Participatory Methods for Entertainment–Education: Analysis of Best Practices

Abstract

Entertainment-education (EE) projects combine entertainment and education to increase knowledge, shift attitudes and promote social change using a range of communication platforms including theatre, radio, television, games, social media and others. Theoretical understanding regarding the underlying mechanisms of this creative communication approach developed alongside evidence and best practices for designing, implementing and evaluating interventions using techniques that reflect the current state of the field. Recent best practices often utilize participatory methods, a bottom-up approach wherein researchers work with stakeholders to identify culturally relevant indicators of change and gather information about the assets and needs of affected communities. Despite calls in the literature for reporting on participatory processes for health communication, a synthesis of such methods specific to EE has yet to emerge in the published literature. This comprehensive search reviews participatory best practices specifically used for the development and implementation of EE interventions with a wide range of behaviour and social change objectives. Findings suggest utilizing participatory research methods provide unique opportunities for inquiry aligned with current theory and evidence for both EE interventions and across other creative communication strategies. Implications include programmes produced by and with an audience as opposed to for an audience.

Keywords

Participatory communication entertainment-education research methods best practices social change

Gather Around the Fire

Picture our human ancestors thousands of years ago gathered around a fire listening to an elder. Before written text, oral storytelling passed on history and traditions to future generations. As humans took word to stone and paper, storytelling continued to communicate history, teach lessons and impart wisdom to others. Examples include morality texts that have been passed down for millennia, such as Aesop’s Fables, The Upanishads or the Analects of Confucius.

Entertainment-education (EE) is analogous to the age-old concept of storytelling for change. EE projects combine entertainment and education to increase knowledge, shift attitudes and promote social change using a range of communication platforms including theatre, radio, television, games, social media and others (Papa & Singhal, 2009). EE is a conscious health communication strategy that has been effectively disseminated and studied in countries around the world for at least 50 years (Singhal & Rogers, 2004).

The understanding of EE followed the evolution of communication theory overall as a discipline, from social-learning models to mediated explanations and, more recently, to models of normative influence and persuasion (Moyer-Gusé, 2008; Rimal, Lapinski, Cook & Real, 2005; Sood, Menard & Witte, 2004). As theoretical understanding developed regarding the underlying mechanisms of this approach for behaviour and social change, so too have evidence and best practices evolved for designing, implementing and evaluating EE interventions using techniques that reflect the current state of the field. Participatory methods, a bottom-up approach wherein researchers work with stakeholders to identify culturally relevant indicators of change and gather information about the assets and needs of the affected communities, have been identified in the literature as best practices (Badowski et al., 2011; Dutta & Basnyat, 2008; Felt, Dura & Singhal, 2014; Novak, 2010; Parks, Gray-Felder, Hunt & Byrne, 2005; Singhal, Papa et al., 2006). Despite calls in the literature for reporting on participatory processes for health communication (Servaes, 2007; Singhal, 2001; Sood, Shefner-Rogers & Skinner, 2014), however, a synthesis of such methods specific to EE has yet to emerge in the published literature.

This comprehensive search reviews participatory methods specifically used for the development and implementation of EE interventions with a wide range of behaviour and social change objectives. The purpose of this search is not to create an exhaustive list of methods but rather to review and consolidate the existing evidence of where and how participatory methods are being utilized around the globe to design and evaluate EE programmes. The best practices that emerge from applying participatory research methods align with the underlying theories and goals of EE projects, but are also applicable across other creative communication strategies in settings around the world.

Looking Back at Best Practices

EE is a health communication strategy that has roots in oral and performing arts traditions, such as storytelling and spoken word (Storey & Sood, 2013). EE combines both fiction and non-fiction in its design. At the heart of this creative approach to behaviour and social change are positive, negative and transitional characters that serve as role models to provide educational information to audiences (Singhal, Obregon & Rogers, 1995). Piotrow and de Fossard (2004) delineate nine P’s that define EE; EE is pervasive, popular, passionate, personal, participatory, persuasive, practical, profitable and proven effective. The development and diffusion of EE around the world over the last 50+ years is well-chronicled elsewhere (Singhal & Rogers, 1988, 1999; Storey & Sood, 2013; Wakefield, Loken & Hornik, 2010). Much of the published literature on EE, however, has focused on the last component of Piotrow and de Fossard’s (2004) typology—proven effective—but has yet to succinctly explain ways in which EE engenders participation.

Theory

Theory has been part and parcel of EE since its nascent beginnings as a communication strategy (Singhal & Rogers, 2004). Early practitioners of EE planned programmes using constructs from social-learning theory (Bandura 1977, 1986). As EE spread around the world, mediated theories helped to explain the individual ‘effects’ of EE including audience involvement, diffusion of innovations and a hybrid of approaches (de Fossard & Lande, 2008; Sood, 2002; Sood, Menard et al., 2004). The most recent theories to be applied to EE, meanwhile, are multi-level approaches that move beyond individuals to focus on broader social-level change (Singhal & Rogers, 2002).

Social norms are unwritten rules that guide behaviour (World Health Organization, 2010). While terms in the literature often overlap, the most recent theories of EE include concurrent social norms constructs. For example, the theory of normative influence stipulates that various factors moderate the relationship between norms and behaviour (Rimal et al., 2005). The theory of entertainment persuasion, meanwhile, explains that as an inherently persuasive approach, EE facilitates involvement with the story and characters that, in turn, shape resistance to change (Moyer-Gusé, 2008). Involvement has been part of EE since its inception and is part of what is meant by participatory EE—the audience participating with the programme (Kincaid, 2002; Papa et al., 2000; Sood, 2002; Sood & Rogers, 2000).

While the most recent EE interventions continue to utilize theory in planning and evaluating programmes (Frank, Chatterjee, Chaudhuri, Lapansky, Bhanot & Murphy, 2012; Moran, Murphy, Frank & Baezconde-Garbanati, 2013; Storey & Kaggwa, 2009), a fundamental chain remains unlinked. A social norm of any kind does not exist without individuals and communities participating in perpetuating that norm. EE, by definition, is a strategy designed to promote social change and, in turn, shift social norms. This review thus focuses on best practice examples of EE where teams have worked alongside local audiences to plan, implement and evaluate EE programmes reflecting constructs of most recent multi-level theories.

Participation

While the use of participatory research methods to design and evaluate programmes has emerged in recent years, the idea of participation itself is not new. Brazilian educator Paulo Freire called for participation through education and believed the process of dialogic pedagogy could empower individuals (Freire, 1970). Augusto Boal, a fellow Brazilian, gathered these concepts into the creation of a participatory social change technique called Theatre of the Oppressed (Boal, 1979). These tenets have been further replicated and honed in other areas, such as community organizing and community-based participatory research (Alinsky, 1972; Israel, Eng, Schultz & Parker, 2013). Participation has been a component of communication programming and research, including EE, for some time, but the lessons learned from the adoption of these methods remain scattered across the literature (Rattine-Flaherty & Singhal, 2008; Singhal, Harter, Chitnis & Sharma, 2007; Singhal, Papa et al., 2006; Tufte, 2001).

Singhal (2001) explains that participation exists on a continuum from co-option at one end (top-down approach) to collective action (bottom-up approach). Participatory communication, Singhal explains, is the process by which individuals and communities are empowered to take control of their own lives through planned communication efforts. In essence, participation seeks to engage and empower a wide range of stakeholders, particularly including marginalized populations who have not been traditionally given a voice in planning and implementing programmes (Felt et al., 2014; Lennie, Tacchi, Koirala, Wilmore & Skuse, 2011).

It is hypothesized that participatory approaches are more effective than top-down communication approaches because participatory approaches draw insight and ideas from the population (Singhal & Rattine-Flaherty, 2006). The audience is more engaged (i.e., there is increased audience involvement) because characters are designed to be like the audience members and the issues are relevant to their lives and lived experiences. It is therefore clear why the Centre for Communication Programs at the Johns Hopkins Bloomberg School of Public Health says the audience is ‘essential’ for designing and implementing successful EE (de Fossard & Lande, 2008, p. 1). Numerous articles, reports and handbooks outline these participatory techniques for practitioners and researchers, but no such publication has ever synthesized such research methods specifically for EE.

Methods

We conducted a comprehensive search of the literature for examples of where and how participatory research methods have been used to design and evaluate EE programmes. We then looked for best practices that emerged from how participatory methods were used to plan, monitor or evaluate EE Programmes. The aim of this review was to bring together best practices from methods used across EE interventions and not to replicate previously published works that detail the ins and outs of each of these methods. Traditional notions of evaluation require robust randomized controlled trial-type designs with qualitative data providing anecdotal evidence to supplement findings. While no value judgments about the efficacy of large, population-based quantitative studies are being made, we simply searched for evidence of alternative methods as a way to understand behaviour and social change processes.

Results

Our comprehensive search revealed four categories of best practices—visual methods, oral methods, written methods and listening methods—which spanned formative, process and impact research. Visual methods include photography, video and drawings. Oral methods include stories, theatre and phone calls. Written methods include diaries and letters. And listening methods include formal listening groups (Figure 1).

Figure 1.

Source: Authors’ own.

Visual Participatory Methods for Entertainment–Education

Participatory Photography

Participatory photography is an umbrella term for a set of methods that give cameras to audience members to generate content and share lived experiences for or from an EE programme. One of the most well known of these techniques is photovoice, a photo and social change technique credited to Wang and Burris (1994). Photovoice allows participants, rather than researchers, to capture scenes that convey their perceptions and experiences (Catalani & Minkler, 2009; Wang & Burris, 1997). Wang and Burris (1997) described photovoice as having three goals: ‘(1) to enable people to record and reflect their community’s strengths and concerns, (2) to promote critical dialogue and knowledge about important issues through. . . group discussion of photographs, and (3) to reach policymakers’ (p. 370). Data collected from photovoice comes from both participant discussions of the photographs taken and the photographs themselves (Catalani & Minkler, 2009).

As a first best practice example of this method, Singhal et al. (2007) used participatory photography for a long-running EE radio drama titled Taru (named after the female protagonist) in India. The embedded health topics included in this 52-episode programme were family size, gender equality and family planning. The purpose of the photography activity was to learn how listeners engaged with the programme and to determine whether their experience as audience members matched the characters in the EE programme. The photos, and accompanying narratives, were then used in community discussions with the research team. This technique enabled audiences to take the storylines to their own communities, generate awareness of issues and mobilize to take action. In terms of grounding in a theoretical basis, the activity becomes a cue to action (health belief model), a way to gauge subjective norms (theory of planned behaviour) and a way to build critical consciousness (community organizational model) (Glanz, Rimer & Viswanath, 2008).

One participant, for example, who was influenced by the poverty in her village, took a photo and described it in the following way, ‘This oven is a source of smoke, which affects the health of women. The WHO has said the women who use this oven inhale 40 per cent more smoke than an average person’ (Singhal et al., 2007, p. 219). This example provides evidence that participatory photography can enable community members to look beyond the planned subjects or topics of an EE programme. Environmental health was not one of the main objectives of the radio serial. Using participatory photography, however, enabled communities to determine their own needs influenced by the storylines and characters.

Photography was also used to evaluate Ashreat Al Amal (Sails of Hope), a 144-episode radio serial in Sudan focused on female circumcision, safe motherhood and HIV. Photographs were used to answer the question, ‘How has your life changed, or what aspects of your life have been affected by listening to Ashreat Al Amal?’ (Singhal, Greiner & Hurlburt, 2006, p. 2). One woman’s photo was described by the following, ‘This is the room of the already circumcised girl. She was circumcised in this room a week ago. . . . The girl is 8 or 9 years old’ (p. 14). The best practices that emerge from the participatory photo examples above showcase that photographs are a powerful mechanism to personalize portrayal in a national EE programme and how EE programmes can generate local awareness of those issues, while at the same time allowing audiences to integrate the issues into their own lives.

Participatory Video

Participatory video utilizes the same concepts as Photovoice but with video cameras. A best practice example of this method comes from Tanzania. The Tanzanian non-governmental organization (NGO) Maneno Mengi (Many Words), a group founded by media employees, uses video to give a voice to the people and to create projects. The organization produced the video Tukomeza Kipindupindu (Let’s Get Rid of Cholera) using participant footage, as well as community-driven editing and production processes (Dagron, 2001). Video from this organization has contributed to numerous programmes and TV shows. Participatory video, like photography, pulls from empowerment theory and has been used at every step of an EE project.

Participatory Drawing

Participatory drawing (or sketching) is a data collection technique in which respondents sketch their responses to a question posed by researchers (Literat, 2013). Like participatory photography and video, sketching is an appropriate technique to use with populations with low literacy skills. Reading and writing skills are often seen as a privilege and thus this method pulls from the theories of Michel Foucault, specifically the construct of subjugated knowledge, and empowerment from Freirean and community organization theories (Foucault, 1980; Glanz et al., 2008). Entertainment–education raises awareness of an issue, and thus sketching before or after exposure further pulls from stages and step models in the decision whether or not to take action based on that new awareness. Sketches of respondents’ communities are useful because researchers can determine which resources are available to respondents and which are lacking based on what is present or absent in these figures (Tacchi, Fildes, Martin, Mulenahalli, K., Baulch, E., & Skuse, 2007). Sketching with children is useful because it recognizes the role of children and youth—who are often large percentages of the population—in designing and implementing EE projects. This tool has been used with both children and adults (Lennie et al., 2011; Literat, 2013; Sapkota & Sharma, 1996).

A best practice example of this technique with children comes from Peru. Children in an Amazon community were asked to draw their communities as part of the evaluation process for several community interventions that included the radio programme Bienvenida Salud! (Welcome Health!) (Singhal & Rattine-Flaherty, 2006). These drawings and the explanations that accompanied the drawings revealed indicators of community improvement as a result of the intervention, including chicken coops, fish farms and agro-forestry projects (Singhal & Rattine-Flaherty, 2006).

Participatory sketching has also been used with adults. Barker, Connolly and Angelone (2013) used participatory sketching to develop and evaluate Umurage Urukwiye (Rwanda’s Brighter Future), a long-running radio programme covering the topics of family planning and population growth. Sketching was included as one part of a mixed methods evaluation design to depict how the programme changed participants’ lives. One best practice from this application was the separation of men and women during the activity. This was important due to the subject matter and to respect cultural norms. Another takeaway is how the researchers triangulated findings from focus groups with the picture data. The sketches confirmed what participants had revealed in focus groups and, thus, enhanced validity. A third best practice from this example is communicating the rigour of these participatory methods, as they can be unfamiliar to funders and researchers alike. And, finally, this example illustrates how participatory methods may be used alongside traditional measures to both enhance and explain results using the voices of the audience members.

Greiner, Singhal and Hurlburt (2007) used participatory sketching in Sudan to gauge the impact of Ashreat Al Amal (cited above). This project is unique because it asked participants to draw two pictures—one of their lives before the programme and one after the programme (Singhal, Greiner et al., 2006). This pre-post technique is a best practice from this participatory method because proving causation (i.e., the EE intervention caused a change in behaviour) is challenging in traditional methods, such as surveys, unless panel designs and large sample sizes are used. Yet another lesson learned from this example is the practice of recording participants’ descriptions of drawings and having these narrations translated into another language (e.g., English) for analysis. Whereas much international health work has traditionally involved outside ‘experts’ travelling to remote areas for data collection, rapid dissemination of new technologies means that local participants can collect data. Local researchers can send drawings and recordings to the research team by scanning and sending digital files through computers or phones. This means that such activities will be less likely to reflect socially desirable answers often seen with the presence of outside or foreign researchers. This further increases validity in the findings.

Oral Participatory Methods for Entertainment–Education

Most Significant Change Stories

Oral methods used for EE include stories, theatre and analysis of phone calls. The most significant change (MSC) technique is a ‘dialogical, story-based technique’ (p. 137) in which participants share stories of the most meaningful impact an intervention has had on them (Dart & Davies, 2003). In the MSC technique, stories are collected and the most significant of these stories are selected, discussed and analyzed (Davies & Dart, 2005). The MSC technique is an inductive rather than a deductive approach. Deductive, or traditional research approaches, starts with theoretical frameworks, for example, mediated models of EE; EE causes an increase in knowledge, which in turn causes behaviour change. The MSC starts with the audience. This method is based on the Targeting Outcomes of Programs (TOP) framework developed by Rockwell and Bennett (2004). This model states that goals and objectives of planning and evaluation should occur concurrently along a hierarchy.

This method was used successfully in the Bell Bajao! (Ring the Bell!) project in India. Bell Bajao! was a multi-pronged communication campaign to end domestic violence that used public service announcements (e.g., TV, radio and print spots) and mobile video vans dispatched across the country to bring video, theatre and dance as part of the intervention to cities and villages. Individuals, specifically men and boys, were encouraged to intercept violence by ringing a bell literally and figuratively. Researchers used the MSC to monitor the implementation of this project and to learn strategies for the future. Below is an excerpt from one story of change (summarized and translated into English):

Mohini is a 19 year old from Kanpur, a cheerful, sociable person, easy to talk to, but when it comes to women’s rights she means business. . . . She became a role model for girls in her community. Once Mohini heard a couple (tenants in her house) fighting. She decided to intervene. She went to their room and rang the bell. . . . Mohini says that after that day, she has not heard any violent disagreements from them. (Aleya, 2012, p. 37)

In another best practice example, from Nepal, MSC stories were used to evaluate the impact of listening to the radio programme Saathi Sanga Manka Khura (Chatting with my Best Friend) (Lennie et al., 2011). Researchers implemented the MSC technique with groups of four to six people in four research sites across the country over a period of 2 months. Five stories were related to improved communication skills. Six stories were related to increased motivation to study. For example, as one participant described, ‘This drama, as well as pressure from my mother and brother, helped me to realise the importance of education. . . This is all due to the help of the SSMK radio program and my family.’ (p. 11). Both of these examples illustrate how the MSC technique can show action as a result of an EE intervention in a way that traditional surveys cannot capture.

Participatory Theatre

Community members can also share stories of personal growth through participatory theatre. The theoretical roots of this technique come from the work of Paulo Freire and Augusto Boal. This technique involves audiences and actors working together to create pieces that are performed for other community members (Harter, Sharma, Pant, Singhal & Sharma, 2007). This formative technique was used in Timor Leste to disseminate agricultural information to farmers (McGillion & McKinnon, 2014). The project began with a 40-hour workshop at a university in Australia to produce a basic structure and training for the performances. Upon arrival in Timor Leste, improvisation, a dance and a song were added to the loose ‘script’. Local language performances were then presented in villages and involved audience participation. For example, farmers were asked how they felt about the scenes and whether the scenes were relatable to the farmer’s experiences. The performances provided a way for participants to apply critical thinking about sensitive topics and discussion about change within the community. For example, as one female farmer explained, ‘I can see directly with my own eye and therefore I can do it on my own’ (p. 508).

Phone Calls

Analysis of phone calls to programmes is a final oral participatory method that has been used to design and implement EE. The Mabrouk! (Celebration!) initiative in Egypt was a multifaceted and large communication project for maternal and child health (Hess, Meekers & Storey, 2012). This initiative was designed using the P process, a roadmap for designing health communication that draws from multiple theories of social and behaviour change (Health Communication Capacity Collaborative, 2013). A televised game show was an embedded part of this intervention. The game show segments, included as part of a weekly variety show, quizzed newly married couples on the planned health topics and included funny props, such as fake crying babies. Television viewers across the country called in to the show to answer questions and win prizes. The information from the calls helped to plan new segments and determined, in part, the effectiveness of the messages from the programme.

In the United States, Wilkin et al. (2007) analyzed calls to 1-800-CANCER after a breast cancer storyline was embedded in a Spanish language soap opera on the Telemundo channel. Researchers found calls significantly increased when the number was shown during the programme. A best practice from this example is that participatory methods need not be measured using qualitative analysis techniques alone, but can be part of mixed methods research designs.

Written Participatory Methods for Entertainment–Education

Letters

Written participatory tools include letters and diaries. Audience letters sent to a programme or to an actor are written without solicitation from researchers and are, therefore, a true representation of viewers’ thoughts and a central mode of feedback (Law & Singhal, 1999; Sood & Rogers, 2000). Papa et al. (2000) estimated that over 150,000 letters were sent to All India Radio during the first year of broadcast of Tinka Tinka Sukh (Happiness Lies in Small Things). Analysis of a sample of these letters, alongside survey data, was used to unwrap the processes of change exhibited by the EE programme. As one listener wrote to the show, ‘Inspired by Tinka Tinka Sukh, we have established a youth self-help association for the sole purpose of tacking and eradicating social evils’ (p. 45).

Of course, unprompted letters vary in their purpose. Some letter writers may offer plot suggestions, others may just want to engage with celebrities. Content analysis of letters, meanwhile, is a lowcost method that may help researchers understand the audience’s degree of parasocial interaction (identification with characters and situations) and the impact an EE intervention has had on them (Sood, 2002; Sood & Rogers, 2000).

While only a small proportion of the audience sends in letters, that is, ‘superfans’ of a show, this feedback helps researchers understand who the intervention is reaching and what audience members like and dislike about an EE programme so that it can be adjusted accordingly during programme monitoring (Sood & Rogers, 2000; Sypher, McKinley, Ventsam & Valdeavellano, 2002).

In terms of evaluation, content analysis of audience letters was used to evaluate Musekeweya (New Dawn), a radio drama broadcasted in Rwanda that promoted reconciliation, peaceful coexistence and healing following the Tutsi genocide in Rwanda (Tanganika, 2015). Over 700 letters were received over the course of the broadcast, and a random sample of 216 were analyzed. The letters demonstrated audience understanding of the messages conveyed in the drama, parasocial interaction, self-efficacy and decreased prejudice. One listener, for example, wrote:

I wish to tell you how far Musekeweya has transformed me. From a very early age I had been under strong influence of tribalism. I grew up indoctrinated not to interact with people perceived to be enemies, but now as a young man I have learnt the truth about people inhabiting our country Rwanda from Musekeweya. I have benefited from it tremendously because now I confidently participate in reconciliation programs of my country which experienced bad governance; I try to educate those who have not learnt the truth about the reality of our country today. We are all brothers. (Tanganika, 2015, p. 65)

Implications include that letters may indicate changes in social norms and allow participants to thoughtfully and openly discuss sensitive issues in non-traditional forums.

Diaries

Diaries are a participatory method that allows participants to either form content for an EE programme or document how an EE intervention has impacted their attitudes and actions over time (Singhal, Papa et al., 2006). The Radio Diaries programme in Malawi is an example of how diaries can be used to create EE content (Rimal & Creel, 2008). In this project, narrators shared personal stories about HIV on the radio each week using their own words and experiences. Diary segments lasted approximately 10 minutes and were followed by call-in segments and other supplementary information. This example is best practice regarding the ethics of participation for all of these activities. While participatory methods are useful and important ways to design and evaluate projects, particular attention must be made to protect participants, especially traditionally marginalized and vulnerable groups. For example, in the Malawi Radio Diaries project, participants were chosen who knew their status and were willing to share their stories and experiences (Rimal & Creel, 2008).

Listening Participatory Methods for Entertainment–Education

Listening Groups

The final type of participatory methods for EE is listening methods. One such method is listeners’ groups. Listeners’ groups are a participatory tool that has been used to collectively discuss the issues addressed in EE interventions (Singhal, Papa et al., 2006; Sood, SenGupta et al., 2004). This technique reinforces messages conveyed in an EE intervention, generates dialogue among community members about sensitive issues and builds social capital within communities (Singhal, Papa et al., 2006; Sood, SenGupta et al., 2004). Furthermore, participation in listeners’ groups increases the likelihood of community members taking collective action to improve their communities (Singhal, Papa et al., 2006; Sood, SenGupta et al., 2004;).

A best practice of this approach comes from the Radio Communication Project in Nepal. This project included an EE radio drama titled Cut Your Coat According to Your Cloth, as well as radio spots, printed posters and other components. Individuals who listened to the EE broadcast were compared to (i) individuals who both listened and participated in listening groups and (ii) individuals who neither listened to the broadcast nor participated in the listening groups (Sood, SenGupta et al., 2004). The results found individuals who both listened and participated in the listening groups were significantly more likely to report positive outcomes than those who only listened to the broadcast. Participation in the groups was associated with higher individual and collective action on the intervention topics.

Discussion

The premise that EE is successful at creating social change because it engages and empowers audiences aligns itself with the tenets of participation. We found evidence of participatory methods used for EE in four categories—visual methods, oral methods, written methods and listening methods. We found several other participatory tools that may be applicable to EE but have not yet been used for EE. These techniques include, but are not limited to, ranking activities, sequencing activities, social media posts and diagrams (Parks et al., 2005; Tacchi et al., 2007).

Our search was not without limitations. We used online databases to review the literature using keywords, such as participatory, EE and similar phrases, but we did not conduct a formal systematic review or meta-analysis of results and, therefore, it is possible that we may have overlooked examples or evidence of participatory methods used for EE. In addition, our review only focused on printed and electronically available evidence. Some EE projects may have never shared their findings or articles may have been edited or rejected. We believe results from future EE projects must be made more accessible and disseminated more widely.

We found, however, that participatory methods have been used in many different settings around the globe and are grounded in an array of theories and frameworks (Figure 2). These methods have been used at every step of research from formative and design, to monitoring and process evaluation, and to impact and outcome assessment. We found that these methods offer many benefits for EE research and have typically been used to supplement conventional methods rather than replacing them (Dart & Davies, 2003). We also found that utilizing both conventional methods and participatory tools allows for ‘triangulation’ in which researchers use multiple methods to verify the significance of indicators (Felt et al., 2014). For example, during interviews for a water sanitation project in Tanzania, every family stated that they stored their water in covered containers (Badowski et al., 2011). Photographs taken by community members, meanwhile, showed several uncovered water containers. These methods, therefore, may lead to more accurate reporting.

Figure 2.

Source: Authors’ own.

Participatory methods, meanwhile, not only empower respondents and promote collaboration between diverse stakeholders but also allow researchers to learn from members of the affected community and carry out research processes for EE interventions in a culturally sensitive manner (Felt et al., 2014; Parks et al., 2005). And many of these methods are ideal for marginalized populations that have not traditionally been given a voice in research. Findings suggest utilizing participatory research methods provide unique opportunities for inquiry aligned with current theory and evidence both for EE interventions and across other creative communication strategies.

Onward

Entertainment–education is an effective communication and social change strategy based on sound social and behavioural theory. How EE works in terms of constructs in the most recent multi-level theories, such as shifting social norms, is not fully answered. What is known is that the social norm change requires participation, either in continuing positive norms as the status quo or in working collectively to create new norms while shifting harmful norms. We hypothesize that participation by audiences in planning, implementing and evaluating EE can determine the prevalence of norms, generate potential solutions and lead to more effective programming. The methods and best practices reviewed here are grounded in theory and evidence and can uncover the extent to which EE programmes are integrated into people’s lives and have helped to change norms. Implications include programmes produced by and with an audience as opposed to for an audience. Using such methods may not only make programmes more effective, but also, in so doing, will equitably involve individuals and communities and therefore come closer to achieving the historical aims of social justice and participation upon which this communication strategy emerged.

References

Aleya

(2012). Bell Bajao! campaign. A report by breakthrough. Retrieved 6 July 2016, from http://www.bellbajao.org/home/research/most-significant-change-stories/

Alinsky

S.D.

(1972). Rules for radicals. New York, NY: Random House.

Badowski

, Castro

C.M.

, Montgomery

, Pickering

A.J.

, Mamuya

, & Davis

(2011). Understanding household behavioral risk factors for diarrheal disease in Dar es Salaam: A photovoice community assessment. Journal of Environmental and Public Health, 1–10.

Bandura

(1977). Social learning theory. Englewood Cliffs, NJ: Prentice Hall.

Bandura

(1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice Hall.

Barker

, Connolly

, & Angelone

(2013). Creating a brighter future in Rwanda through entertainment education. Critical Arts, 27(1), 75–90.

Boal

(1979). The theatre of the oppressed. New York, NY: Urizen Books.

Catalani

, & Minkler

(2009). Photovoice: A review of the literature in health and public health. Health Education & Behavior, 37(3), 424–51.

Dagron

(2001). Making waves: Stories of participatory communication for social change. A Report to the Rockefeller Foundation. Retrieved 6 July 2016, from http://www.communicationforsocialchange.org/pdf/making_waves.pdf

10.

Dart

J.J.

, & Davies

R.J.

(2003). A dialogical, story-based evaluation tool: The most significant change technique. American Journal of Evaluation, 24(2), 137–55.

11.

Davies

, & Dart

(2005). The ‘most significant change’ (MSC) technique: A guide to its use. A report by CARE International, Oxfam, Ibis, and Lutheran World Relief. Retrieved 6 July 2016, from http://www.mande.co.uk/docs/MSCGuide.pdf

12.

de Fossard

, & Lande

(2008). Entertainment–education for better health (INFO Reports, No. 17, Baltimore, INFO Project), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.

13.

Dutta

M.J.

, & Basnyat

(2008). The radio communication project in Nepal: A culture centered approach to participation. Health Education and Behavior, 35(4), 442–454.

14.

Felt

L.J.

, Dura

, & Singhal

(2014). Cultural beacons in health communication: Leveraging overlooked indicators and grassroots wisdoms. In Kim

D.K.

, Singhal

& Kreps

G.L.

(Eds), Health Communication: Strategies for Developing Global Health Programs (pp. 334–351). New York, NY: Peter Lang.

15.

Foucault

(1980). Power/knowledge. New York, NY: Pantheon.

16.

Frank

L.B.

, Chatterjee

J.S.

, Chaudhuri

S.T.

, Lapansky

, Bhanot

, & Murphy

S.T.

(2012). Conversation and compliance: Role of interpersonal discussion and social norms in public communication campaigns. Journal of Health Communication: International Perspectives, 17(9), 1050–1067.

17.

Freire

(1970). Pedagogy of the oppressed. New York, NY: Continuum.

18.

Glanz

, Rimer

B.K.

, & Viswanath

(2008). Health behavior and health education: Theory, research, and practice (3rd ed.). San Francisco, CA: Jossey-Bass.

19.

Greiner

, Singhal

, & Hurlburt

(2007). With an antenna we can stop the practice of female genital cutting: A participatory assessment of Ashreat Al Amal, an entertainment–education radio soap opera in Sudan. Investigación & Desarrollo, 15(2), 226–259.

20.

Harter

, Sharma

, Pant

, Singhal

, & Sharma

(2007). Catalyzing social reform through participatory folk performances in rural India. In Frey

, & Carragee

(Eds), Communication and social activism (pp. 285–314). Cresskill, NJ: Hampton Press.

21.

Health Communication Capacity Collaborative. (2013). The P process. Five steps to strategic communication. Baltimore, MD: Johns Hopkins Bloomberg School of Public Health Center for Communication Programs.

22.

Hess

, Meekers

, & Storey

J.D.

(2012). Egypt’s Mabrouk! initiative: A communication strategy for maternal/child health and family planning integration. In Obregon

& Waisbord

(Eds), The handbook of global health communication (pp. 374–407). E-book: Wiley-Blackwell.

23.

Israel

B.A.

, Eng

, Schultz

A.J.

, & Parker

(2013). Methods for community-based participatory research for health. San Francisco, CA: Jossey-Bass.

24.

Kincaid

D.L.

(2002). Drama, emotion and cultural convergence. Communication Theory, 12(2), 136–152.

25.

Law

, & Singhal

(1999). Efficacy in letter-writing to an entertainment–education radio serial. International Communication Gazette, 61(5), 355–372.

26.

Lennie

, Tacchi

, Koirala

, Wilmore

, & Skuse

(2011). Equal access participatory monitoring and evaluation toolkit: Helping communication for development organisations to demonstrate impact, listen and learn, and improve their practices. Retrieved 6 July 2016, from http://www.seachangecop.org/sites/default/files/documents/2011%2002%20EA%20%20Equal%20Access%20Participatory%20Monitoring%20and%20Evaluation%20Toolkit.pdf

27.

Literat

(2013). A pencil for your thoughts: Participatory drawing as a visual research method with children and youth. International Journal of Qualitative Methods, 12(1), 84–98.

28.

McGillion

, & McKinnon

(2014). Participatory theater as a science communication tool in Timor Leste. Science Communication, 36(4), 502–510.

29.

Moran

M.B.

, Murphy

S.T.

, Frank

L.B.

, & Baezconde-Garbanati

(2013). The ability of narrative communication to address health-related social norms. International Review of Social Research, 3(2), 131–149.

30.

Moyer-Gusé

(2008). Toward a theory of entertainment persuasion: Explaining the persuasive effects of entertainment–education messages. Communication Theory, 18(3), 407–425.

31.

Novak

D.R.

(2010). Democratizing qualitative research: Photovoice and the study of human communication, communication methods. Communication Methods and Measures, 4(4), 291–310.

32.

Papa

M.J.

, & Singhal

(2009). How entertainment–education programmes promote dialogue in support of social change. Journal of Creative Communications, 4(3), 185–208.

33.

Papa

M.J.

, Singhal

, Law

, Pant

, Sood

, Rogers

E.M.

, Shefner-Rogers

C.L.

(2000). Entertainment–education and social change: An analysis of parasocial interaction, social learning, collective efficacy, and paradoxical communication. Journal of Communication, 50(4), 31–55.

34.

Parks

, Gray-Felder

, Hunt

, & Byrne

(2005). Who measures change? An introduction to participatory monitoring and evaluation of communication for social change. Communication for Social Change Consortium, South Orange, NJ.

35.

Piotrow

P.T.

, & de Fossard

(2004). Entertainment–education as a public health intervention. In Singhal

, Cody

M.J.

, Rogers

E.M.

& Sabido

(Eds), Entertainment-education and social change (pp. 39–60). Mahwah, NJ: Lawrence Erlbaum Associates, Inc.

36.

Rattine-Flaherty

, & Singhal

(2008). Analyzing social change practice in the Peruvian Amazon through a feminist reading of participatory communication research. Development in Practice, 19(6), 726–736.

37.

Rimal

, & Creel

(2008). Applying social marketing principles to understand the effects of the Radio Diaries program in reducing HIV/AIDS stigma in Malawi. Health Marketing Quarterly, 25 (1/2), 119–146.

38.

Rimal

R.N.

, Lapinski

M.K.

, Cook

R.J.

, & Real

(2005). Moving toward a theory of normative influences: How perceived benefits and similarity moderate the impact of descriptive norms on behavior. Journal of Health Communication, 10(5), 433–450.

39.

Rockwell

, & Bennett

(2004). Targeting outcomes of programs: A hierarchy for targeting outcomes and evaluating their achievement (p. 48). Faculty Publications: Agricultural Leadership, Education & Communication Department. Retrieved 6 July 2016, from ftp://bsesrv214.bse.vt.edu/grisso/Program_Logic/Targeting_Outcome_Programming.pdf

40.

Sapkota

, & Sharma

(1996). Participatory interactions with children in Nepal. PLA Notes, (25), 61–64 (London, UK: International Institute for Environment and Development). Retrieved 6 July 2016, from http://pubs.iied.org/pdfs/G01621.pdf

41.

Servaes

(2007). Harnessing the UN system into a common approach on communication for development. International Communication Gazette, 69(6), 483–507.

42.

Singhal

(2001). Facilitating community participation through communication. A Report by GPP, Programme Division, UNICEF, New York, NY. Retrieved 6 July 2016, from http://utminers.utep.edu/asinghal/reports/Singhal-UNICEF-Participation-Report.pdf

43.

Singhal

, Greiner

, & Hurlburt

(2006). A participatory assessment of Ashreat Al Amal, an entertainment–education radio soap opera, in the Sudan. A Qualitative Assessment Report for Population Media Center. Retrieved 6 July 2016, from http://www.populationmedia.org/wp-content/uploads/2008/02/final-9-7-2006-sudan-report-by-singhal-et-al.pdf

44.

Singhal

, Harter

L.M.

, Chitnis

, & Sharma

(2007). Participatory photography as theory, method and praxis: Analyzing an entertainment–education project in India. Critical Arts, 21(1), 212–227.

45.

Singhal

, Obregon

, & Rogers

E.M.

(1995). Reconstructing the story of Simplemente Maria, the most popular telenovela in Latin America of all time. International Communication Gazette, 54(1), 1–15.

46.

Singhal

, Papa

M.J.

, Sharma

, Pant

, Worrell

, Muthuswamy

, . (2006). Entertainment education and social change: The communicative dynamics of social capital. Journal of Creative Communications, 1(1), 1–18.

47.

Singhal

, & Rattine-Flaherty

(2006). Pencils and photos as tools for communicative research and praxis: Analyzing Minga Peru’s quest for social justice in the Amazon. International Communication Gazette, 68(4), 313–330.

48.

Singhal

, & Rogers

E.M.

(1988). Television soap operas for development in India. International Communication Gazette, 41(2), 109–126.

49.

Singhal

, & Rogers

E.M.

(1999). Entertainment–education: A communication strategy for social change. Mahwah, NJ: Lawrence Erlbaum Associates, Inc.

50.

Singhal

, & Rogers

E.M.

(2002). A theoretical agenda for entertainment–education. Communication Theory, 12(2), 117–135.

51.

Singhal

, & Rogers

E.M.

(2004). The status of entertainment–education worldwide. In Singhal

, Cody

M.J.

, Rogers

E.M.

& Sabido

(Eds), Entertainment–education and social change (pp. 3–20). Mahwah, NJ: Lawrence Erlbaum Associates, Inc.

52.

Sood

(2002). Audience involvement and entertainment–education. Communication Theory, 12(2), 153–72.

53.

Sood

, Menard

, & Witte

(2004). The theory behind entertainment–education. In Singhal

, Cody

M.J.

, Rogers

E.M.

& Sabido

(Eds), Entertainment–education and social change (pp. 117–149). Mahwah, NJ: Lawrence Erlbaum Associates, Inc.

54.

Sood

, & Rogers

E.M.

(2000). Dimensions of parasocial interaction by letter-writers to a popular entertainment–education soap opera in India. Journal of Broadcasting & Electronic Media, 44(3), 386–414.

55.

Sood

, SenGupta

, Mishra

P.R.

, & Jacoby

(2004). ‘Come gather around together’: An examination of radio listening groups in Fulbari, Nepal. Gazette: The International Journal for Communication Studies, 66(1), 63–86.

56.

Sood

, Shefner-Rogers

, & Skinner

(2014). Health communication campaigns in developing countries. Journal of Creative Communications, 9(1), 67–84.

57.

Storey

, & Sood

(2013). Increasing equity, affirming the power of narrative and expanding dialogue: The evolution of entertainment education over two decades. Critical Arts: South-North Cultural and Media Studies, 27(1), 9–35.

58.

Storey

J.D.

, & Kaggwa

E.B.

(2009). The influence of changes in fertility related norms on contraceptive use in Egypt, 1995–2005. Population Review, 48(1), 1–19.

59.

Sypher

B.D.

, McKinley

, Ventsam

, & Valdeavellano

E.E.

(2002). Fostering reproductive health through entertainment–education in the Peruvian Amazon: The social construction of Bienvenida Salud! Communication Theory, 12(2), 192–205.

60.

Tacchi

, Fildes

, Martin

, Mulenahalli

, Baulch

, & Skuse

(2007). Ethnographic action research training handbook. Retrieved 6 July 2016, from http://ear.findingavoice.org/toolbox/index.html

61.

Tanganika

(2015). The role of ‘Musekeweya’, an entertainment–education radio soap opera in the promotion of reconciliation in Rwanda. Rwandan Journal of Education, 1(2), 55–68.

62.

Tufte

(2001). Entertainment–education and participation: Assessing the communication strategy of Soul City. Journal of International Communication, 7(2), 25–51.

63.

Wakefield

M.A.

, Loken

, & Hornik

R.C.

(2010). Use of mass media campaigns to change health behavior. The Lancet, 376, 1261–1271.

64.

Wang

, & Burris

M.A.

(1994). Empowerment through photo novella: Portraits of participation. Health Education Quarterly, 21(2), 171–186.

65.

Wang

, & Burris

M.A.

(1997). Photovoice: Concept, methodology, and use for participatory needs assessment. Health Education and Behavior, 24(3), 369–387.

66.

Wilkin

H.A.

, Valente

T.W.

, Murphy

, Cody

M.J.

, Huang

, & Beck

(2007). Does entertainment–education work with Latinos in the United States? Identification and the effects of a telenovela breast cancer storyline. Journal of Health Communication, 12(5), 455–469.

67.

World Health Organization. (2010). Violence prevention: The evidence. Retrieved 6 July 2016, from http://www.who.int/violence_injury_prevention/violence/4th_milestones_meeting/evidence_briefings_all.pdf