Television has been described as one of the most powerful idea disseminators and socializing agents in the contemporary world and its power to change attitudes and behavior has long been assumed. Billions of dollars are spent worldwide on television campaigns to promote population health even though we lack clear evidence of a causal link between television and family formation and reproductive health. Although a substantial research literature documents television's effects, existing research is primarily associational;making it impossible to establish a causal direction or to eliminate the possibility that a third variable is responsible for the observed associations. In defending these existing research problems, many note that because television is so widely available, "it is extremely difficult, if not impossible, to randomly assign members of a target audience to comparison and intervention groups" (Gurman &Underwood, 2008, p. 56). However, we do have the rare opportunity to conduct a randomized experiment on television's effects. In cooperation with the Vietnam government, we have selected 14 villages in a remote, mountainous area of Vietnam that currently lacks electricity. After collecting baseline information on all 14 villages using mutually reinforcing qualitative (family and community ethnographies) and quantitative (survey interviews) data collection strategies, we will randomly assign half the villages to the treatment group and the other half to the control group. Treatment villages will receive televisions and generators with gasoline to operate the televisions. Control villages will not receive generators or televisions. All 14 villages will be followed annually for 3 years after television's introduction. This will be the first study to examine the causal impacts of television on family formation and reproductive health using a large, randomized design.
The specific aims of this research are: (1) Examine the causal impacts of television on family formation attitudes and behaviors, including age at marriage, parent's role in the mate selection process, desired family size, age at first birth, and contraceptive use;(2) Examine the causal impacts of television on reproductive health knowledge (knowledge of STI's and their prevention, knowledge of modern contraceptives), premarital sexual activity, use of reproductive health services, and condom use;and (3) Examine the specific mechanisms through which television effects operate. This study is innovative in its reliance on an experimental design, its integration of quantitative and qualitative approaches, and its international and interdisciplinary research team. This large experiment with sufficient statistical power (14 villages with approximately 4,200 respondents) can significantly advance our theoretical models of both population change and media effects and has important implications for the design and delivery of population health interventions.
Public and private agencies worldwide are increasingly using television as a deliberate tool for changing reproductive and health behaviors (i.e., contraception and HIV risk behaviors). However, the causal impacts of television on attitudes and behaviors remain unclear. This design will provide one of the most rigorous assessments to date of the causal impacts of television, and has important implications for theoretical development on media effects, the mechanisms leading to international family change, and for the design and delivery of public health interventions.