1. “Crossroads: Without Health, There is Nothing” A Soap Opera That Incorporates Health Topics, Medicaid & CHP+ Into Its Drama APHA Annual Meeting November 8 th, 2010

2. Presenter Disclosures (1) The following personal financial relationships with commercial interests relevant to this presentation existed during the past 12 months: Cristina Bejarano Consultant for Evolve Communications Sub-grantee for The Colorado Health Foundation

3. Authors Cristina Bejarano, MPH Health Content Director Mariana Enrquez, PhD Mariana Enríquez, PhD Encrucijada Evaluator Anne Smith Project Manager Jesús Fuentes Executive Producer

4. Background The birth of the idea The birth of the idea A Colorado partnership focused on improving the health of the Spanish speaking community A Colorado partnership focused on improving the health of the Spanish speaking community The vehicle of communication: electronic media, specifically soap operas with a record of success and popularity The vehicle of communication: electronic media, specifically soap operas with a record of success and popularity

5. Encrucijada Objectives Increase the number of Spanish Speaking Latinos (SSL) in Colorado who enroll in CHP+ and Medicaid Increase the number of Spanish Speaking Latinos (SSL) in Colorado who enroll in CHP+ and Medicaid Increase SSLs’ disease management knowledge Increase SSLs’ disease management knowledge Modify SSLs’ behavior that will have an overall positive impact in their health Modify SSLs’ behavior that will have an overall positive impact in their health

6. Components for Success  Support from a trusted TV station  Entertaining and educational  Relevant characters  Relevant health content

7. Components for Success (cont.)  Support from a trusted TV station 78% of the SSL in the area watch participating TV station 78% of the SSL in the area watch participating TV station  Entertaining and educational It included all engaging elements of a soap opera It included all engaging elements of a soap opera The audience identified with storylines The audience identified with storylines Health topics made it engaging to female and male audiences Health topics made it engaging to female and male audiences

8. Components for Success (cont.)  Relevant Characters The audience identified with the characters The audience identified with the characters Demographically driven Demographically driven Piloted by evaluation team Piloted by evaluation team Health promoters as main protagonists Health promoters as main protagonists Professional actors skilled to establish emotional connections and deliver health content Professional actors skilled to establish emotional connections and deliver health content

9. Components for Success (cont.)  Health content Community leaders and health professionals serving the SSL leading the advisory & working groups Community leaders and health professionals serving the SSL leading the advisory & working groups Health topic experts and health promoters as key informants Health topic experts and health promoters as key informants Successful integration of health messages into the drama Successful integration of health messages into the drama

10. Health Topics Covered Episode 1 Episode 1 CHP+ & Medicaid CHP+ & Medicaid Episode 2 Episode 2 Prenatal Care Prenatal Care Healthy Eating Healthy Eating Episode 3 Episode 3 Sports Physicals Sports Physicals Childhood Obesity Childhood Obesity Asthma Asthma Episode 4 Episode 4 Breast Cancer Breast Cancer Ovarian Cancer Ovarian Cancer Episode 5 Episode 5 Diabetes Diabetes Episode 6 Episode 6 Teen Issues Teen Issues STI/ HIV/ AIDS STI/ HIV/ AIDS *All episodes included CHP+ & Medicaid Information

11. Health Topics Covered (cont.) Episode 7 Episode 7 Childhood Immunizations Childhood Immunizations Episode 8 Episode 8 Mental Health Mental Health Domestic Violence Domestic Violence Episode 9 Episode 9 Smoking Smoking Alcohol Abuse Alcohol Abuse Heart Disease Heart Disease Episode 10 Episode 10 Family Planning Family Planning Cervical Cancer & HPV Cervical Cancer & HPV Episode 11 Episode 11 Oral Health Oral Health Episode 12 Episode 12 Child Abuse Child Abuse Safety Safety *All episodes included CHP+ & Medicaid Information

12. Health Information Criteria Cover at least two important points per health topic Cover at least two important points per health topic Address at least one myth or barrier per health topic Address at least one myth or barrier per health topic Provide at least one tool that the audience could use to address the health topic Provide at least one tool that the audience could use to address the health topic

13. The Result: Rich Health Content EpisodesMedicaid/CHP + Health FactsBarrier/MythStorylineTools Episode One CHP+ & Medicaid -Medical rights/ entitlement -CHP+ covers ER expenses -US laws in relation to CHP+ & Medicaid – to protect children -5 years minimum as a legal resident or a US citizen -It includes medical checkups, vaccines, emergencies -Temporary card that will cover medical expenses; complete application on the day and send it in -A letter letting you know if your child qualifies for services from any of the two programs will be sent to your address- this is dependent on family income and number of people living in your household -Insurance card issued in 45 days -It’s very important to keep the health insurance and maintain it -CHP+ & Medicaid applications do not impact citizenship applications -Chiquis and Alvaro initiate their crossroad at a party where Chiquis gets drunk and Alvaro tries to help her -A car accident links Angelito and his uncle into the drama. Chiquis’ mom and Alvaro’s host, Marta are health promoters in the same clinic -The role of the health promoter is introduced -A typical family is informed about CHP+ and Medicaid services -Example of application -There are people able to help applicants -People should not drink and drive -Thank friends for driving without drinking -Value of health insurance mentioned -Health clinics have accessible fees

14. Encrucijada Impact: The Encrucijada audience presented changes in: Knowledge Knowledge Disease management behaviors (*) Disease management behaviors (*) Healthy living behaviors (*) Healthy living behaviors (*) Seeking enrollment in public health insurance (*) Seeking enrollment in public health insurance (*) Attitudes towards self-care, family health, and healthy living Attitudes towards self-care, family health, and healthy living (*) statistically significant change

15. Website www.encrucijada.tv

16. Contact Information Cristina Bejarano, Health Content Director (720) 300.1248, bejaranocl@gmail.com bejaranocl@gmail.com Mariana Enriquez, Encrucijada Evaluator (303) 755.4491, marianaenriquez@hotmail.com marianaenriquez@hotmail.com Anne Smith, Project Manager (303) 349.7650, anne@evolvecomm.net anne@evolvecomm.net Jesús Fuentes, Executive Producer (303) 598-8017, jesus@encrucijada.tv jesus@encrucijada.tv

17. QUESTIONS?