key findings from the post- broadcast reception analysis of we beat tb television adverts 4 april...

Key findings from the post-Key findings from the post-broadcast reception analysis broadcast reception analysis

of of We Beat TB We Beat TB television television advertsadverts

4 April 2012 4 April 2012

Helen Hajiyiannis, Alice Clarfelt, Tselisehang Motuba

Centre for AIDS Development, Research and Evaluation www.cadre.org.za

USAID TB Project

• The USAID TB Project, coordinated through the University Research Corporation, is a 5-year programme (2009-2014) aimed at strengthening tuberculosis control & prevention initiatives in SA.

One of the key pillars of the USAID TB Project, the Advocacy, Communication and Social Mobilisation Strategy (ACSM), has been developed by Johns Hopkins Health and Education in South Africa (JHHESA).

Objectives of the ACSM strategy are to: (1) reduce number of new TB cases; (2) improve quality of TB services; (3) increase availability of TB treatment; (4) increase demand for TB services; (5) improve management of TB support systems.

USAID TB Project

Part of the ACSM strategy entails a mass media campaign called We Beat TB!

Three television personal service announcements (PSAs) were produced in several languages and broadcast on the national TV broadcaster. Radio PSAs were also produced.

The television PSAs were field tested prior to broadcast and findings were used to revise adverts and scripts.

USAID TB Project

The campaign has had four media bursts on national TV and radio stations:

November 2009 to January 2010

March 2010 to April 2010

October 2010 to December 2010

July 2011 to September 2011

A post-broadcast reception analysis was conducted in March 2012 focused on the television adverts. This was five months since adverts were last broadcast on TV.

Target audiences

Mass media component of strategy is implemented at national level, whereas community mobilisation activities are implemented at provincial and district levels.

Target audiences of TV adverts are urban, peri-urban and rural South Africans of all ages and particularly those between the ages of 16 to 64, from low to middle income households.

Description of three TV adverts and messages

Infection control: Open your windows and cover your cough. Messages: Open the window, cover your cough, and wash hands after coughing or sneezing to prevent the spread of TB.

Treatment adherence: Take 180 doses to be number one okay. Messages: Complete the full course of treatment to be cured of TB; “180 to be number one okay”.

Description of three TV adverts and messages cont.

TB/HIV co-infection: TB is curable even if you have HIV. Messages: TB is curable even if a person is living with HIV; get tested for HIV and TB.

Objectives of post-broadcast reception analysis cont.

Objective 1: Explore reception environment of the adverts.

Objective 2: Explore personal responses.

Objective 3: Explore contexts of interpersonal communication.

Objective 4: Explore relationship between educational objectives and actual reception

Objective 5: Identify gaps in TB knowledge & develop recommendations for development of new adverts.

Study design

Six focus groups were conducted with representatives of the target audience.

Focus groups were conducted in three South African provinces (Gauteng, Eastern Cape, KwaZulu Natal).

Focus groups were conducted to include three localities: urban, peri-urban and rural.

Focus groups included males and females and were representative of two age ranges: 18-30 years and 30 years plus.

Study design cont.

39 people participated in the focus groups. 16 males and 23 females.

28% of urban participants had tertiary education, 33% from peri-urban areas had matric or less and 80% of those from rural areas did not have matric.

Minimum criteria for inclusion: seen at least two TV adverts; willingness to talk openly.

Groups were conducted in language of participants’ choice, discussions audio recorded & audio files translated to English and transcribed verbatim.

Data analysis

Team of researchers involved in this project were tasked to each read through all of the transcripts and become familiar with the data.

A coding structure was developed that allowed for data from each advert to be coded separately, as well as for the coding of data that was general about the adverts.

Though an inductive approach was taken to the development of codes, care was taken to ensure that coding was done in relation to the key research questions.

Take 180 to be number 1 okay

Advert was well remembered and seen across the various localities.

Commonly was seen on SABC 1 or SABC 2 in English. Only participants from rural KZN had heard the advert on radio in Zulu.

Advert was generally described as “the advert with the dancing cartoons”, perceived as attractive, appealing and attention-grabbing.

Dancing was perceived as “local”, “South African” and appealed to youth culture.


Inclusion of dance was said to communicate a positive message about TB:

“I think the energy and the fact that the cartoons are dancing, it kind of clears the thought that if you have TB you are at death’s bed or something. So the fact that there is energy around it, it kind of improves the positivity” (Female, 18-30, urban, Eastern Cape).


There was some cross-over between adverts, with this advert including descriptions of when the animated characters go to the clinic to get tested (the HIV and TB co-infection advert). This can be attributed to having the ‘180’ visual message appear in both adverts.


Four aspects were identified and referred to as the distinguishing features of this advert:

(1) four dancing characters or cartoons;

(2) one of the animated characters begins to cough and changes colour;

(3) the animation showing pills being swallowed; and

(4) the inclusion of ‘180’ at a visual and audio level.

Take 180 to be number 1 okayUnaided recall: message takeout Focus group participants reported four

messages from this advert. Overall, the common message or lesson and the one most often reported as taken from this advert was the importance of completing the full course of TB treatment.

“What I saw as very important is that you must take your treatment in full because you default you will have a problem. You must persevere to the end” (Male, 18-30, peri-urban, KwaZulu Natal).

Take 180 to be number 1 okayUnaided recall: message takeout The second most common message

among focus group participants was that TB treatment needed to be taken for 180 days.

This message was often linked to the message about the importance of completing the full course of treatment:

“If you are a TB patient take your treatment for one hundred and eighty days” (Male, 30+, rural, KwaZulu Natal).

Take 180 to be number 1 okayUnaided recall: message takeout Third message identified by participants

emphasised the need for community and individual support in order to assist people to complete their TB treatment.

“There was an idea of community and not separating people with TB, because when the one character started breaking down, the others were like helping him or her up. There was an idea of community and not stigmatising TB, like separating TB people, but rather supporting them” (Female, 18-30, urban, Gauteng).

Take 180 to be number 1 okayUnaided recall: message takeout Fourth message identified by participants,

focused on debates around whether the ‘180’ referred to in the advert is referring to number of days of treatment or number of pills.

“Is it 180 days or 180 tablets, or is it the same?” (Female, 18-30, urban, Eastern Cape), while others, spoke about 180 doses of medication.

Take 180 to be number 1 okayUnaided recall: message takeout There were clearly instances where

participants had understood the message to be about the 180 pills: “It emphasises that a person has to take one hundred and eighty pills to cure TB” (Female, 18-30, peri-urban, KwaZulu Natal).

Another aspect identified as unclear, related to the visual representation of the animated character taking his pills, shown as a continuous flow of pills. This resulted in some thinking the advert was saying all 180 pills are taken at the same time.

Take 180 to be number 1 okayUnaided recall: message takeout“M3: I have an issue with the animation. It’s like they take all their medication all at once. They should show properly how they take their medication. …F4: I agree with M3. It’s like he is taking the whole medicine, so what does that say, that we must take the whole medicine?” (Male and female, 30+, peri-urban, Gauteng)

Take 180 to be number 1 okayUnaided recall: narration

Some participants in one of the groups commented on the narration of the advert, stating that there was a mismatch between the narrator’s voice and the actions of the cartoons.

The fact that the narrator’s voice begins about 15 seconds into the advert, seemed to make these participants only begin listening to the advert then.

Take 180 to be number 1 okayUnaided recall: narration

“M2: The narration is not relevant to the cartoons. You can hear there is someone speaking on the side and there are cartoons playing… There are two different things happening at the same time. This has made it to lose meaning.M1: The picture depicted by the narration at the end does not relate with the actions that already took place. F1: The narration is at the end. The cartoons are already played. By the time you listen the advert is over” (Male and female, 30+, rural, KwaZulu Natal).

Take 180 to be number 1 okayInterpersonal communication

There were examples of participants talking to others about the advert: (1) aspect that triggered discussion was the dancing cartoons; (2) a female participant described how she had discussed the advert with her roommates, discussing the topic of defaulting on treatment and the resultant consequences; (3) a male participant encouraged his wife, who had once had TB, to watch the advert on TB treatment; (4) a female participant talked with her children about the importance of treatment adherence.

Take 180 to be number 1 okayInfluence on behaviour

There were two instances reported by focus group participants of knowing someone who had been influenced to continue to take their TB treatment after watching the advert. Both were from rural localities.

“My relative was on treatment and wanted to default thinking he was cured. By watching this advert he was encouraged to take the pills for 180 days because he does not want the disease to come back” (Male, 30+, rural, KwaZulu Natal).

Take 180 to be number 1 okayInfluence on behaviour

“F2: I have a friend of mine who was helped by this advert. She stopped taking her pills and drank (liquor). She thought she was alright, about three months she was healthy, but after then she fell sick again. She had to start all over again to take the treatment. Facilitator: She had stopped taking treatment…F2: She had stopped yes. She thought she was healed. When watching the advert, she saw the character cough and collapse, we joked about it and said she will be like that” (Female, 30+, rural, KwaZulu Natal).

Take 180 to be number 1 okayAided recall: message take-out

Participants identified the same messages as during unaided recall. The debates around ‘180’ continued and within the context of aided recall, participants noted that even though they had paid close attention to this aspect of the advert, it was still not clear to them what was meant by 180 doses: is it 180 doses of pills i.e., pills taken once a day, or does it mean that pills are taken over a period of 180 days, but that there can be more than one daily dose and or, more than one pill.


Commonly, among participants that were unclear what ‘180’ referred to, there were also remarks about the advert being “too busy” and that the narration around ‘180’ took place as the same time as when music played, contributing to a lack of clarity.

“I think the part that says you have to take 180 days of medicine, 180 days, so we thought it was 180 tablets” (Female, 18-30, urban, Eastern Cape).


Three participants identified the message after watching the advert, as being that TB treatment takes 52 days to complete.

This may have been as a result of seeing this figure during aided recall, whereas previously had not noticed them, or had understood that when the numbers are flashing by and stop briefly at ‘52’, that this meant the end of treatment.

Unclear if this is as a result of aided recall context and focusing closely on the advert, or due to the existence of the potential for misunderstanding the message.

Take 180 to be number 1 okayAided recall: recommendations

Reduce number of messages and make advert less busy.

Voiceover or narration be clear and match the actions in the advert.

Drop references to 180 doses of medication, rather focus on a sentence that says something like, “you should take your tablets within 180 days” (Female, 18-30, urban, Eastern Cape).

Take 180 to be number 1 okayAided recall: recommendations

Have calendar appear close to person taking the pills rather than elsewhere in the frame, so when watching person taking pills, the calendar is linked to this person.

Have narrator clearly articulate the consequences of defaulting on treatment, noting aspects such as person will get sick again (or importantly, infect others), may develop treatment resistance.

Common question was whether antiretrovirals (ARVs) can be taken at the same time as TB medication.

TB/HIV co-infection: Overall views

This advert generated a strong response, and critical engagement with and debate over features of the animation.

Multiple messages were derived, including:

o How TB impacts the immune system destroying your “balance”.

o Everyone is vulnerable to TB infection.

o You can be cured of TB if you are HIV positive.

Overall participants liked the ad and found positive meaning in it.

Some participants struggled to remember the advert during unaided recall.

After aided recall additional meanings were found.

The target audience was said to be younger people living in more urban areas, as older rural people would not understand the animation.

TB/HIV co-infection: Overall views cont.

Unaided recall: Message takeout

Everyone is vulnerable to TB infection: One must test for TB.

TB does not discriminate according to HIV status.

One must maintain a hygienic lifestyle, washing hands and eating healthy food.

Your treatment is the same if HIV positive or negative (need for clarification).

Unaided recall: Message take-out

Positive knowledge acquisition – TB can be cured even if you are HIV positive:

o Inspires hope

o Helps de-stigmatize TB

o One must take one’s family to the clinic, knowing they can be cured

Symbolism around the pots and pans on people’s heads:o The “story of the kettle and the pot” (idiom) – do not judge

someone else when you are in the same situation

o TB can make you lose your “balance” or “power” – you need to take TB treatment to regain your balance.

o The pots were also described as “symbols of the future” – which you can rebuild “the tin falls, but you can still lift your tin” (female, 18-30, peri-urban, KZN)


Positive knowledge acquisition – TB can be cured even if you are HIV positive:

o Inspires hope.

o Helps de-stigmatize TB.

o One must take one’s family to the clinic, knowing they can be cured.


Symbolism around the pots and pans on people’s heads:

o “Story of the kettle and the pot” (idiom) – do not judge someone else when you are in the same situation.

o TB can make you lose your “balance” or “power” – you need to take TB treatment to regain your balance.

o The pots were also described as “symbols of the future” – which you can rebuild “the tin falls, but you can still lift your tin” (female, 18-30, peri-urban, KZN).

Clarity – UR messaging

Confusion / ambiguity over “180” – number of days or pills? Still unclear after aided recall.

Ambiguity over whether can take TB treatment whilst taking ART (gaps in information).

Some participants did not understand the significance of the pots and pans.

In one group participants thought the narration needed to be stronger / more present.

Influence on behaviour and interpersonal communication

There were no explicit examples of participants taking a particular action in relation to this advert. New information acted as a catalyst for generating conceptualised forms of action (going to the clinic, getting tested etc).

There were no clear examples of interpersonal communication. In one focus group (18-30, urban, Eastern Cape) participants said that TB is not something that is talked about openly. Would mention ads in passing, not in depth discussions.

Unaided recommendations

Several participants said they would like clearer narration for clarification on how to take your medication, and what the characters learnt from going to the clinic.

Narration was preferred to writing (some are illiterate).

Some participants wanted more from the visual quality of the animation – more colour, more vivid – the setting was said not to be clear.

Aided recall: Message take-out

After seeing the advert, discussants identified certain features more clearly which led to enhanced interpretations of messaging

Participants liked how the HIV negative person became ill first, showing that we are all susceptible to HIV.

The laughter was more clearly identified, and how this follows on from the coughing. A common interpretation was that one character thinks he is better than the other one “the saying of the kettle and the pot” – but we are all vulnerable to HIV infection, and whether we are HIV positive or negative.

The story of the pot and the kettle

“In as much as the other one is thinking that he is better than the other one, they’re in the same situation. Even the made the cartoon’s head the pot and then the other one the kettle, put more emphasis on it, because if she hadn’t said it, even now looking at it again, I wouldn’t have noticed. But it does have a lot significance”.

The story of the pot and the kettle cont.

“The pot and the kettle are in the same pot, as in they both go to the same fire, but most of the time you find the pot. So when they go to the same fire, they are HIV negative and positive, so the TB is maybe saying you are in the same pot. So they are saying the Xhosas and the Zulus understand the pot and the kettle thing, but other cultures wouldn’t understand it” (Female, 18-30, urban, Eastern Cape).

AR: Message take-out Advert was said to counteract stigma by

showing that TB affects HIV+ and HIV- people and that one can be cured if you are HIV positive.

After aided recall participants commented more extensively on features eg., the pots:

More noticed characters getting tested.

There was more clarity around treatment taking time-period, and for HIV+ and HIV-.

Pots symbolise that we are all the same / balance the same things in life.

Pots are our every day responsibilities.

Pots represent our everyday world

It represents your everyday things, your routine that you do, I could say it represents your world, and that when you are weak, your world falls apart, because it’s your basic needs, your kettle and whatnot. So those are things that were up straight when you were healthy, you were able to carry them on, but when you are weak, they start falling apart because you cannot do certain things (Male, 18-30, urban, Gauteng).

AR – Unintended Messaging

Increased attention to how one character laughs at another – interpretation that he is laughing because the other one is sick.

One participant (female, rural, Eastern Cape, 30+) thought that TB was transmitted through germs on the pots and pans to the other character.

Some confusion over the bird and the dog. One participant attributed TB infection to the dog. (Male, peri-urban, 30+, Gauteng).

Aided recall - Recommendations Desire to see different social classes in the

ad, and within different settings.

Gap in information identified – if you are positive do you take same treatment as someone who is negative? Need for clarity.

Gap in information: Does it take longer for an HIV positive person to be cured than an HIV negative person?

Desire for clearer narration, either written or spoken.

Aided recall - Recommendations There should be the same level as

attention on TB as on HIV in media campaigns. TB is a serious threat.

Ad could have reached a broader audience by including more modern items like laptops, rather than just pots and pans – implication that this is not just targeted at people from a poorer socio-economic background.

AR - Recommendations

So it wasn’t more appealing to a vast number of people. I would maybe take the same journey, but on the screen divide it into two different worlds. So the other one might have kettles on the head, and maybe the other one, have things that speak to s now, like your laptop, things that are more (Male, 18-30, urban, Gauteng).

Open your windows and cover your cough: Overall views

Overall this advert was well-liked, although engagement was not as strong as with the other two adverts. Participants thought the advert and its messaging was clear.

Some saw the ad on TV in different languages, others saw it in English. Those who heard it on the radio heard it in Zulu.

Participants like the animation and the setting of the household, which they could relate to. The characters were thought to be a family, or a group of friends.

Open your windows and cover your cough: Overall views

Key messages centred on infection control through opening your windows and covering your cough, and also the importance of supporting someone who has TB rather than ostracising them.

In some groups there was poor unaided recall, especially of key features such as the hand washing action.

Some participants said they did not derive anything new from the ad, having been exposed to this information from past campaigns.

Overall views

“I like the advert, I think it has a big impact on the community. It shows that a person with TB should not be an outcast, we should not reject or run away from a person with TB. And when we are sitting with a person with TB, we should make sure that the area is well ventilated so that the wind can blow in and germs go out. I like it” (Female, 18-30, peri-urban, KZN).

Unaided Recall: Message take-out

The main overall message taken from this advert was about infection control through opening windows, allowing for ventilation and for TB germs to be let out of the environment:

“It shows us how to prevent the spread of TB. Like it can go out, and we should open the windows and have air bricks inside the house so that it goes out, that kind of ventilation. It shows that TB can actually be taken out of the environment through those mechanisms” (Male, 30+, peri-urban, Gauteng).

Some said that this was a new message and that previously they had thought you needed to close the window in order for germs not to come in.

UR: Message take-out The knowledge that you can prevent TB through

opening your windows was said to be empowering because it allows you to sit next to someone or live with someone without contracting TB if you take this action:For me, we’ve already said it, but I think it was important that it, well personally, it created that power in knowledge in terms of when you know that okay, you can still sit with someone who has TB and not get it because of ventilation. You are empowered by that knowledge, and then you don’t stigmatise it or run away from it. You know that you can live with a person and not get it because both of you have been responsible in that way. (Female, 18-30, urban, Gauteng).

UR: Message take-out The second most common message derived from

this advert was about coming together to support someone who has TB.

Sticking together and not excluding someone who has TB was connected to the way the characters continue to sit together even though they know one of them is ill.

Support was said to be important for treatment adherence.

Support is essential in de-stigmatising TB.

One participant saw a progression from the first advert (180) where they have moved on from stigmatising TB and are now accepting and supporting the TB infected character.

Supporting not stigmatising someone with TB

“It was a group of people sitting in the kitchen playing cards,

and while they were playing cards one of them coughed. They

opened the window for ventilation reasons, as we have already

established. Drawing from that, I could say, drawing from the

first advert to this one, it could be days when the character who

broke down in the first advert is taking their medication now”.

“Everyone knows about it, that he or she has TB, and it could

be between that period of 180 days taking your medication and

now it’s moved from stigmatising TB, because they are playing

together, and they have accepted and they are supporting him.

They open the window for ventilation reasons because, well,

from my knowledge TB does spread from air particles and

whatnot” (Female, 18-30, urban, Gauteng).

UR: Message take-out

The third overall message taken from this advert was on covering your mouth when you cough. This did not come through as clearly as the opening your windows, or support message during unaided recall.

You must cover your mouth when you cough and your windows are open “you do not just cough anyhow” (Male, 18-30, peri-urban, KZN).

When discussing covering one’s mouth as a method of infection control, additional messaging was derived over the issue of how to dispose of phlegm – with a tissue, or to cover it with soil (gap in information).

UR recall: Message take-out

Washing your hands as a method of infection control was the final message derived during unaided recall.

This was not as common as the other methods of infection control, as participants could not remember the action clearly. This only came through as a stronger message during aided recall discussions.

UR recall: Clarity Participants did not have clear recall of the washing of

hands. Some remembered the running water, but the association with hand washing was not clear.

Some did not see the hand of the person who was coughing, said to be a feature of the animation.

Need for information around how to dispose of sputum if you cough into your hand.

A few participants were unclear about the ad because it conflicted with other messages that someone with TB should not catch cold, so you should keep your windows closed.

There was some unintended messaging, as two participants thought that it was possible to catch TB through playing cards (Female, 18-30, peri-urban, KZN; female, 30+, rural, Eastern Cape).

Influence on behaviour and interpersonal communication

Several participants spoke about how viewing this ad encouraged them to educate and communicate with others.

One participant (female, 18-30, urban, Gauteng) said that the advert helped her and her family as they attempted to get her father to adhere to his TB treatment (although it was not clear whether they were successful).

One participant said that this advert would encourage her child to teach another child to cover his mouth when he coughs (Female,18-30, urban, Gauteng).

Another participant spoke to his sons about infection control (covering your mouth and washing your hands) (Male, 18-30, peri-urban, KZN).

Aided recall: Message take-out

After seeing the advert the washing of hands and covering of mouth actions were said to be clearer.

There was a more in depth engagement with the washing of hands action including that you must immediately wash your hands, and not just before preparing or eating food.

The association between coughing and washing hands was observed to be important, and new messaging.

A further message was about protecting one’s family through infection control

The bacteria were more clearly observed after aided recall, and how they are quick to exit when the window is opened.

Recommendations

There was a call for more information about the signs and symptoms of TB, apart from just coughing.

A few participants wanted more information in this advert about where to get tested.

Discussions indicate that there is a gap in information around infection control when you cough. If you cough into your hand, where do you dispose of the sputum / phlegm? Many areas do not have running water.

Recommendations

Some participants wanted clearer narration, with more information provided at the beginning as well as the end of the advert. It was said that, currently, “if you do not use your mind well you will not get the message of the advert” (female, 18-30, peri-urban, KZN).

Some would like brighter colours in the advert.

Participants liked the household setting for TB infection control, and suggested other popular, public spaces like a taxi or car.

Animation

There were mixed and diverse responses to the animation.

In general animation was met with a positive response, but some participants disliked what were often described as “popeyes”.

It was said that older viewers would not respond as well to the animation as younger viewers, or people living in rural as opposed to urban areas.

Animation: Positive responses Positive responses to the animation

included:

o Liking the ways that the characters moved – often in unison, showing support for the person living with TB (180)

o Liking the colours in the advert and how they direct to a certain action, such as hand washing in the infection control advert.

o Enjoyment of the music, identified as ‘marimba’ which was said to be catchy and an easy way to recognise the advert

Animation: Positive responseso Participants liked the black and white

colours of the animation, which was said to be more serious as compared with other cartoons.

o The animation seen not to type-cast people by class or race. This was said to be particularly important in conjunction with the issue of TB stigma, so that TB is not immediately associated with older or younger people, a particular race or class.

o The advert also reaches young children as well as adult viewers:

Animation: Positive responses

The characters I think it is best. It relates to kids, it relates to adults. It is the best one. As the brother has said, it relates to kids yes, they can watch and see that there is a message in these cartoons. In the same way adults do not like cartoons. But at the end of the advert as an adult, you will end up wanting to see this advert and you will get the message (Female, 18-30, peri-urban, KwaZulu Natal).

Animation: Negative responses

Negative responses to the animation:

o That some participants could not identify with or relate to the animated characters: “I think the cartoons are not humanoid enough, they are confusing if they are human-like or just a strange creature” (Male, 30+, rural, KwaZulu Natal).

o That older people or those living in rural areas would not be able to relate to the animated characters“ [older people]don’t take consideration of the cartoons” (Male, 30 +, peri-urban, Gauteng)

Animation: Negative responses

o Sometimes there was a lack of clarity around certain features of the messages due to the animation, such as showing a real hand for covering your cough in the infection control advert, and in the HIV / TB co-infection advert some participants thought that TB was transmitted through the pots and pans.

o Finally certain features of the animation were said to be distracting or confusing, such as the dog and the bird.

General: Slogan

Slogan generally spontaneously remembered and was well-liked.

‘We’ in We beat TB associated with support and countering stigma and discrimination against people living with TB. “We” beat TB instead of “I” beat TB is heard as message to counter isolation.

Slogan perceived to reinforce that TB can be cured in the presence of HIV.

General: Slogan

I think even the voices, “we beat TB”, that thing, it sticks in you that no matter what status you have, you can always beat TB, you can always be treated (Female, 18-30, Urban, Gauteng).

During aided recall participants added to the point about “we” adding that it can refer to a personification of the pills and the “we” becomes the person and the pills unified in the fight against TB.

Slogan perceived to encourage positivity and to become a sub-conscious reminder.

General: Slogan

The slogan is perceived to be a brand associated with the TB adverts.

The slogan with “little voices” was easily recognisable and associated by participants as “that’s the TB advert”.

I would say don’t change the idea, the style, because people relate to it. So next time, the minute they see it, they’ll identify with the product, that it is the TB brand. It will become like the trademark (Male, 18-30, Urban Gauteng).

General: Other TB adverts or programmes

Little or no recall of previous or current TB adverts apart from an advert called Stop TB. This remembered vaguely.

Aspect liked from Stop TB advert was the 5 steps. Suggested these are incorporated in We Beat TB.

Paucity of TB information on TV. Sources of information reported were storylines in Soul City and 4 Play: Sex Tips for Girls.

Call for more attention to TB in mass media.

Critical and common gaps about symptoms of TB apart from coughing.

Questions ranged from whether there were symptoms to look out for prior to the appearance of a cough; to straight forward requests for more information on symptoms of TB.

Request for more detailed information about when to take action, for example, how long to wait before going to a clinic to seek treatment for a cough.

Questions and gaps in TB knowledge

Myths and gaps in information about the transmission of TB:

Sharing of eating and drinking utensils with someone who has TB;

Kissing someone who has TB;

Whether pregnant women with TB can transmit TB to their unborn children;

Strong beliefs exist about the association of pollution, dust, and smoke in the development of TB, with many believing that these are causes of TB.


Gaps in information about TB prevention:

Noted by many that there are many HIV prevention methods but the only ‘tool’ they had in relation to TB prevention, was to cover one’s cough.

Questions about the risks of getting TB in relation to having had TB in the past, and whether risk is increased if a person is living with HIV.

If those vaccinated still develop TB and if yes, why.


Gaps in information about types of TB:

Some had heard about multi-drug resistant TB (MDR), extremely drug resistant TB (XDR) but wanted information about how these forms of TB come about.

Some participants had heard about TB that affects the spine and other parts of the body, apart from lungs. There were requests for information about symptom presentation for these types of TB and how diagnoses are made.


Gaps in information about TB treatment:

Role of alcohol in TB treatment: 1) does intake of alcohol while on TB treatment interfere with the medication and or cure, and 2) how to encourage or support people who drink excessively and who default on their TB treatment.

Common question: whether PLWHA and on ARVs can take TB treatment as well. Can a person take ARVs and TB medication simultaneously or should person suspend their ARV treatment during TB treatment.


M4: The issue of mixing medication is very dangerous! They did not show any danger there because these are related diseases and medicine can be mixed I guess.M1: As an HIV positive person you should first finish your TB medication before continuing to HIV.F3: You have to take the TB treatment first because it is short but the HIV treatment takes long (Males and females, 18-30, peri-urban, KwaZulu Natal).


Is TB treatment the same for people living with HIV and those not living with HIV?

Does length of TB treatment vary between PLWHA and those who are not.

Is length and type of treatment for MDR TB and XDR TB different from regular TB and if so, how?

Length of treatment versus the daily dosage of TB treatment. 180 days known but not what the dosage is (once daily dose?180 pills? More than 180 pills?


Challenging stigma & discrimination:

Noted that that TB is not spoken about openly or easily, especially rural localities visited.

Participants explained that there was a strong inhibitor against talking about TB in their communities because of its association with HIV.

Participants recommended community-based activities that would promote TB information & debunk myths & stereotypes.

Gaps in information about TB treatment:

Role of alcohol in TB treatment: 1) does intake of alcohol while on TB treatment interfere with the medication and or cure, and 2) how to encourage or support people who drink excessively and who default on their TB treatment.

Common question: whether PLWHA and on ARVs can take TB treatment as well. Can a person take ARVs and TB medication simultaneously or should person suspend their ARV treatment during TB treatment.


Conclusion and recommendations

The overall objectives of the adverts were achieved. Participants identified and recalled the main messages from each of the adverts.

There is a significant discrepancy in the views of urban viewers as opposed to peri-urban and rural viewers with regard to the use of animation (the latter would prefer the use of ‘real’ people). Despite dislike of the format, message recall unhampered.

Suggest continue with current format.

Conclusion and recommendations

Exposure to the adverts took place over 18 months in 3-month bursts with 3-6 months break in-between. This contributed to conflation of messages between adverts, which serves to re-inforce messages.

Evidence of We beat TB brand recognition but it is still elementary. Suggest other mass media to accompany adverts (pamphlets, billboards, posters and continuation of radio broadcast).

key findings from the post- broadcast reception analysis of we beat tb television adverts 4 april...

Documents

tb television adverts

tb knowledge

spread of tb

tb projectthe usaid

usaid tb projectpart

availability of tb treatment

quality of tb services

usaid tb projectthe