Department of Political and Social Sciences - UIA

Health communication and media participation in Flanders/Belgium

Nico Carpentier
University of Antwerp UIA


Contents

Introduction
Example 1: Community radio
Example 2: Den Vrijen Courant
Example 3: The 'Safe sex video show'
Example 4: The Aidspages
Levels of participation
Conclusion
Flemish Aids campaigns
Bibliography


Introduction

In the period 1986-1995 the Flemish government has launched 10 Aidscampaigns, of which only the first two were on a relatively small scale. In the other 8 cases, from 1987 until 1995 government (in collaboration with STAG (the Flemish Aids-telephone)) has made use of all the available means of mass communication.

The first Flemish campaigns were meant to inform and to raise the awareness of their audiences, to fulfil an agenda-setting task. After different studies proved that people had, to a very large extent, become aware of the risk of HIV contamination and of the possible protective strategies - for example 96% of the people between 15 and 59 years old knew in 1993 that the use of a condom can prevent HIV contamination - the attention switched very rapidly from agenda-setting to behaviour modification.

Especially the two last Zet'm Op ('Put it on') campaigns aimed very ambitiously at removing emotional barriers for the use of condoms, concentrating on communication by means of radio, television, cinema, advertisements and posters. This approach was heavily criticised because of its overestimation of the possibilities of mass communication in the field of behaviour modification. Having access to information is a necessary condition for behaviour change, but not a sufficient condition. Mass media campaigns remain valuable as instruments for agenda-setting and for spreading basic information, but are weak instruments for behaviour modification.

This hypothesis was confirmed by a Belgian research project in 1993, questioning nearly 1000 youngsters between 15 and 24 years old. Respondents were asked which source of information about Aids they considered to have been the most important. This subjective evaluation of the use of information sources lead to the conclusion that 49% of the respondents named the media as their prime source of information. School and parents came on the second and third place. Within an interval of about 15 minutes, respondents were also questioned on their subjective evaluation of the impact of these sources of information. Again, the media played a major role, but to a lesser extent in comparison with the first question: 40% said that the media had influenced their opinion and behaviour about Aids the most. On the other hand, the parents and peergroup increased in significance: 25% of the people between 15 and 24 years old named their parents as the main influence, and another 25% of them stated that the peergroup had influenced them the most.

Graph 1

If the respondents were questioned on the impact of information sources on the use of condoms, the role of the media decreases even further. The peergroup, a major form of interpersonal, face-to-face communication, is the main influence on the opinion and behaviour concerning the use of condoms. Media and parents are on a shared second place (18%).

Graph 2

This leads to the conclusion that although mass media still remain important, especially as a source of basic information and as a agenda-setting instrument, interpersonal communication is an important factor of influence on the opinion and behaviour of people. The main question of this presentation is how to increase the influence of mass communication, considering the characteristics of interpersonal communication. This influence is usually explained by the increased trustworthiness and closeness of the messages, in combination with the individualisation of the message: it is possible to adapt the contents and form of the message to the needs of the audience, even at the moment of the communication itself. My original question can then be reformulated as how to increase the trustworthiness and closeness of mass communication. One of the answers to this question - but not the only one - lies in media participation. If the target group is allowed to interact with the producer of the communication, the form and contents of the message will be more adapted to the target group. This will indeed increase the trustworthiness and closeness of the message. I will try to clarify this hypothesis using four examples. The first two examples will concern participation in the field of the radio broadcasting and the production of a newspaper. The two other examples are situated in the sector of the new media, namely the use of video and of the Internet. In these examples the main emphasis lies on participation in the creating of the product; only the first example includes participation in the organisation.

Community radio

The first example concerns the presence of topics related to homosexuality in the Flemish audio-visual media. The Flemish public broadcasting company (BRTN radio and television), the commercial television stations VTM and VT4, and the regional television stations don't spend much structural broadcasting time on items related to homosexuality. Specific gay programs can only found on a few Flemish local radio stations. Most of the 350 local radio stations use a commercial format, and limit the information they offer to the minimum. Three Flemish radio stations have specific programming concerning gay topics: Radio Centraal in Antwerp, Radio Beiaard in Dendermonde and Radio Katanga in Aalst.

In this presentation I would like to focus on Radio Centraal, a non-commercial community radio station in Antwerp. One of the basic concepts of this station is to allow people to participate in the functioning of the station as a medium and as an organisation. They adhere an open door policy, which allows people to start a one hour radio program without many restrictions; within this period he or she can broadcast whatever he or she wants. Members of this radio station are also co-owner of the radio station and have a decisive vote in the general assembly. As such they are involved in the functioning of the organisation. This liberal and democratic climate has attracted people from different ethnic, social, political and sexual minorities, who want to spread information to and about those minorities. 'The pink wave', one of the Radio Centraal-programs, focuses on items related to homosexuality, more specific on legislation and government policy, discrimination and violence, sexuality and, of course, Aids. In this program safe sex is considered normal, responsible and the right thing to do. By creating an environment that enables an open and sometimes humorous discussion among peers, the impact of these unintended preventive safe sex messages can not be underestimated. They do not carry the aura (or stigma) of a government telling people what to do and what not to do, but are a continuous - almost unconscious - confirmation of the safe sex standard.

Den Vrijen Courant

The second example is 'Den Vrijen Courant', a yearly 100.000 copy newspaper/brochure produced by In Petto (formerly known as Fijac), subsidised by the Flemish government. In Petto is an organisation that promotes the participation of youth within different preventive fields, including the Aids- and drugsprevention. In 'Den Vrijen Courant' In Petto tries to inform people between 14 and 18 years old about safe sex, contraceptives, risk behaviour and the emotional aspects of sexuality and relationships, adapting the style and language of this publication to the specific culture of the target group. This adaptation has been ensured by engaging a youth redaction and a youth promotion team. The youth redaction consisted in 1995 out of 18 youngsters between 15 and 19 years old, who gave advise on the articles and interviews in 'Den Vrijen Courant', did research on the questions their peers had, concerning relationships and sexuality, and wrote texts and articles themselves. The promotion team consisted out of five students who did a survey, wrote an article about it, organised the press conference, were interviewed at the press conference and supported the distribution of 'Den Vrijen Courant'.

The collaboration of these youngsters led to a newspaper that uses quite explicit language. A previous edition in 1993 caused a confidence vote in the Flemish parliament, where the extreme right party Vlaams Blok accused the subsidising minister of endorsing and promoting promiscuity. The Flemish Christian-Democrats (CVP), a government party, partially supported this motion: during the debate the current CVP-minister of economics and media called 'Den Vrijen Courant' vulgar. The motion was rejected 56 votes to 52 votes.

The 'Safe sex video show'

The third example is the 'Veilig Vrijen Video Show' of the Aidsteam. The 'Safe Sex Video Show' is an American creation, inspired by the famous Tupperware-evenings, where a host invites as many friends or colleagues as possible, in this case to be exposed to an explicit videotape and to discuss the advantages and difficulties of safe sex. Most of the attendants (98%) are bi- or homosexual men (which can be explained by the fact that bi- and homosexual men are the target group of the 'Safe sex video show'). In this example participation has to be interpreted quite literary. As the videotape is intended to stimulate the discussion during the session, it shows realistic sexual encounters, and gay people talking about engaging in sexual encounters. Another factor that ensures the link with the gay subculture is that the Aidsteam is specifically oriented towards Aids prevention for homosexual men. Most members of the staff of the Aidsteam are also a member of the target group.

Topics that are treated in this video are (among others) technical problems with condoms, the correct use of condoms and situations where it becomes difficult to persist on using a condom. The strength of this project lies in the combination of mass and interpersonal communication: the videotape is used as an incentive to start a discussion among the participants. Because the tape is adapted to the specific and culture of the participants, it is accepted as a starting point for an open discussion about sexualtity.

In an evaluation survey with 613 attendants of a 'Safe Sex Video Show', 70% of them said to have learned much about safe sex and 81% said that the video was a good introduction to the discussion that followed. 96% would advise theirs friends to attend a 'Safe Sex Video Show', but only 19% wanted to organise a video show themselves.

The 'Veilig Vrijen Video Show' is usually shown in a private setting, but there have been a few attempts to organise a public display of the video, for pr-reasons. At least one attempt, at a gay life-style fair, ended when the police intervened and prohibited the showing because the video was said to be an offence against public decency.

The Aidspages

The final example concerns a Internet-project of the University of Antwerp: the Aids-pages. It is often said that the Internet is the most accessible global medium. It is indeed correct that whoever has enough knowledge and financial means to 'surf' the WWW, has access to an enormous amount of information. It is often forgotten that not everybody has the knowledge or the financial means to access the WWW. The lack of technical knowledge and financial means becomes even more acute when an organisation decides to make information available by means of the WWW. Making a website is a time-consuming and expensive project. On the other hand the availability of information about Aids on the WWW is an opportunity that cannot be neglected. For this reason the UIA - in collaboration with the Flemish Aids co-ordinate Ipac - started the Aids-pages. This project has four objectives:

  1. to group all information about Aids that is available on the Internet
  2. to offer Dutch Aids-prevention information
  3. to stimulate the scientific research by making results available on the Internet
  4. to offer information about the Flemish Aids-prevention and care organisations
The UIA had some experience with building websites, and had a server that was linked to the Internet, and decided to offer the Flemish Aids-prevention and care organisations the possibility to participate in this project. Each of the 38 members of the 'Aidsoverleg', the consultative body of Ipac, were offered the opportunity to start their own home-page on the UIA-server. Converting the original texts to html-documents was done by the UIA, who also trained two members of the Ipac in html-programming, so that the updating of the home-pages could be done by the Ipac. The final goal was to arouse enough interest of the organisations, so that they would independently take the initiative to start a website of their own. At this time 6 organisations have a homepage, 3 of them constructed it themselves, and 3 of them had their homepage constructed by the UIA. One of those last three organisations decided - as hoped - that a homepage did not offer enough information, and later decided to develop their own website.

Levels of participation

Although these four examples all relate to participation, there are some major differences. Participation in the case of 'Den Vrijen Courant' and the 'Veilig Vrijen Video Show' is relatively similar, except for the fact that in case of 'Den Vrijen Courant' participation itself is explicitly intended and organised, and is part of the concept of the organisation In Petto. In both examples, and in the example of Radio Centraal people participate on a individual level, and are not represented by another organisation. Participation in the Radio Centraal example is more complex, because the target group is not only allowed to participate at the time of the broadcast, but also has the opportunity to participate in the functioning of the organisation itself. Finally, in the example of the Aidspages, participation on a individual level is limited as the participants of this project are the Flemish Aids-prevention and care organisations. As these organisations often have people from the target group working for them, participation through representation is ensured.

Graph 3

Conclusion

The first point that these examples have made is that participation in Aids communication is possible and can have an impact on the message of the Aids communication. It would be difficult to produce a newspaper like 'Den Vrijen Courant', a videotape like the 'Safe Sex Video Show' or a radio program like 'The pink wave' that uses the same language as their target group and that connects to their specific culture, without participation of members of the target group. On a more structural level, the Aidspages-project shows that it is possible to motivate Aids-organisations to offer their information by means of a new global communications system.

A second conclusion is that these examples still remain relatively small scale, low budget media experiments. They cannot replace large scale mass communication campaigns, but they can supplement them and correct them. As said before, mass media campaigns are an important agenda-setting instrument towards the general public, but are at the same time weak instruments for behaviour modification. The examples in this presentation could give a better impulse for behaviour modification, but they do not have the ability to influence the agenda of an entire population. They also offer a model for the large scale Aids campaigns, emphasising the importance of adapting the form and contents to the specific culture of the target group.

My third conclusion is that adapting form and contents to the specific culture of the target group sometimes leads to problems with the more conservative part of society. Two of the four examples I used have had problems with the authorities, and one of them even risked losing their subsidies. Some people, including some politicians, still consider it improper to discuss sexuality openly, even when the aim of this communication is to inform and protect people from HIV-infection. It still has to be stressed and argued that open and honest communication about sexuality and Aids are the best guarantee for behaviour modification.


Flemish Aids campaigns

Slogan Year Media used Evaluation of campaign? Cost
Wat je moet weten over Aids
What you should know about Aids
1986 folder (to individuals)unknown unknown
Gepaste informatie over Aids vraag je aan je huisarts
Ask your doctor about Aids
1986poster, bulletin (to doctors)unknownunknown
Open je ogen voor Aids ze sluit
Open your eyes, before Aids has them closed
1987tv, folder (bussing)yes14.000.000
Is je vakantie je lief?
Do you like your holidays?
1988folder (in 6 magazines)unknown5.000.000
Aids. Praat Erover. Vooraf
Aids. Talk about it. Before.
1989radio, television, cinema magazines, poster, newspaperslimited300.000
Aids. Praat Erover. Vooraf. 2
Aids. Talk about it. Before. 2
1990television, posterunknown60.000
Bewust maakt gerust
To know is to be at ease
1990televisionunknown14.000.000
Aids, beter voorkomen dan nooit genezen
Aids, to prevent is better than never to cure
1992television, brochureunknown14.000.000
Zet'm op 1
Put it on 1
1993radio, television, cinema poster, adds stickers, postcardsyes7.100.000
Zet'm op 2
Put it on 2
1994-5television, posters, postcardsyes8.100.000


Bibliography