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Enhancing Sexual Wellbeing In Scotland: A Sexual Health Relationship Strategy
Promoting positive sexual health through the media and mass communications
1. Introduction
1.1 Mass communications is the term used to describe the use of the media to interact with the general public. The media is made up of many different forms including television, radio, magazines, newspapers, advertising and the Internet. Some media are Scottish based but, increasingly, media influences are UK wide or global and this presents additional challenges both in analysing the effect of the media on individuals and in developing appropriate media strategies for use locally.
1.2 Like many western countries, Scotland is increasingly becoming a media saturated society. Some studies estimate that young people (6-17 year olds) spend around five hours per day with one form of media or another.
1 Most research has been done on the effect of the media on young people and young adults, however we know that the media is a dominating influence for all ages. Given this it is virtually impossible to ignore the media as a potential vehicle for delivering health related messages.
1.3 Sexual intercourse, or its implication, is often used as a marketing tool and sexual imagery pervades many aspects of modern society. These messages tend to reinforce stereotypes about the expected activities and behaviours of women and men, ignore the risks associated with sexual behaviour and have little resemblance to real life.
2 The media also presents a range of views about gender roles, body image and relationships. When messages in the media about sex (and particularly those targeted at young people) were compared across newspapers, television and teen magazines, the following themes were highlighted:
3;4 young people were nearly always portrayed as heterosexual;
references to homosexuality were typically made through humour and fear;
sexual stereotypes were reinforced, with young men viewed as 'up for sex' and young women as interested in emotions;
the limited references to contraception were within the context of female responsibility;
there was little discussion of how safe sex might be negotiated;
male magazines aimed to titillate rather than educate, while the content of female magazines was graded according to age to provide information and advice; and
newspapers tended to focus on sex crimes and the dangers of teenage sex.
1.4 In the absence of other reliable sources of information and advice unbalanced or inaccurate media messages can therefore lead to pressures and confusion over the realities of sex and sexuality particularly for young people. Feedback from the NATSAL survey shows that young females, in particular, view the media as one of their main sources of information.
5 It is therefore important to provide some balance to these messages, including provision of accurate, positive information about sex and sexual health. One important way of doing this is through the media, but this must be supported by a range of other activities.
1.5 The evidence would suggest that the media is a useful means to provide information to the general public, and particularly for a target audience, to raise awareness of a particular issue and to reflect back current thinking to users. In addition, popular media can be powerful in shaping attitudes and supplementing knowledge while either facilitating or inhibiting discussion.
6;7 There is little evidence of media interventions changing behaviour directly, however findings from those that have suggest that campaigns are most effective when they have a positive message and are combined with a range of activities of which the media is only one. Whilst the media alone is limited is its potential to affect change, it has an important role in a multifaceted approach to sexual health improvement, as is being advocated by this strategy.
1.6 This strategy is proposing an approach to working with the media to promote sexual wellbeing that has three broad components: media campaigns, media advocacy and media literacy. It is vital that this approach links activities at both national and local levels. At a national level the media is a useful scene setter and provides a context for work at a local level; national media activities are most successful as part of an integrated approach which is multi-faceted and co-ordinated with other work on the ground. At local level it is vital to provide tailored information to the population, to address area specific needs, to promote local services, to build up relationships with local press and to support and reinforce key national messages. While the way that national and local media communicate can and will vary, it is important that the core messages are consistent.
2. Media campaigns
2.1 There is considerable research and practitioner experience in the field of media campaigns, but in terms of sexual health this is largely in relation to young people under 30.
2.2 The most recent evidence suggests that key features of effective media campaigns aimed at young people include:
8 one clear and consistent message;
positive, factual and non judgemental tone;
respect for the target audience, treating them as responsible for their own choices;
accurate reflection of the target group's world;
communication through a range of formats for different facets of the message;
reinforcement of the key message over time;
delivery of messages from an organisation considered to be impartial, authoritative, trusted and identifiable; and
consideration of the needs of specific groups e.g. young men while avoiding gender stereotypes.
2.3 The same authors looked at communicating with parents and society at large and concluded that campaigns for parents should draw attention to the importance of sex education to the future welfare of their children but must also provide them with the tools to communicate effectively with their children at various ages.
8 They also cited evidence that adverse media coverage can damage campaigns and so, to avoid this, proactive approaches to communicating the key facts to the media need to be adopted.
2.4 Evidence suggests that communications about sexual health which have personal relevance and which recognise the realities of sexual encounters will communicate as well to young adults from ethnic minorities as to the mainstream audience as language is not normally a problem for this age group.8
2.5 More research and work with older age groups is needed to increase our understanding of the role of the media in promoting sexual health with them.
3. Media advocacy
3.1 This is defined as the strategic use of mass media to influence the public and policy makers and encourage social change. It can be used to educate the public, sway public opinion and influence policy makers. It assumes that media exposure will be positive, in this instance, to sexual health.
9
3.2 The media have a tendency to sensationalise sex, sexuality and sexual health issues and this helps to reinforce negative stereotypes, stigma and discrimination. It follows that in order to successfully influence a broader community, an initial target for media advocacy work is the media itself.
3.3 Elements of media advocacy work include:
a proactive press and public relations strategy, and particularly through interaction with media at a local, as well as national, level.
influencing the content and the way in which sexual heath issues are communicated. There are problems in this area, not least the globalised nature of our media, there are recognised successes too, such as 'fly on the wall' documentaries of sexual health services and soaps operas with storylines that include teenage pregnancy. In the USA, guidelines for media personnel have been developed and endorsed by the National Commission on Adolescent Sexual Health. If they are followed, a more balanced image of sexuality in the media may emerge.
giving users a voice, by providing opportunities for people to produce their own media messages and make contact with the broader media. Some successful examples of this have taken place with young people in Scotland (for example, the Young Scot project).
4. Media literacya
4.1 Media literacy is the ability to interpret and analyse media messages and has been described as an alternative to censoring, boycotting or blaming the media when it is perceived as not promoting 'accurate' points of view.
4.2 Supporting the development of media literacy may enable users of the media to be more critical, more aware of the power of the media and, importantly, help them develop skills to interpret the media in the context of their own lives. However, media literacy is relatively new in the UK and while there is some evidence from the USA, more research into the effectiveness and usefulness of this approach is required.
5. Conclusion
5.1 The Reference Group concludes that work with the media should support action to improve sexual health. Specifically, the National Sexual Health Advisory Committee, which will be established as part of this strategy, should link with those with media responsibility in NHS Health Scotland and the Scottish Executive to develop a multifaceted mass communications strategy for improving sexual health. This should include the three components highlighted above (media campaigns, media advocacy and media literacy) and link activities at national and local levels. Whilst the key messages require to be agreed, the approach should seek to:
Encourage a cultural shift towards a more open and positive view of sexual relationships and sexual health that is accepting of diversity;
Promote an ethos that promotes relationships based on equity and respect;
Challenge gender stereotypes and reinforce the responsibility of both men and women for protecting sexual health;
Provide support for parents in communicating with their children about sexual relationships and sexual health;
Increase awareness of ways to reduce poor sexual health outcomes;
Raise awareness of services at both a local and national level; and
Encourage interaction with the public on sexual health matters.
The development and implementation of this mass communications strategy should be overseen by the National Sexual Health Programme Co-ordinator.
5.2 This will require:
Identification of the target groups based on broader priorities and effectiveness of methods
Identification of the most effective means of reaching the target groups
Development of 'core' messages from the strategy to be used with national and local media; and
Delivery from a trusted source.
5.3 The mass communications strategy should support local practitioners by:
Ensuring that support and training is provided for practitioners at a local level to work with local media; and
Developing mechanisms to link media coverage in Scotland and across the UK with local information, lifelong learning and health service provision in order that local services are prepared to respond to increased demand.
5.4 There will also be a need to provide information and support to, and develop relationships with, different media both in Scotland and across the UK. This should include:
Establishment of a pool of experts from a variety of disciplines and from localities across Scotland which local or national media can approach for accurate information and comment;
Means to facilitate proactive work and innovative ideas to promote key sexual health messages with different aspects of the media in Scotland at both local and national level; and
Development of information packs and/or guidelines for media.
5.5 Finally, because there are significant gaps in evidence, further work and research should be commissioned to:
explore the potential of media literacy training, including a pilot project;
learn more about the way in which media, in particular sexual media, is used by consumers;
further investigate and expand existing opportunities to give consumers a voice; and
better understand the influence of the media on gender.
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