Leveraging Entertainment Narratives to Decrease Adolescent E-Cigarette Use

Television programs featuring health storylines have long been popular with viewers, and prior research suggests health content on fictional television programs can influence viewers’ health-related knowledge, perceptions, and/or behavior. This dissertation employs a scoping review, content analysis of Twitter data, and qualitative analysis of focus groups with adolescents to (1) characterize the current landscape of research on health storylines on fictional television and (2) explore the potential for television storylines depicting e-cigarette, or vaping, product-use associated lung injury (EVALI) to serve as an intervention tool. Each aim builds upon one another to advance the science of health communication through a focus on entertainment television health storylines. Results from Aim 1 suggest several important gaps in the literature, mostly notably the need for research utilizing social media data, research with adolescent participants, and research examining the influence of health storylines about chronic disease or substance use. In light of these findings, Aim 2 utilized Twitter data to examine viewer responses to EVALI storylines on New Amsterdam, Chicago Med, and Grey’s Anatomy. Results suggest these storylines may be a valuable way to inform viewers about harms associated with e-cigarette use, particularly if accompanied by the dissemination of up-to-date public health information from the social media accounts affiliated with the television programs. Aim 3 involved focus groups with 7th and 8th grade students during which participants viewed clips from the EVALI storylines and provided feedback about their potential use as an intervention tool. Participants were engaged while watching the clips and thought they could be useful as part of tobacco prevention education. Triangulation of findings across the three aims, combined with input from a writer who worked on one of the EVALI storylines under examination, suggests the importance of future collaborative partnerships between entertainment media and public health, continued evaluation of the influence of television health storylines on viewers, and the potential for health storylines on television to address health misinformation. These findings are significant for public health in that they can inform these future partnerships and provide a foundation for the use of television programming to improve adolescent health