CITATION AND COPYRIGHT INFORMATION:
Cite as: Frenette, M. (1999, May). “Reading” the meaning-making potential of televised health messages. Paper presented at a non-divisional workshop held at the meeting of the International Communication Association, San Francisco.
© Micheline Frenette (1999).

ESSENCE OF PROJECT:
Within the larger context of reception studies, I have been looking at the media component of health campaigns from a Sense-Making perspective over the past few years. These efforts are aimed at testing the relevance of this approach which leads us to view information as a construct in contrast with persuasion strategies that view information as content. This has involved interviewing young people about their interpretation of television and print messages on the issues of smoking and AIDS prevention, for example. Thus, some messages have been identified by respondents as more meaningful than others with some degree of convergence. Building upon these results, I have been examining a variety of television messages in an attempt to identify those that seem to offer an open structure that might be more conducive to meaning-making on the part of young people, all other things being equal. I have kept the title of the initial proposal but it belies a partial view of the process, that of someone looking at the message when in actual fact, this study is also trying to look at the process from the other end, that is as an attempt on the part of the health promoter to talk to/with that someone. The challenge is to test the idea that a message may be construed as engaging varying degrees of dialogue with the “audience”.

THE REASONS I TOOK THIS ROAD:
Health campaigns typically include the mass media as part of their communication strategy and make use of a variety of outlets such as posters, flyers, radio and television advertisements. Even though it is common knowledge that media are most effective in promoting health issues when they are used in combination with community support and interpersonal affiliates, the media still have a crucial role to play in fostering collective awareness of specific health issues as well as in reaching individuals with regard to issues that are especially relevant for them. However, the expectations placed upon the media component of health campaigns are often misguided. Tobacco smoking among young people is one such case. The fact that 90% of adult smokers began smoking before the age of seventeen makes it an important health issue. But even though information about the health hazards of smoking is generally well disseminated, health workers are dismayed that young smokers do not seem to act upon that information. As an attempt to understand this phenomenon, media researchers might ask to what extent the design and evaluation of media health campaigns are conceptualized according to an implicit linear theory of communication, emphasizing the message as a deliverable content that is likely to be understood as the producers intended it to be. The fact that the message is tailored to be as pleasing and as convincing as possible for the target audience, or that it may ultimately be rejected, does not necessarily raise doubts about the underlying paradigm of a sender addressing a receiver.

I feel personally committed to health issues (among other topics of social and educational import) and welcomed the opportunity to try to contribute in a different way. Indeed, I think there is a practical need for a means to evaluate to what extent health promoters appear to be acknowledging a meaning-making process on the part of the ‘viewer’ through their messages. I became excited about Sense-Making when I encountered some of Dervin’s early papers on the reconceptualization of the audience. Two aspects appeared especially promising to me: one is the challenge of sustaining a dynamic theory of communication whilst researching all phases of media communication; the second is the fundamentally democratic philosophy undergirding this approach. I have been exploring how the Sense-Making theory of communication could be relevant for the manner in which we conceive of media’s role in the context of health campaigns. This approach posits individuals as constantly striving to create meaning out of their diverse experiences (including their encounters with the media) in a way that connects with their personal life goals as they move through specific times and places. In this view, a successful communication is one where the person finds some resonance as to where she is at and, hopefully, some usefulness as to where she wants to go. In short, an individual cannot receive information, he or she can only conceive it. How then could media health messages be viewed within this dynamic process, especially since they are not purposefully sought out by the individual?

The first attempts in this regard consisted in interviewing teenagers about two television messages on AIDS prevention. One message showed a young couple overcoming their shyness in buying a condom in a drugstore; the second was an intimate scene conveying the idea that a condom can be a pleasant part of lovemaking. The second message was considered very appealing by adults but was meaningless to young teenagers because it did not correspond to their real-life situation (i.e., leisurely intimacy in one’s own apartment) and gave them no clue about negotiating condom use with one’s partner. In other words, it did not speak to a problem they had. In contrast, the first message had greater personal relevance for them. Therefore, the idea of investigating individuals’ interpretations of media messages through the lens of Sense-Making seemed to provide a new and useful perspective.

THE BEST OF WHAT I HAVE ACHIEVED:
Pursuing this line of investigation, I believe that I have obtained further confirmation that the Sense-Making framework might be useful to guide the design and evaluation of health promotion messages. For instance, a recent study focused on televisionmessages realted to smoking. The detailed results describe how the adolescents perceive the messages to relate to their personal experience as well as to their current life situation and needs with respect to smoking. In keeping with this perspective, the messages were also examined in terms of whether they are relevant to the problems the adolescents encounter with regard to smoking, whether they answer questions they might have, whether they address specific obstacles and gaps that they face when trying to quit or attempting to remain a non-smoker. Finally, the data explain whether or not the messages make any connections to possible ressources or solutions that might be useful for young smokers and non-smokers. Indeed, the Sense-Making model first leads us to pause and consider the personal meaning that adolescents may derive from the tobacco experience as such. For instance, if smoking cigarettes is a way to tell the world that one is one’s own person, the long term health hazards are not likely to be a major consideration.

During the interviews, it became apparent that adolescents’ experiences and expectations with media in general and with PSA’s in particular also play a part in the way they construct meaning from such health messages. Therefore, the Sense-Making model was also useful in showing how the stylistic elements of PSA’s also participate in adolescents’ construction of meaning. For example, some messages made use of special effects to illustrate the deleterious consequences of smoking but these were accepted by the teenagers only to the extent that they were semantically meaningful. In other words, they reacted negatively to gratuitous effects that did not spark a question in their minds or make them discover some new facet of smoking (in addition to being spectacular to watch). The importance of careful artistic crafting of PSAs was also underscored by the fact that some messages, instead of contributing to adolescents’ meaning-making about tobacco smoking, created gaps and obstacles in their understanding of the message itself. For example, if the behavior of the actors or the relationships among them were ambiguous, the adolescents’ efforts were sidetracked into trying to grasp the context. Consequently, it was deemed that a sound conceptual design would consider the characteristics of the respective media genres were as an incentive to formulate realistic goals in terms of a meaning-making process. For example, a television message may be used to raise a question in the adolescent’s mind or to point to a resource while a print medium may be more appropriate to answer potential questions or to illustrate specific solutions. The overall conclusion was that the health message could be envisioned not as a vehicle for some predefined information but rather as a catalyst for the adolescent to construct his or her own “information.” In other words, media health campaigns could be conceptualized as a dialogue between the health agency and the young people it is attempting to reach, striving to create a situation whereby they find some clarification on their life situation. Serving as a reverse demonstration of how the model might inform the design of health campaigns, some of the messages analyzed turned out to be counter-productive from a meaning-making point of view. For instance, young smokers felt that one of the television PSAs did not acknowledge how difficult it is to quit smoking and was in fact useless for them. While attempting to encourage non-smokers, another message inadvertently portrayed young smokers as dependent and unresponsive to others’ needs. (Some of the messages addressed smokers directly while others were geared to non-smokers but in both types, young smokers and non-smokers were portrayed together and interacted about smoking). Even non-smokers reacted to this message as unfair, given their experience with their friends who smoke. In short, the elements that stood out in the adolescents’ minds were not those the producers of the messages had hoped for.

WHAT HAS BEEN HELPFUL:
It has proven essential to conduct intermittent investigations into individuals’ perceptions of health messages as a way to anchor reflections about Sense-Making as a framework for creating a distance dialogue enacted through media. For instance, the Sense-Making study referred to above was conducted with smokers and non-smokers aged 14, 15 and 16 years, male and female, who were interviewed in a small group setting. First, their experience with tobacco smoking was explored in terms of the circumstances and motivations surrounding their first cigarette, the perceived advantages and inconveniences related to both smoking and not smoking, the relationships with their friends and family in relation to smoking, the motivations and obstacles related to quitting, etc. The participants then viewed some antismoking television advertisements and examined some posters and other print material produced by governmental agencies for young people. Following Sense-Making Methodology, the remainder of the interview attempted to understand how adolescents make sense of such messages; thus they were asked what questions come to their mind upon encountering these messages, what, if anything, about these messages was relevant for them, how they could be have been made more meaningful, etc.

WHAT WE HAVE STRUGGLED WITH:
On first thought, applying the premise of Sense-Making to media communication presents a particular challenge, especially with regard to health promotion, because such messages are not sought out by the individual with regard to a need. In addition, considering the complexity of individual reactions to a single message is almost mind-boggling and can easily paralyze the whole intellectual enterprise. Trying to maintain an interactive/dialogic view of media while vocabulary that comes “naturally” (i.e., message, audience, reception, content analysis, …) belies another view of communication has also been an obstacle. Threading the slippery terrain of analysing a message on its own without losing sight of the basic premise of Sense-Making as a theory of communication can also be a struggle at times. Finally, I need to make progress in my theoretical mastery of Sense-Making and to work on building connections between Sense-Making and other theories of communication.

WHAT WOULD HELP NOW:
Feedback from the participants upon the usefulness of this kind of endeavor and on the methodological pitfalls would be extremely useful in charting out the next steps or alternative routes. On the methodological front for example, the voluntary nature of the tobacco study may have drawn more confident and outspoken adolescents to participate in the group interviews. The meaning-making process is likely to differ among other adolescents, especially when viewing PSAs in natural settings. However, the need to try out the Sense-Making model as an investigative tool for the reception of media messages related to health justifies the exploratory nature of the study. The qualitative data obtained are also used as a base to discuss some theoretical issues about the relevance of Sense-Making for “reception” studies. For instance, to what extent can the chance encounter of health messages be considered to support a significant meaning-making process on the part of young viewers? In addition, how can the Sense-Making model apply to individuals who do not appear to be doubtful about their smoking habits? Given the expense of producing PSAs and their notoriously weak impact in terms of behavior change, it is reasonable to doubt their usefulness. However, I think that situating media health messages in the context of the Sense-Making model leads us to view them in a different light, as partaking in adolescents’ general efforts to create meaning and a sense of direction in their lives rather than imparting a meaning and direction to them. This approach calls for radically different design and evaluation procedures from most of those we are accustomed to seeing. Many issues about the feasability of the Sense-Making approach for health campaigns still need to be addressed but so far, I have found that interrogating media messages from the perspective of their meaningfulness to be relevant in understanding how adolescents are likely to make them their own. In addition, I believe we may be able to build upon this kind of research with traditional media to envision how the newer interactive media offer creative opportunities for health promotion in ways that are truly significant for individuals.

PROJECT ABSTRACT:
Sense-Making theory suggests that individuals are constantly seeking to make sense of their world in order to achieve their life goals and that in so doing, they are led to engage in constant dialogic relationship with potential sense-making resources. A qualitative study verified the relevance of this approach for our understanding of smoking habits among adolescents and for the design of related health campaigns. Teenage smokers and non-smokers were interviewed on their experience with cigarettes and their perceptions of anti-smoking television messages. Their responses were analyzed according to the Sense-Making model which sees the individual’s progression as rooted in his experiences, needs and present situation, solving problems which arise by asking appropriate questions, overcoming obstacles and closing gaps in his understanding until he identifies the resources that provide solutions to be used and evaluated. This study provided an additional opportunity to discuss the theoretical and methodological implications of conducting media research in accordance with a dialogic model of communication. The results also lead to some recommendations for the design of messages related to smoking with young people in mind when viewed within an interactive/dialogic framework.

REFERENCES:
(For references to works by Dervin and colleagues, see Dervin’s writings: Chronological listing.)

Leathar, D. S., Hastings, G. B. & Davies, J. K. (Eds.). (1986). Health Education and the Media II. Oxford: Pergamon Press.

Millstein, S., Peterson, A. & Nightingale, E. (Eds.). (1993). Promoting the Health of Adolescents. New York: Oxford University Press.

Rice, R. E. & Atkin, C. K. (Eds.).(1989). Public Communication Campaigns, 2d ed. Newbury Hill, CA: Sage.

U.S. Department of Health and Human Services (1994). Preventing Tobacco Use Among Young People (A Report of the Surgeon General, Executive Summary). Washington, DC: Centers for Disease Control and Prevention.

OTHER MATERIALS BY THIS AUTHOR ON THIS WEB SITE:
See: http://communication.sbs.ohio-state.edu/sense-making/AAauthors/authorlistfrenette.html