Entertainment TV Can Help Teach Teens Responsible Sex Messages

TV entertainment programs can be a responsible sex educator for teenagers, and the likelihood that teens will learn an accurate lesson increases with parental reinforcement, according to a RAND Corporation study released today.

RAND Health researchers surveyed a group of teens who had watched an episode of the popular comedy “Friends” with a plot that included a pregnancy caused by a condom failure. The study found that most viewers remembered that the episode contained information about condom effectiveness.

However, teen viewers who watched with an adult or discussed the episode with an adult were about twice as likely as others to remember the correct information about condoms. Viewers still remembered the lessons six months later, according to the study in the November edition of the journal Pediatrics.

“We've always known that teenagers get useful information about sex from factual reporting and advice-oriented media, but now we know they can get this information from entertainment television programs as well,” said Rebecca Collins, a RAND psychologist and lead author of the report. “That's important because entertainment programs, especially highly rated ones like 'Friends,' reach many more teens.”

The RAND Health study is one of the few rigorous studies carried out in the United States on an individual television show's impact on public health issues. Most of the research on the topic has been done in Africa, where television soap operas have been used to successfully deliver public health messages about HIV.

Researchers were able to do the novel study as a part of the RAND Television and Adolescent Sexuality study, a national effort that is examining the role television plays in teenagers' development of sexual attitudes and behavior.

“Television may create a 'teachable moment' where we can influence teenagers in ways that we can't in the classroom or by using other traditional means,” Collins said. “It can also get parents involved in the teaching process. When parents and kids watch television together, a program may present an opportunity to discuss issues the children might not raise on their own.”

During the season when the “Friends” episode aired, the character Rachel becomes pregnant after having sexual relations with the character Ross, her former boyfriend. In the episode studied, she reveals this to Ross. He expresses surprise at the pregnancy, noting he had used a condom. Twice during the episode, characters say that condoms are “only 97 percent effective.”

Days after the episode was first broadcast in October 2001, RAND researchers surveyed about 500 teens involved with the larger study who were regular “Friends” viewers. Among teens who recalled viewing the episode, 65 percent remembered that it involved a condom failure that caused a pregnancy.

About half of the teenage viewers interpreted the episode as showing that “lots of times condoms don't prevent pregnancy.” However, those who, as a result of viewing, talked about condom effectiveness with an adult, tended to see condoms as more effective than they had in a survey conducted prior to the episode.

Teens who watched the condom episode with an adult were twice as likely to recall that the episode reported that condoms were more than 95 percent effective. Among those who discussed the episode with an adult, almost half remembered condoms being described as more than 95 percent effective—nearly twice as many as among teens who did not discuss the show with an adult.

“Our study suggests that if more shows included a message about responsible sexual behavior and what the risks are in having sex, we might have fewer problems with teen pregnancy and sexually transmitted diseases,” Collins said. “But the specific message is really important. In the 'Friends' episode we studied, the message was accurate, but a bit ambiguous. Some kids might have come away thinking that condoms aren't worth using. It was the kids who watched the show with their parents or discussed it with an adult who got the message that condoms are mostly effective, but can fail on rare occasions.”

Funding for the RAND Health study was provided by the Kaiser Family Foundation (KFF). KFF Vice President Vicky Rideout met with Collins shortly after the episode aired, and they conceptualized the study together. Other members of the RAND research term were Marc Elliott, Sandra Berry, David Kanouse, and Sarah Hunter.

Nearly half of all high school students in the United States have had sex, with the rate of sexually transmitted diseases and unintended pregnancy high among this group. The prevalence of sexual content on television is sometimes blamed as one factor in adolescents' sexual attitudes.

Studies show that the average American adolescent views almost three hours of television each day. In addition, it's estimated that 70 percent of primetime network programs contain sexual content, with the average of those shows having six scenes with sex per hour. Depictions or mention of condom use are rare among these portrayals.

RAND Health is the nation's largest independent health policy research organization, with a broad research portfolio that focuses on health care quality, costs, and delivery, among other topics.