Teenage Sexuality
Speaker: Dr. Felicia Hance-Stewart (click here for biography)
Soap Summit 2

Transcript of Proceedings
September 7, 1996

DR. FELICIA HANCE STEWART: Thank you. I had the opportunity last year to participate in the Talk Show Summit with my government hat on and it turned out to be one of the more interesting and exciting days. So it's a real pleasure for me to be here today, and I especially appreciate as Sonny mentioned last night, just the fact that all of you are here illustrates one of the little-known realities about just what an important commitment the media really has to a constructive role in our lives and the lives of our kids.

My job today is to introduce Dr. Heintz-Knowles who is the researcher. But before that I get to take advantage of those couple of minutes, first of all, to share with you the statistical information that the press will be getting at noon, so you'll all have it. To explain a little bit about what Kaiser's commitment in this are and the rationale for it. I get to share with you one story plot idea. [LAUGHTER] Because I know that probably everybody in America has story plot ideas, and the fact that I have the microphone right now gives me the [LAUGHS].

But it's a story plot idea that also gives some sense of what a difference the works that you all do makes, and to make an offer from the Kaiser Family Foundation to be of more help. Before I start, first of all I would like very much to acknowledge the incredible work that Sonny Fox has done in not only getting this particular workshop together but in making this whole area happen in the United States and I think get us a long way down the road towards applying for our own people some of the lessons, frankly, that are better understood in other parts of the world. So I first of all would like to thank him and congratulate him both on his wisdom, his strength, and tenacity in getting this together. [APPLAUSE] I would also like to acknowledge two people, Suzanne Delbanco and Tina Hoff, who are standing, sitting over here. They actually were responsible in very substantial part for the design and the ideas that went into making this whole survey process as meaningful and substantive as it is. Kaiser Family Foundation has had a long time interest in the issue of media and their role in providing public health information about reproductive health issues. The fact is that you are the people that actually talk to the people that we would like most to be able to communicate with. And not just a few at a time.

You know, after 25 years in clinical practice myself, talking one at a time to women, there's no question that there's nothing more wonderful and fun than that. But it is not the same impact. And in fact I think, generally speaking, despite my hard work for those 25 years, we may have been slipping a little behind on some of these issues. [LAUGHS] Clearly, we have to find ways to make this part of a much bigger undertaking. And that bigger undertaking of talking to 40 million people who are exactly the kind of people who most need accurate information every single day, is what not only are you good at, but you're way better than any of us in public health ever has been or probably ever will be. So we really need to have the help of your incredible expertise on how to communicate effectively how to get people's attention, how to make things interesting and how to get some factual information in there that's as constructive as possible for them.

Now, in terms of the research studies that we're going to be talking about today, as Sonny explained, this project involved monitoring---, and you're going to hear a great more depth about this from the research herself, monitoring the content and comparing it essentially to the findings that we had two years ago that you all had the opportunity to see in 1994. The study, however, had a little more depth and context than the previous study did in the sense that we didn't just count up little sexual behaviorettes. You know, a hug, a kiss, a glance, a meaningful word. This time there was an opportunity to put a context around each of those little vignettes to determine whether there was or was not planning ahead or sense of what consequences people might need to consider in relationship to what was going on. And that actually brings us, I think, some of the most powerful and heart-warming information about major change and major constructive role that all the work that all of you do, can have. So, as you can see from this little chart, there, one of the fundamental messages is that overall the total number and behaviors here are each little teeny piece. So, the top, it doesn't mean that there was six acts of intercourse on ever hour of soap programming. But the overall focus on sexual issues is about the same.

Overall, the total amount of emphasis on sexual issues really did not change significantly. One thing that did change, very interesting and I do not know whether this is generally true of other issues that you may be covering in the storylines, but there's less talk and more to see. So the shift was from predominately two-thirds talking about sexual issues in 1994 to now, two years later, more visual representation. Now I suspect that is meaningful because generally speaking visual things are imprinting and kind of having a meeting in a different way than talking does. But it's an interesting observation. Now what about consequences? One area where we are particularly interested in trying to do this in a good way is to have the issue of decision-making about sexuality and sexual activity and reproductive health issues generally connected to someway of counting or counting for consequences. And we did see in 58 little vignettes some accounting for consequences as part of the story-line.

But the vast majority of the time, 90% of the time, that isn't part of the story-line now. So that's an area where maybe some creativity and possible improvement can happen. Similarly, looking at the bottom here, condoms now actually seem to be safe to show on TV. And, in fact, there were five glimpses of condoms in the little intervals that we studied. Most of them connected, though, with two specific story-line plots. So it wasn't something now we're seeing this commonly interwoven with other stories. Similarly, out of the 17 actual intercourse acts that were depicted, there was condom in only one. So we're still kind of a long ways from the proportion of showing some kind of contraceptive and STD prevention actually there in connection with intercourse than maybe we'd ideally like to be. But one of the things that was the most heartening, and this is the top one, the little baby carriages here, that despite the fact that the actual use of a method was not very common, woven into the story-line plots and in, or into the vignettes, in almost half the cases, was at least something about consequences.

The planning ahead for or anticipating and considering possible consequences. Now that, we don't really have a direct comparison because we know the study two years ago didn't include as much contacts. So we weren't able to make a direct comparison. But in my opinion, that is certainly an extremely positive, and frankly amazing finding in terms of what possible constructive role these stories might have for real people. Now we're going to go through in much more detail, the results of the rest of the study and Dr. Heintz-Knowles will explain in depth and there were lots of other very interesting findings that she'll have a chance to talk to you about. But I would like to share with you one little glimpse of how we can tell that what you're doing matters so much. And this has to do with my story-line, plot idea. So, please take notes. [LAUGHTER]

Now I want you to kind of mentally close your eyes and picture yourself back to the time in your own lives, and maybe some of you are still there, the time, as my kids put it, when you had a life. [LAUGHS] And it is now like 1:30 in the morning on a Saturday night or a Sunday night and you really had a wonderful evening the night before. It was a meaningful relationship. You really cared about this other person you're with. You had a wonderful night. More passionate and intense experience that you normally would have. But there you are lying in bed and you're thinking about the fact that a condom broke maybe or you really had meant to kind of get re-started on your pills but you hadn't quite gotten around to going to the doctor and so you actually probably should have started again on Friday but, you know, you were kind of thinking well maybe I'll be all right. And you're lying there on Sunday morning thinking, "You know, that really was not such a good idea. This would not be the time that I would like to be pregnant" Or maybe, a really good friend calls because she was raped the night before and she is okay, you know, not hurt. But going through that awful mental checklist, not only woundedness but fear that she's going to be facing around the issues of maybe STD exposure or pregnancy. Now if you were there lying in the bed thinking at 1:30 in the morning, "oh my goodness, this was not a good idea, what you could do for your friend, what would your concerns be and what would you do the next day? One of the concerns, of course, would be pregnancy and the issue of wouldn't it be wonderful if there was something I could do now that would reduce that risk?"

And the fact of the matter is there is something that can be done now to reduce that risk and it's a very simple, low-tech thing that we have had for 20 years and if indeed you went to the Student Health Service at a college or you went to the emergency room to be treated after a rape, you would almost for sure be offered emergency contraceptive pills to take the morning after that could reduce the risk of pregnancy by 75%. Now how many of you in this room know about emergency contraceptive pills? Fabulous.

I can tell you that five years ago if I had asked that question in this room there wouldn't have been anybody. And as I've been speaking around the country over the last years, we've gradually seen an increasing knowledge. But very few people, percentage-wise are aware of this option. And it is a simple option. It is available right today. There's not a reason in the world that anyone in that situation shouldn't have some way to make a connection with emergency contraceptives. So finding some way, I suggest this story-line plot because I really do understand that public health messages, you cannot intrude on your entertainment value story-lines and plots if it's boring. You know, you cannot trade for the boring and banal. But this would be a really juicy little plot line that I think would be really a great one for young people. Now, and we have, furthermore, some evidence of what a difference it makes. This does not relate to the soaps because we don't--, we haven't had any 800 number follow-up for soaps. But we have had an 800 number for emergency contraception and it was covered on MTV.

Now this little graph is the number of phone calls to the national hotline for emergency contraception in the month of April 1996. Normally, it's been running about 130 a day. MTV ran a less than one minute news clip in their little news clip in the middle of April for two days. The calls to the emergency hotline, which includes information about emergency contraception and also provides referral numbers for three doctors or nurse practitioners nearest the caller's area code for referrals where they can actually get it. The calls jumped from 130 a day to 3,000, the two segment days that that ad was run. Now I like to think that at least for some of those people, finding somebody to get emergency contraception actually helped them in their actual real life, right then that day. I'm sure there were some people calling out of curiosity. But if you doubt for a minute that the people who are watching your shows actually listen and hear the medical stuff and relate it to their own lives, this is proof positive that that is not the case and that actually people believe everything you say and think that you are an extremely important and accurate source of information.

Now that leads me to the offer I want to make. You can call us any time if you need help gathering background information similar to the kind of help that Dr. Shalala was offering. If you want me to go running around and try to find out what's the best info on warts or something like that, I will do that very gladly. And we certainly understand your need for quick turnaround time. And we have pretty good connections with most of the other major organizations so that it's a feasible thing that we can do. So you can call me anytime, day or night and I will be glad to find out about whatever miscellaneous medical aggravation in the area of reproductive health that you think might be helpful to your work.

So if you're a scriptwriter and you're wondering what to say about wart virus, you just call me up and I'll be glad to send you stuff, or find out who knows if I don't. The second thing that we'd be very interesting in doing and offering as a resource, we have had jointly sponsored 800 numbers and jointly, joint kind of collaborative ventures with various different media organizations, including the Washington Post. And we're working with various different mainline resources. And one of the things that we imagine might be attractive to you is to have the ability to set up a temporary 800 number. So if you're going to cover something that's a hot topic that you want to be able to give your viewers someplace to go, a little more depth of resources, we would be very glad to jointly organize the materials and appropriate information and get that hotline up and running and underway and funded to run for the period of time that you need it as a back-up on your particular story-line. So if that seems like something that would be helpful, I would certainly love to hear from any one of you and we'll be glad to try to figure out a way to make these things work. Now with that all said and done, it's my wonderful pleasure to introduce the woman who actually watched all your stuff with such great care and did the calculations and analysis that is the basis of this research. Katherine Heintz-Knowles was a graduate of the University of California, Santa Barbara and did her graduate work at the University of Illinois. And she's now a researcher mainly focused on the influences of media on children. So it's a great pleasure to introduce Dr. Heintz-Knowles. [APPLAUSE]