case study

Vencer el Miedo

We co-produced an entertainment-education telenovela that aired on prime-time television in Mexico and evaluated its impact on adolescent reproductive health outcomes nationwide

Client: Population Media Center

The Issue

Adolescents in Mexico experience high pregnancy and birth rates. 

Parent-child communication about sexual risks is associated with adolescents’ use of contraceptives. 

Telenovelas are popular in Mexico and can be powerful platforms for entertainment-educational approaches to improve sexual and reproductive health.

The Outcomes

We co-produced Vencer el Miedo, (Overcome the Fear) with Grupo Televisa, Mexico’s largest television network.  This telenovela promoted adolescent reproductive health and had 3.5 million viewers each night for 47 episodes.

Our evaluation found that adolescent viewers were more likely to use contraception, including dual methods.  Parent viewers were more likely to have talked with their adolescent children about sex and contraceptive methods, including condoms. 

Publications

Overcome the Fear (Vencer el Miedo): using entertainment education to impact adolescent sexual and reproductive health and parent-child communication in Mexico.
Montoya JA, Plant A, Neffa-Creech D, Orvañanos C, Barker K. BMC Public Health. 2022;22(1):2366.

Drama, Intrigue, and Discussion: The Role of Telenovelas in Facilitating Conversations about Reproductive Health in Mexican Households.
Suresh S, Walter N, Montoya JA, Plant A, Barker K.J Health Communication. 2022;27(7):484-494.

Presentations

In Search of Entertainment-Education’s Effects: Linking Variations in a Telenovela’s Storyline with Calls to a Sexual and Reproductive Health Hotline.
Suresh S, Demetriades S, Walter N, Montoya J, Plant A, Barker, K Carranza J, Orvañanos, C. Oral presentation at: 73rd Annual International Communication Association Conference, Reclaiming Authenticity in Communication, May 25-29 2023. Toronto, Ontario, Canada

Parents as Gatekeepers? Co-Viewing in Entertainment Education to Improve Health Outcomes.
Suresh S, Walter N, Montoya JA, Plant A. Oral presentation at: D.C. Health Communications Conference; April 28-29, 2023; Washington DC.

Entertainment-Education for Sexual and Reproductive Health
Entertainment-education (EE) is a powerful but underutilized tool for creating wide-scale, positive behavior change.  EE engages viewers with interesting and relatable characters, allowing viewers to experience health-related choices and consequences through their storylines.  Sexual and reproductive health (SRH) topics are particularly amenable to EE and have shown promise with improving health-related knowledge and behaviors. 

Developing Vencer el Miedo
We conducted eleven interviews with key informants working in governmental and non-governmental organizations in the field of reproductive healthcare within Mexico.  These interviews outlined the political, legal, cultural, and social contexts of adolescent SRH in Mexico.  We conducted 18 focus groups with adolescents (total N = 155) in three areas of Mexico to explore norms around romantic relationships, communication about sex, and attitudes and beliefs around unplanned pregnancy and contraception.  Additionally, 68 focus group participants shared photos through social media, depicting their home environment, school, work, neighborhood, and friends. We used the collected data and insights to create an engaging and relatable intervention and Vencer el Miedo characters.

We then conducted three days of workshops with the Vencer el Miedo director, producer, set designers, location scouts, and script writers in Mexico to share results of the formative research and to help train them in EE methodology.

Vencer el Miedo had incredible reach for an adolescent sexual and reproductive health intervention. The telenovela had over 3.5 million viewers for 47 episodes in Mexico, and later aired in over a dozen countries in Latin America and in the United States.  

Program Reach and Outcomes
Airing January 20 through March 22, 2020, Vencer el Miedo reached 3.5 million nightly viewers.  Transmedia promotion to amplify the program’s messaging through the Grupo Televisa website and social media accounts resulted in another 21.4 million video views and 40 million individuals reached, an enormous impression range for a public health intervention. 

Post-broadcast (from March 25 through May 28, 2020), we conducted street-intercept and phone survey interviews with adolescents (n = 1,640) and parents of adolescents (n = 820) across the five most populated metropolitan zones of Mexico.  Based on their responses to questions about viewership, participants were categorized as viewers (two or more episodes per week) or non-viewers (one or no episodes per week) of Vencer el Miedo.  Adolescent participants were asked about behaviors and attitudes about sexual behaviors and contraceptive use, and parent participants were asked about attitudes and communication with their adolescent children about SRH and romantic relationships.

Adolescent viewers of Vencer el Miedo were more likely to use contraception, including dual methods. Parent viewers were more likely to speak with their adolescent children about sexual health and contraception.   

Nearly half the parent (47.7%) and adolescent (47.9%) participants were viewers of Vencer el Miedo.  Among adolescents, watching two or more episodes per week was positively associated with seeking information about contraception and unhealthy romantic relationships, using a contraceptive method other that condoms, and using dual methods (condoms plus another contraceptive method) in the last three months. Adolescent viewers were also less likely than non-viewers to report negative attitudes toward contraception. Co-viewing Vencer el Miedo with a parent was significantly related to contraceptive behaviors in the last three months.

Among parents of adolescents, watching two or more episodes per week was positively associated with talking with their adolescent children about sexual behavior, contraceptive methods, condoms, and abstinence in the last three months. Parent non-viewers were more likely than viewers to report positive attitudes toward abstinence and negative attitudes toward contraception and toward talking to adolescents about sex.

Future Entertainment-Education Efforts
After Mexico, Vencer el Miedo aired in over a dozen countries in Latin America, and in the United States on Spanish-language television (Univision). Vencer el Miedo adds to the decades of evidence that EE programs can positively impact SRH outcomes. Few intervention methodologies can reach populations on a country or multi-country scale so efficiently. Future EE programs can be used to further improve these outcomes for adolescents in Mexico and across the globe.