Background: Cancer is one of the most important public health challenges in the world, with over 23 million new cases/year and 10 million deaths/year, that will only be properly tackled with a stronger focus on prevention. This calls for an informed population, aware of risk factors and willing to adopt preventive behaviours and early cancer screenings. However, implementing cancer-prevention guidelines at the population level is challenging due to the need for significant lifestyle changes amidst competing priorities.
For that purpose, 2’ Life-changing minutes was created, the first ever televised series on cancer prevention based on entertainment education (E-E) – a communication strategy used to incorporate educational messages into entertainment media to positively influence awareness, knowledge, attitudes and behaviours.
Objectives: This study aims to evaluate the impact of 2’ Life-changing minutes, a novel E-E format on cancer prevention, in order to understand how effectively can fictional narratives promote knowledge gains and/or behaviour changes on such a challenging topic like cancer.
Methods: This study followed a cross-sectional design, with all outcomes measured after exposure to the series. Two complementary studies were performed involving a total of 1314 participants: a test-screening (TS) study, targeting potential viewers of the series, and a natural-screening (NS) study, targeting those that spontaneously watched the series on television.
Results: 2’ Life-changing minutes introduced the format of fictional entertainment television to the field of cancer prevention, building on character identification and social modelling principles, shaping outcome expectancies and behaviour self-efficacy with simple practical messages and aiming for viewer transportation through the engagement with the dramatic elements of the storylines.
The current study shows that the series, composed by 20 narrative fictional episodes, had a strong impact in its audience, particularly with (i) very high levels of appreciation and narrative engagement, and willingness to see more episodes; (ii) statistically significant knowledge gains, ranging from 17% to 44%, on all topics tested; (iii) evidence of effective behaviour change. Regression analysis showed that narrative engagement was the best predictor of behaviour change [NS: odds ratio (OR)=3.38, 95% confidence interval (CI) = 1.70–6.74, p = 0.001; TS: OR = 2.05, 95% CI = 1.13–0.371, p = 0.018].
Implications: Results from the present study align with recent research that shows that narratives can effectively promote healthy habits, have high health promotion potential, and indicate that this specific cancer prevention format increased the audience’s knowledge and elicited behaviour change. The fact that knowledge was not a good predictor of behaviour change, but narrative engagement was, greatly undermines the reigning paradigm of the primacy of information still seen in many health communication and cancer communication strategies, and supports the use of compelling health narratives to engage viewers and change behaviours.