A Healthy Theory to Healthy Television

Today, I'll attempt to bring two very different worlds together. Television and Theory. Some great scholars* have already lived a long life revealing how systematic theories can be translated into effective television to enable widespread social change (see work by Dr. Albert Bandura and colleagues for how Observational Learning was utilized in a similar way).

Now consider the following short story, made in a matter of minutes for illustration purposes.

A famous television actor slowly succumbs to drug addiction in his later 40s. One consistent character in his life is a pizza delivery girl. Whenever they meet, they chat for a good 10 to 20 minutes in a friendly pure-hearted way, making this generally reclusive actor share similar stories and experiences. One day, he doesn't open the door due to an overdose collapse. The pizza delivery girl breaks the door and calls for help. They get the guy to the nearest hospital. At the time of being found on the floor, he is holding on to some old book with pictures, nostalgic cards and notes hidden inside, from the time when he used to be better known. He is saved on time and in the next scene is found sitting calmly on the hospital bed. The girl shows up with a pizza and then they smile at each other. The end.

In an Indian television series, such is a scene is then likely to end with a narrator dialogue, such as, 'Kuch rishtey jaan bachane ke liye hotey hain.' (Some relationships are meant to save your life.) Then you leave it all to a widespread multi-cultural audience to imagine and decide in their own moral imagination what all could happen in the future (it's an old strategy to make endings work for all kinds of audiences who may watch your series).

You'll have the tendency to assume the above as a love story. However, my main purpose here is to show the importance of identification and relatability of television characters in bringing health behavioral changes in the long run. Typically, people who tell or write stories wonder, 'How can systematically and scientifically formed social theories get translated into a script?' Because I am interested in both these types of expression, I'll show a step-by-step description of forming a health promoting story using the Theory of Planned Behavior.

Many behavioral and motivational theories of health exist, of which Theory of Planned Behavior is one with origins in Theory of Reasoned Action (Ajzen & Fishbein, 1980).

Theory of Planned Behavior has three main components — one's attitude toward the behavior, subjective norms held by the person, and perceived behavioral control. Attitude, here, means if the behavior is recognized as good or bad. For example, dieting may not align well with one's familial attitudes or wasn't considered important while growing up. Along the same lines, smoking or drinking may have been seen as fashionable rites of passage by some, not so much by others, all depending on your early life surroundings.

Subjective norms denote the degree of acceptability of the problematic behavior you engage in regularly. Such norms have the capacity of changing depending on the social circles we choose. For example, this is what partly explains why people can suddenly become health conscious or dedicated drug addicts and alcoholics depending on the approval or rejection by their immediate peer group. Lastly, perceived behavioral control is about beliefs regarding personal ability bringing positive health related changes in your life.

In the flashback of the aforementioned story in the beginning, a fairly normal young, motivated actor begins to become an alcoholic or drug addict in his coping with fluctuations felt in daily life struggles. 'One day king, another day kong' kind of existence does this to people. So read ahead without much judgement. The initial attitude toward these behaviors may have gotten formed in an environment where similar struggling others did the same. To relate, imagine how as a ten-year-old you got soda drinks and cake at a birthday party without thinking much. For this group, it was drugs and alcohol. For our main character here, though, this habit becomes out of control beginning to impact the quality of his work. In the realm of attitude, identified before, he is more likely to be found with people who approve of such habits and some of his old friends may not keep much contact. The subjective norms would shift inevitably over the next few months. This means the person will lose work that requires good focus and being conscientious in habits and is found in contexts where similarly minded people get together. Not to mention, some other well-aligning poor habits will accumulate as well. Then we are bound to see a collapse of health at some time leading to admission in a rehabilitation program — a good scene for any psychologist following this story with the theory in mind because we have now enabled a shift from poor attitudes and subjective norms to a space of health improvement.

Here in the presence of people facing similar struggles at different stages, the person who was caught in the dark clouds of bad behaviors is now able to see another route, a path to life.

To make things realistic, we then introduce a relapse — the moment of truth for what our character is made of, particularly in his beliefs in oneself about still continuing with behaviors that will yield positive results in the end. This is where a new cohort of people with good health habits and beliefs will be needed to sustain the change. Early experiences can sometimes be quite strong and feel like second nature, which is why stronger larger motivations ingrained in form of good relationships are often required to bring massive shifts. In the end, our character builds a good sense of perceived behavioral control due to witnessing stories of improvement in people nearby in the facility and due to a carefully planned incremental systematic intervention that enables success by the end of two years.

Now, when you revisit the first scene, don't see the incident as a sign of fall but progress because once people are out of poor health habits, they often find themselves face to face with their actual problems rooted more in the psychological story of their life. Once they return home, and have identified all their capacities, they are then ready to live.

If such a story was ever written, here's how this could matter in bringing social change.

1. Identification with a main character encourages better ability to imagine similar changes in self. For this reason, many successful television characters are just glamourous enough to catch your eye but at the same time feel like a family member. For an audience, this means, if this character can bring a change in their life, so can I.

   
   

2. Showing incremental or step-by-step shifts is better possible in television series compared to ads. Even in the way a story is told, a serial, by structure, is told over weeks, enabling better span for the characters and plot to grow over people. Over time, many popular television characters are often lived by people as regular friends or family members you get to meet in a predictable manner. This trust can translate to good decisions.

   
   

3. Several situations can be depicted using the character the audience identifies with, and a template can be presented for how to behave if and when found in similar problems. An actor can help the audience translate their intentions into behavior. Health behaviors and important steps that may seem obvious to someone socialized in cities may not be so in rural areas or small towns, for example. Even in something as simple as the talking that is supposed to happen when dealing with a health issue. This is where observational learning is often combined as a method, which rests on the idea of observation being more impactful than being told what is good or bad for a person.

   
   

References

Ajzen, I. and Fishbein, M. (1980). Understanding attitudes and predicting social behavior. Prentice-Hall.

Ajzen, I. (2020). The theory of planned behavior: Frequently asked questions. Human Behavior and Emerging Technologies, 2(4), 314-324.

*Bandura, A. (1965). Influence of models' reinforcement contingencies on the acquisition of imitative responses. Journal of Personality & Social Psychology, 1, 589-595.