scene with the health beliefs
(see Table 2).
We also examined by program type the mean number of scenes including each health
belief.
Because of the high number of scenes without drinking, and
therefore without any of the
health beliefs, the actual means are low, but the differences are
similar to those found
when presence of the beliefs in the programs were examined.
When programs were left in their separate categories, scenes with sexual
enhancement as an
alcohol belief were higher in the evening soaps (1.00) than in either the
afternoon soaps
(.14) or the comedy programs (.16); (F (5,97) = 3.15, p = .011). While
interesting,
these differences are influenced by the small number of
programs in some of the evening
categories and by one evening soap program that focused on an
alcohol-related accident and
should be interpreted cautiously.
After collapsing the programs to three: soaps, evening soaps and nonsoap evening
programs,
sexual enhancement, relaxation, aggression and cognitive impairment showed
differences.
For sexual enhancement, the results paralleled the uncollapsed
categories; means for soaps
and evening soaps did not change; mean scenes per program for the nonsoap
evening
programs was .19 (F (2,100) = 7.09, p = .001). Again, the one evening
soap focusing on an
alcohol-related incident is influencing this analysis.
The afternoon soaps had fewer scenes per program (.18) than the nonsoap
evening programs
(.58) showing relaxation as an alcohol belief (F (2,100) =5.05, p= .008);
afternoon soaps
(.09) were much lower than the evening soaps (.75) in showing cognitive
impairment
(F(2,100) = 4.29, p = .016); afternoon soaps (.04) showed fewer
scenes per program than
the nonsoap evening programs (.23) indicating aggression as a health
belief (F(2,100)=
4.30, p = .016).
As indicated earlier, when the programs were further collapsed into soaps and
nonsoap
evening programs, t-test results paralleled the results of the
chi square analyses. The
soaps had about half the number of scenes per program showing
relaxation as a health
belief (.17) as did the nonsoap programs (.40); (t = -2.55, df =
74.82, p = .013).
Aggression as a health belief was almost negligible in the soaps (.03);
other programs had
.22 scenes per program showing aggression as a health belief (t = -2.63, df =
53.71, p =
.011).
DISCUSSION AND CONCLUSIONS
To our knowledge, this is the first attempt to identify in entertainment
programs the
underlying messages about alcohol that can affect expectancies
or, in our terms, health
beliefs about alcohol use.
The most frequently identified health belief or expectation about alcohol in
the programs
overall was that alcohol is perceived as affecting social enhancement; the
second
greatest health message sent was that alcohol use is associated
with relaxation, and the
third association was with assertiveness. Regardless of the type of
analysis, there were
no differences between soaps and nonsoap evening programs in
associating social
enhancement and assertiveness with alcohol, but nonsoap evening programs had
many more
messages associating alcohol use with relaxation.
Five of the other six health beliefs, (affective change, sexual enhancement,
dependence,
carelessness, and cognitive impairment) are present equally
between the soaps and nonsoap
evening programs, but evening nonsoap programs associate alcohol with
aggression more
often than the soaps.
We need to emphasize again that the numbers reported here are the number of
different
programs that include these message, not the number of times the
message appeared per half
hour or per program. The implication would be that the message may have been
repeated
more than once per program, and therefore the number of messages
would increase.
We must also acknowledge that analysis of a different week during the two
seasons or a
different television season may produce different results.
However, every effort was made
to use a week that represented the "normal" programming rather than
the highly advertised
season beginning, ending and sweeps.
If we add our information about beliefs about social enhancement messages to the
literature that has found upper class individuals are more likely to
drink than lower
class (Signorielli, 1990) and the "good guys" are drinking (Health and
Fitness News Servi
ce, 1991), the implication is that alcohol is desirable. Even though
the social
enhancement items included beliefs about negative as well as positive
effects on social
situations, the emphasis is on the situation rather than the
individual. With an adolesc
ent population where the words "party" and alcohol are still
synonymous, the message
implied from these studies is a problem.
The frequent association of alcohol with both relaxation and assertiveness sends
a message
that alcohol can be used as a tool or a cure-all for stress and/or other
problems, a very
misleading message. The suggestion that alcohol can cure like an aspirin or
that a drink
can give someone "courage" or self confidence sends a
dangerous message for those who
might be looking for help. The messages about affective change are
again sending the
message that alcohol can be used to change a mental situation or mood.
The programs containing messages about sexual enhancement could be positive if
with the
current fear of AIDS they are accepted by the audience as a
warning. Further analysis of
scene mood (see below) should help us understand the framework of
these sexual messages.
Disconcerting is the low number of programs containing messages about aggressive
and
cognitive changes associated with the use of alcohol. The
aggressive belief included items
about both control of aggression and loss of control. Most of the aggressive
messages
were in the evening nonsoap programs which included crime dramas and
mysteries. Ignored in
the belief messages is the real-life association of alcohol use with aggression
that can
lead to spouse abuse and other aggressive situations.
The same concern exists about the low number of messages about cognitive
impairment, an
issue that contributes to the number of drunken-driving
arrests and accidents.
Future: This report is the first from a larger project that is exploring health
belief
messages in entertainment programs. We plan to immediately
continue analysis using more of
the scene information. For example, the mood and the setting associated with
each belief
message should help us understand more about the information being
transmitted by these
drinking behaviors. Because our particular interest is women, we
plan to then use rating
information to explore the exposure to these beliefs by the female
audience of different
ages.
Additional exploration will be conducted when the character data is available.
As already
noted, we have gender, profession, role in the scene, and
other demographic-type data.
Again, we are most interested in the female drinkers, but will
examine both genders in
order to compare. We would also like to acquire archived programs
and conduct the study
on a long-term basis to determine whether patterns of messages have
been broadcast. A long
term objective is to identify health beliefs in the population as a whole and
determine
whether these beliefs are associated with television viewing
patterns.
--------------------------------------------------------------------------------
----------
------------------------------------------------------
Table 1: Percent of programs with at least one scene indicating a
health belief about alcohol use (n=103)
_____________________________________________________________
Health Belief
Social Enhancement 37.9%
Relaxation 26.2% B C D
Assertiveness 21.4%
Affective Change 19.4%
Sexual Enhancement 16.5% A C
Dependence 15.5%
Carelessness 13.6%
Cognitive Impairment 11.7% C
Aggression 10.7% B C D
A = mean number of scenes different across six program types
B = mean number of scenes different across six program types; no individual
groups
different
C = mean number of scenes different - soaps/evening soaps/other evening programs
D = mean number of scenes different - soaps/other programs
--------------------------------------------------------------------------------
----------
------------------------------------------------------
--------------------------------------------------------------------------------
----------
------------------------------------------------------
Table 2: Percent of "Soaps" and "Evening Nonsoap Programs" with at least
one scene indicating a health belief about alcohol use
_____________________________________________________________
Soaps* Evening
Nonsoaps
Health Belief (n=60) (n=43)
Social Enhancement 35.0% 41.9%
Relaxation 16.7% 39.5%**
Assertiveness 20.0% 23.3%
Affective Change 15.0% 25.6%
Sexual Enhancement 16.7% 16.3%
Dependence 20.0% 9.3%
Carelessness 13.3% 14.0%
Cognitive Impairment 11.7% 11.6%
Aggression 3.3% 20.7%**
* = Includes evening soaps
** = Significance < .01
--------------------------------------------------------------------------------
----------
------------------------------------------------------
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[1] Because the initial coders were part of a methods class (see below),
weeks for
coding had tobe selected after the students understood content
analysis. If a
program was
preempted, the coders were instructed to tape the week immedi
ately following.
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