Index

Corresponding Author:
Naomi Chen, University of Alabama - Birmingham School of Public Health, 1530 3rd Avenue South RPHB 227, Health Behavior, Birmingham, AL 35294, Email: nchen@uab.edu

Suggested citation: Chen N; Kohler C; Schoenberger Y; Suzuki-Crumly J; Davis K; Powell J. BodyLove: The Impact of Targeted Radio Educational Entertainment on Health Knowledge, Attitudes and Behavior among African-Americans. Cases in Public Health Communication & Marketing. 2009; 3:92-113.
Available from: www.casesjournal.org/volume3.

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Abstract

Health disparities among African-Americans are well documented, especially regarding utilization of health services, including screening. Such disparities lead to poorer chronic disease health outcomes. BodyLove is a radio serial drama that aims to change the health knowledge, attitudes, and behaviors of African-American women over 35 years of age, using the Social Cognitive Theory. Its characters model adherence, or the lack thereof, to behaviors such as screening, exercise, and healthy eating to shape listener outcome and efficacy expectations. From 2004-2007, BodyLove aired in 15 communities in Alabama. A baseline survey was administered before the first broadcast, followed by four waves of survey follow-up to measure longitudinal changes in knowledge of diabetes, hypertension, depression, diet, and exercise. Behavioral change was measured via questions regarding whether listeners practiced healthy physical activity and dietary recommendations, and if they discussed the issues with family and friends. Preliminary data analysis showed that frequent listeners were more likely than seldom listeners (p<0.05) to report that BodyLove influenced them to discuss diabetes, get screened for diabetes and hypertension, start or increase physical activity, and start eating a healthier diet. The largest increases in listeners reporting increased positive behavior occurred between the baseline and second wave of surveys.

Introduction

Health disparities among African-Americans are well documented, especially regarding utilization of health services such as screening. ¹ Such disparities lead to poorer chronic disease health outcomes among African-Americans. ² BodyLove, a radio serial drama, was developed to change health knowledge, attitudes, and behaviors using a social cognitive model. Its characters model adherence, or the lack thereof, to behaviors such as screening, exercise, and healthy eating to shape listener outcome and efficacy expectations. ³

The goal of this radio serial drama, an application of Entertainment Education (E-E), was to disseminate health information to change knowledge levels and provide models that will impact health-related attitudes and behavior. The target audience was African-American females over the age of 35. BodyLove used mass media to target this typically under-reached subgroup, using a culturally relevant storyline. Eighty-three episodes of BodyLove were aired weekly on 15 local radio stations in Alabama between 2004 and 2007.

BodyLove aimed to address health disparities on three levels of prevention. On a primary prevention level, BodyLove episodes included technical information about diet and exercise. For example, the "hidden" sources of fat in food preparation as well as the high sodium content in packaged and canned foods are discussed. On a secondary prevention level, BodyLove encouraged screening and regular primary medical care by modeling characters heeding or failing to listen to physician recommendations. On a tertiary prevention level, BodyLove radio show hosts, who are often health professionals, encouraged current diabetes patients to join diabetes self-management classes held in affiliated clinics.

On an individual level, BodyLove had four aims: increase knowledge, positively change attitudes, improve self-efficacy, and connect listeners with local health services. To increase knowledge, BodyLove episodes provided health information in an entertaining format. Modeling was used to influence positive changes in attitudes and increase self-efficacy regarding individual implementation of healthy behaviors. Finally, BodyLove connected audience members with local health services that could help them avoid and manage chronic conditions.

BodyLove impact evaluation measures took place primarily on an individual level using surveys to measure knowledge and attitude change. Self-reported behavior was measured on an individual level via scales that tested content knowledge and assessed self-efficacy, outcome expectations, and the level of influence of BodyLove exposure on listener behavior. The goal of the process evaluation was to establish whether program activities are being carried out and implemented with fidelity. This entailed regular communication between BodyLove staff and radio station hosts to confirm that episodes and call-in periods were being aired.

Background

Education entertainment presents both advantages and limitations. When compared to other mediums, the advantages of E-E include the ability to affect listener attitudes over an extended period of time and the opportunity to create and resolve conflict within a storyline. Using a soap opera format allows characters to portray conflicts between "good," or positive role models, and "evil," or negative ones. ⁴ Because its character roles are clear, BodyLove can unambiguously model positive behaviors and discourage negative ones. Meanwhile, because of the serial format, transitional role models who are trying to adopt healthier behaviors have time to overcome difficulties and deal with setbacks as part of the story line. The radio soap opera is therefore realistic, and provides opportunities for characters to overcome perceived barriers to desired behaviors, and try to substitute healthy behaviors for detrimental ones. This creates opportunities for the audience to identify with character struggles and become emotionally invested in the serial drama.

The primary limitation of E-E is the difficulty of evaluating its impact. The impact of radio serial drama has been evaluated in countries outside the United States. ⁴ However; it can be a challenge to evaluate mass communication health promotion interventions in the U.S. due to "media saturation." Media saturation means constituents already receive many messages and have extensive daily exposure to a variety of mass media formats that compete for their attention. In such a context, radio is only one of several different sources of information, and it is difficult to gauge how much exposure to radio-carried messages is occurring, and how much health content is retained. In contrast, citizens of developing countries may not have as much constant exposure to mass media such as radio, television, and movies. Consumers may, therefore, be more attentive to radio messages and demonstrate more accurate recall of program content with less potential informational contamination from other media sources.

"Media saturation" also presents the challenge of competing with all other media exposures. In order to effectively impact listeners, E-E must present health information in a salient manner that creates emotional investment in order to retain the attention of the audience and assist them in making lifestyle changes. In keeping with the Stages of Change Theory, an intervention that helps listeners move from one stage of health awareness to the next engages their sense of decisional balance. With positive, negative, and transitional role models as defined by the Social Cognitive Theory; BodyLove shifts the balance toward healthy lifestyle choices and decreases the desirability of unhealthy choices. ⁵ In addition, an emotional appeal may help the program move listeners past the indifference that often accompanies perceptions of chronic disease.

The Significance of Radio Among African- American Populations
In the African-American community, radio has traditionally been more than an entertainment medium. It also represents a public presence and forum for exchange of ideas regarding all aspects of African-American culture: the arts, society, racial issues, and the community. African-American radio continues to have a profound impact on African-American culture, as well as mainstream popular culture, with programming that has created a "shared public memory" dating back to the 1920s. ⁶

The history of African-American radio ranges from exploitation during the blackface minstrels era (when African characters were parodied by white actors wearing burnt charcoal makeup and speaking in a "creolized West Indian dialect"), to empowerment during the Civil Rights era and the rise of the "Black Power" movement. ⁶ During the Black Power movement, African-American radio station ownership was first established, and African-American deejays responded to racial stereotyping by using "black" vernacular on their shows as much as possible. ⁶

Past E-E interventions among African-American populations have been limited in number and scope. Wray and Hornik reported on "It's Your Business," an E-E intervention that aimed to reduce domestic violence among African-Americans. However, constraints such as limited distribution and a low rate of verifiable listenership made evaluation difficult. ⁷

In general, radio E-E interventions among international audiences have been more successful and have been greater in number than those in the United States. Singhal et al. present several case studies, such as Soul City in South Africa, which dealt with a range of different issues every season, including domestic violence and tobacco control. ⁸ An Internet search revealed other recent descriptions and evaluation of radio E-E internationally, in nations such as Ethiopia and Tanzania, addressing issues such as HIV/AIDS prevention and family planning, respectively. ^9,10

BodyLove Story Development
The BodyLove story line was initially developed as a graduate class assignment targeting for the listening audience of a single radio station in central Alabama. The typical listener was an African-American over the age of 35. In this particular demographic, health indicators of concern included a high prevalence of diabetes, hypertension, and cardiovascular disease. Therefore, efforts were made to tailor the story to the audience by including characters in the appropriate age range who were experiencing similar chronic health conditions. The goal of the programming was to reduce the risk cluster of the stated health conditions, using the method of E-E in accordance with current theories in the field. Development of the story focused on demonstrating the consequences of unhealthy behaviors and modeling negative and positive outcome expectations, as per the Social Cognitive Theory (SCT). Transitions from unhealthy to healthy habits also formed an integral part of the story line.

BodyLove's primary negative model is Rosalyn, who suffers from uncontrolled diabetes and eventually is hospitalized with a diabetic coma. Her sister Fadelia is a positive model, because she manages her diabetes well and is therefore able to work and is more attractive to men. A transitional model is Vanessa, through whom the listener observes the consequences of different actions. All the characters are connected through the BodyLove hair salon, and the story line and character development take place in the context of their relationships. The importance of social support in lowering stress associated with initiating and maintaining healthy behaviors in everyday life is a common theme.

A team including a playwright, a health behavior faculty member, and students from public health, theater and other departments further developed the scripts.

The Marketing Mix: Product, Price, Place, and Promotion
BodyLove aims to impact health outcomes by promoting the adoption of healthy behaviors, rather than a tangible product. ³ Some of the healthy behaviors discussed in episodes have included controlling chronic conditions such as elevated blood pressure and diabetes, modifying eating habits to reduce fat and sodium intake, and increasing exercise levels. The show also discusses the importance of maintaining healthy social networks and seeking professional treatment for mental illness.

The "price" of listening is relatively low, and radio is an easily accessible medium for this traditionally hard-to-reach population. The costs associated with production and airtime are also important considerations; producing for local radio stations was found to be cheaper than producing for television.

The "place," or distribution channel, chosen was radio, because it is widely accessible and requires little time investment on the part of the listener.

Current "promotion" of BodyLove includes brief advertising spots during the show and during the day on the stations it airs on. This is being expanded to promotion at health fairs that are attended by the target demographic to publicize and increase awareness of the show. On-air promotion of surveys, the primary evaluation tool used, continues to be very important. Small gift incentives are used to encourage audience members to participate in evaluation surveys.

Methods

From 2004-2007, eighty-three episodes of BodyLove were aired weekly on 15 local radio stations in Alabama. Each of the four seasons contained twenty episodes, and lasted approximately half a year. The radio stations selected typically attracted African-American listeners. Other programming on the radio stations included music genres such as R&B, hip-hop, and gospel music. Alabama stations that carried BodyLove typically aired the fifteen-minute episode followed by a live question-and-answer call-in period, moderated by clergy or health professionals.

Station listener demographics included the target population of BodyLove: low-income and low-literacy African-Americans over the age of 35 living in rural communities. BodyLove is tailored to this population, which typically does not respond to conventional health interventions. The fifteen communities were chosen based on their high diabetes mortality rates and large African-American populations. Each of these communities had higher proportions of African-Americans than the Alabama state average. Many of the stations are broadcast in the Black Belt, a region in Alabama that is known for its poverty and extremely poor chronic health indicators. The fifteen cities and towns where BodyLove was broadcast were: Huntsville, Moulton, Monroeville, Birmingham, Marion, Tuscaloosa, Tuscumbia, Greenville, Montgomery, Selma, Thomasville, Tallassee, Jackson, Camden, and Uniontown. BodyLove was generally broadcast on weekend mornings between 9 and 11 am, or on weekday afternoons between 4 and 6 pm. Dothan, AL, was another town that received BodyLove broadcasts by the request of a local foundation. It was not included in the fifteen communities because it does not have a large African-American population.

One evaluation method used during this time span was a mailed longitudinal survey. The analysis presented here discusses preliminary results from the survey regarding the relationship between frequency of listenership and impact on knowledge, attitudes, and behaviors.

Recruitment and Instruments Used
Within the fifteen communities where BodyLove was broadcast, a convenience sample of 241 radio station listeners was recruited via broadcast appeals and on-air advertising offering a small incentive to participate in a longitudinal cohort survey. A baseline survey was administered before the first broadcast, and was followed by four waves of survey follow-up to measure longitudinal changes in knowledge of diabetes, depression, diet, and exercise. Seventy-eight listeners responded to all five survey waves; attrition between each wave is shown in Figure 3.

Recruitment ended and no new participants were added after the baseline data were collected. Follow-up survey data was collected before episode 1 and after episodes 20, 40, 60, and 80. Questions covered basic demographic information, content knowledge, self-efficacy levels, and outcome expectations. In addition, the survey measured behavioral change via questions about BodyLove's influence on listeners' health screening habits and discussion about health conditions with family and friends. The research team grouped listeners by level of exposure to BodyLove (never/seldom/frequent listeners) and examined the relationship between exposure level and changes in health behavior.

Scales were used to measure self-efficacy in two domains: healthy eating and exercise. In the self-efficacy scales, participants were asked to rate their confidence in performing healthy behaviors such as eating a healthy diet or maintaining an exercise regimen, on a scale of 0 to 100%, with 0 being no confidence and 100 being complete confidence. A variety of situations were presented, including exercising regularly during bad weather or periods of stress. The self-efficacy scales focused on exercise and consuming a healthy diet. In the scales that measured outcome expectations, listeners were asked to evaluate the extent to which they expected that a diagnosis of diabetes would impact their daily lives. The same scale of 0 to 100% confidence was used. In the knowledge measures, as shown in Figure 4, participants were asked if they agreed or disagreed with a series of statements about chronic health condition risk factors and symptoms. Questions were coded as correct or incorrect for analysis, and correct answers were summed to gauge the level of participant knowledge of chronic disease. "Don't know" and "unsure" answers were coded as incorrect.

The self-efficacy, outcome expectation, and content knowledge scales were written specifically for BodyLove. The content questions were developed by sampling health content from each episode. The measurement instrument for influence on behavior was derived from the Center for Disease Control and Prevention's Behavioral Risk Factor Surveillance Survey (CDC-BRFSS), and thus has been externally validated. Cronbach alpha (α) scores as a measure of internal reliability for the scales used are shown in Table 1 below.

A separate cross-sectional study is being conducted in Dothan, AL. Evaluation at this site includes recruiting additional survey participants through a postcard drop-box at an affiliated clinic. The cards also solicit information on how the patient heard about the clinic (family or friends, BodyLove broadcast, or other), whether the patient has ever listened to a BodyLove episode, and, if so, how frequently. Demographic information such as race is also collected on the cards. Patients who return the cards receive a small gift incentive and are sent a BodyLove survey. For those who are current listeners of BodyLove, this method will measure the effects of exposure up to the present. For those who have never listened to BodyLove, this method is a way to recruit new listeners and establish baseline measures before exposure. Data collection for this site is currently in process. Through this method, the evaluation team aims to determine whether the show is driving traffic to the affiliated preventative care health clinics or vice versa. If the former is true, this would demonstrate increased utilization of community health services as a result of BodyLove. If the latter is true, then it would suggest that a future area for dissemination efforts might include social networks and community-based organizations.

Because of budget constraints, survey evaluation cannot be incorporated in every community that runs BodyLove. Again, the fifteen communities were chosen based on their high diabetes mortality rates and large African-American populations. Dothan was chosen because of the extensive support from clinic staff in recruiting potential survey participants and in promoting the show.

Results and Evaluation

As mentioned in the introduction and summarized in Figure 5 below, BodyLove impact evaluation was performed via surveys that measured changes in listener knowledge and attitudes towards chronic disease and healthy behaviors. Self-reported behavior was measured through questions about the level of influence of BodyLove exposure on listener behavior. Process evaluation was done to confirm that program activities were being carried out as planned and implemented with fidelity. Regular communication between BodyLove staff and radio station hosts took place to confirm that episodes were being aired. Program staff recorded caller comments in content logs updated on a regular basis. Though commercial Arbitron radio listenership reports and station self-reported listernership figures were tracked, it was difficult to estimate audience reach because subscription-based Arbitron data was too expensive for the majority of partner radio stations, and self-reported figures were subjective. Individual radio stations estimated that their reach ranged from "a couple hundred" to 32,000, depending on the region.

To date, the overall impact of BodyLove in these communities is as follows: An initial panel of 241 audience members was surveyed via a mailed questionnaire after every twenty-episode season. Survey participant demographics are listed in Table 2. Participant ages ranged from 19 to 81 years of age and followed a normal distribution. On the other hand, the majority of those surveyed were female (82.7%), black (90.0%), and non-Hispanic (95.9%). A relatively high percentage of participants had started or completed college (57.1%). This may be due to the fact that there is a major university campus in Montgomery, one of the largest cities in the cohort.

These participants were recruited from regular station listeners as described earlier. Using a five-point Likert-scale (poor/fair/good/very good/excellent), 63-67% called the program "very good" or "excellent" across three survey waves, as shown in Table 3. Forty-three percent of listeners reported that they made changes to their schedule in order to listen to the program. A flow chart of the cohort size at each survey wave is shown in Figure 3.

Chi-square analysis was used to compare the mean percentages of respondent-reported BodyLove influence on health behaviors. The instrument used to measure level of influence on behavior is displayed in the Appendix. Significant differences within waves between seldom and frequent listeners are starred in Table 4. Seldom listeners were defined as those who reported that they listened to BodyLove at a level ranging from "rarely" to "several times a month." Frequent listeners were defined as those who listened to BodyLove "almost every week" or "every week." Preliminary analysis shows that frequent listeners were more likely than seldom listeners (p<0.05) to report that BodyLove influenced them to discuss diabetes, get screened for diabetes and hypertension, start or increase physical activity, and start eating a healthier diet. Survey measures asked participants to rate how much BodyLove had impacted a number of behaviors. On a scale of 0 to 100% influence, many listeners said that BodyLove had a "very high level of influence" (over 70%) on the five behaviors denoted in Table 4. Audience members also noted "a moderate to high level of influence" (over 50%) on discussing depression with friends and family, and being screened for depressive symptoms.11 As seen in Table 4, the greatest increases in listeners reporting positive behavior occurred between the baseline and second wave of surveys. As seen in Figure 3, the greatest amount of participant attrition took place between the third and fifth survey waves; the number of participants decreased from 157 in Wave 3 to 78 in Wave 5.11 Further analysis is currently underway regarding other survey measures, such as the relationship between length of listenership and impact on listener's technical knowledge.

The survey instrument included in the Appendix was used to measure the level of influence BodyLove had on listeners' health behaviors, such as health screening, exercise, and diet. The instrument used the same 0 to 100% scale as the self-efficacy and outcome expectation scales, but asked the participant to rate the level of influence that BodyLove had on their behavior. Participants were asked to indicate how frequently they listened to BodyLove, ranging from "never" to "every week."

No baseline data are indicated for the questions asking how BodyLove influenced listener behavior. This is because at baseline, participants had not yet been exposed to BodyLove and therefore had not been influenced to change attitudes or behaviors yet. Data were analyzed for significant differences within waves between "Seldom" and "Frequent" listeners. One hypothesis was that increased exposure to BodyLove health promotion messages would correlate with increased practice of the five behaviors named.

Limitations and Lessons Learned

There are three main challenges in evaluation: initial recruitment of survey participants, retention of participants, and limitations of available measurement tools. The approach used in the fifteen communities was to recruit listeners with broadcast appeals. The advantage of this approach is that participants are drawn from the target demographic. The disadvantage of this strategy is a relatively small sample size, as well as the possibility of self-selection and respondent bias. Attrition was addressed to a limited extent with a small gift or monetary incentive following the submission of every survey, but can be addressed more strongly in the future. A limitation of the surveys is that the validity of self-reported measures of behavior and attitudes may vary over time. ¹²

The main tool available to assess number of listeners is Arbitron data. This data provides estimates and can track overall trends such as increase in listenership, but is available on a subscription basis only and is not always affordable for smaller, independent radio stations. Thus, Arbitron data is used when available but process evaluation often depends on station self-reports of listenership (see Figure 5).

One limitation of E-E as a format is the tension that exists between its "education" and "entertainment" components. Careful scriptwriting and clear goals are necessary to ensure that the dual goals of E-E are consistently balanced.

Future Directions

The BodyLove team is beginning to explore the possibilities offered by mixing "traditional" media and "new" media approaches to reach different audiences with relatively little additional investment.12 Since the recordings have already been made, it is relatively inexpensive to develop an online presence by streaming episodes online. The figures below are screenshots of the BodyLove website.

One specific goal of tapping a blend of traditional and new media includes expanding the reach of BodyLove to new markets in other regions of the U.S., particularly urban centers. As the BodyLove team considers re-recording the show in a shorter, three-minute format that is more appropriate for larger urban stations, the full fifteen-minute episodes may become auxiliary content on the website.¹¹

When the BodyLove website went active in November 2008 the research team began assessing methods to evaluate user statistics and the impact of the site. One way to use the website for evaluation purposes may be to selectively release episodes and measure their impact accordingly. Currently, episodes can be streamed from partner radio station websites, such as that of Birmingham-based 98.7 KISS FM, http://987kiss.com/ads/bodylove/.

Efforts to brand merchandise are underway, with the goal of using the power of social networks to promote BodyLove and increase the degree of social diffusion. Increasing the exposure of tangible products with the BodyLove logo on them may serve to keep the intangible BodyLove program and messages in potential listeners' minds and therefore increase listenership. A sample marketing graphic is shown in Figure 8.

Future evaluation could measure social diffusion, or the indirect impact of health communication efforts. If listeners are discussing BodyLove content within their social networks, then BodyLove may indirectly impact the knowledge, attitudes, and behaviors of non-listeners and whole populations. Given time, population-level changes in health indices may be measured with outcome evaluation.

A future direction for outcome evaluation will include measuring primary care service utilization at BodyLove-affiliated clinics to determine whether BodyLove changes healthcare utilization patterns on a community level.

Acknowledgments

BodyLove thanks our funders and supporters:

• Media for Health, Inc.
• Alabama ICE: Project Safe Neighborhoods
• Premier Cares Foundation
• Central Alabama Community Foundation
• EyeSight Foundation of Alabama
• Hill Crest Foundation
• Community Foundation of Greater Atlanta/Carefree Fund
• University of Alabama at Birmingham School of Public Health
• Jefferson County Department of Health
• Robert R. Meyer Foundation
• Hugh Kaul Foundation
• Wiregrass Foundation
• Daniel Foundation of Alabama

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References

1. Shokar NK, Carlson CA, Weller SC. Factors Associated with Racial/Ethnic Differences in Colorectal Cancer Screening. J Am Board Fam Med 2008;21:414-426.
2. Williams DR and Jackson PB. Social Sources Of Racial Disparities In Health. Health Affairs, 2005;24: 325-334.
3. National Cancer Institute. Theory at a Glance: A Guide For Health Promotion Practice. 2nd Ed. NIH Pub. No. 05-3896, Washington, DC, 2005.
4. Singhal A and Rogers EM. Entertainment-education : A Communication Strategy for Social Change. Mahwah, NJ: Lawrence Erlbaum Associates, Inc.; 1999.
5. Eds. Glanz K, Rimer BK, Lewis FM. Health Behavior and Health Education: Theory, Research, and Practice, 3rd Ed. San Francisco, CA: Jossey Bass Imprinting, 2002.
6. Barlow W. Voice Over: The Making of Black Radio. Philadelphia, PA: Temple University Press, 1999.
7. Wray RJ, Hornik RM, Gandy OH, et al. Preventing Domestic Violence in the African American Community: Assessing the Impact of a Dramatic Radio Serial. Journal of Health Communication. 2004; 9: 31-52.
8. Eds. Singhal A, Cody MJ, Rogers EM, Sabido M. Entertainment-Education and Social Change: History, Research, and Practice. Mahwah, NJ: Lawrence Erlbaum Associates, Inc.; 1999.
9. Farr AC, Witte K, Jarato K, Menard T. The effectiveness of media use in health education: evaluation of an HIV/AIDS radio [corrected] campaign in Ethiopia. J Health Commun. 2005 Oct-Nov;10(7):679.
10. Eds. Donaldson SI, Berger DE, Pezdek K. Applied Psychology: New Frontiers and Rewarding Careers. London: Routledge, 2006.
11. Kohler CK, Suzuki-Crumly J. Diffusion of mass media messages and their influence on behavior change: Changing diabetes and hypertension screening among African Americans. Presentation at the Annual Meeting of the American Public Health Association, San Diego, October 2008.
12. Abroms L, Schiavo R, Lefebvre C. New Media Cases in Cases in Public Health Communication and Marketing: The Promise and Potential. Cases in Public Health Communication and Marketing, 2008.

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Author Information

Naomi Chen, MPH '10, is studying Health Behavior at the University of Alabama-Birmingham School of Public Health (UAB-SOPH), and her research interests include health disparities and chronic disease.

Dr. Connie Kohler, DrPH, is an Associate Professor in the Department of Health Behavior at UAB and Primary Investigator for the BodyLove radio serial drama health intervention.

Dr. Yu-Mei Schoenberger, PhD, is Associate Director of the Health Communications Unit in UAB Center for the Study of Community Health and an Instructor in the Department of Health Behavior at UAB.

Dr. Julie Suzuki-Crumly, PhD '08, is a recent graduate of the Department of Health Behavior at UAB and has worked on the evaluation of BodyLove.

Kathyrn Davis, MPH '10, is studying Health Behavior at UAB, and her research interests include health literacy.

Jeralyn Powell, MPH '10, is studying Health Behavior at UAB, and her research interests include the use of media in health promotion.

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Appendix

Appendix 1. Sample questions from survey instrument used to measure the level of influence BodyLove had on listener health behaviors such as health screening, exercise, and diet.

LEVEL OF INFLUENCE ON BEHAVIOR

1. On a scale from 0 to 100 where 0 means it did not influence you at all to 100 where it means that the program influenced you very much, how much did the show influence you to talk about diabetes with others?
2. On a scale of 0 to 100 how much did the program influence you to get screened for diabetes?
3. On a scale of 0 to 100 how much did the program influence you to get screened for high blood pressure?
4. On a scale of 0 to 100 how much did the program influence you to start exercising or increase your physical activity level?
5. On a scale of 0 to 100 how much did the program influence you to eat a diet low in fat and high in fiber?