Ever wondered if there really is an effective channel to assure that TV and movies portray things like diabetes and even domestic violence in a realistic, meaningful way? Say hello to the Global Media Center for Social Impact at UCLA, brainchild of its Founding Director Sandra de Castro Buffington.
What they do is work hand-in-hand with Hollywood writers and producers to make sure that storylines addressing these socially sensitive topics are compelling and realistic.
Some of their incredible successes include moving viewers of hit shows like 90210, Grey’s Anatomy and The Bold and the Beautiful to take action on cancer risk, preventing HIV and treating bipolar disorder, to airing clips of storylines to Congress before legislators vote on important public health topics. They also worked on the 2009 Army Wives “story arch” that covered diabetes.
I met Sandra when we sat together on a panel at the Digital Hollywood Health Summit a few months back, and am happy today to share this interview about the unique and very impactful work she leads.
DM) Can you explain briefly the Global Media Center for Social Impact (GMI) and what it does?
SCB) We call the center GMI for short. We’re based at the Fielding School of Public Health at UCLA. We’re actually a bridge between storytellers – or writers and producers in Hollywood – and experts and real people. We know that masterful entertainment actually transports the viewer into a new world, and this is a huge opportunity to shape attitudes and behaviors that can improve health and well-being for enormous populations.
So what we do is inspire the industry to tell the stories – in fact they do it better than the experts. For example, we do a whole series of immersive events at the Writers’ Guild of America West. We bring in interesting panelists and give the talks provocative titles to spark interest: from “5 Simple Ways to Save a Life for Under a Dollar” to “12 More Years a Slave: Is Mass Incarceration the New Slavery?”
So you pitch storylines to writers and producers?
We never pitch a storyline per se; we uphold creative freedom above all. But we know if we capture the attention of a content creator and they get interested in the topic, they're likely to write about it. If they’re looking to include these topics, we bring accurate, compelling information and real stories of real people. So that's essentially what we're doing.
Sounds like a sort of educational program on socially relevant topics for these entertainment industry professionals?
In a way, yes. I also created a whole Story Tour Series for writers and producers, starting with taking them overseas into India and South Africa, because I wanted to create a global perspective. This was so transformative for them!
In South Africa, we went into Soweto and met all these people doing innovative, community-based action. For example, they told us about a community solution to domestic violence: When they hear violence going on in a home, community members (both men and women) will go home and grab a pot or pan or utensil and go back out to the doorstep of the home where the violence is taking place, and they start banging and clanging so everybody can hear it – and they do not stop until the violence ends.
It’s a way of shaming the perpetrator, of witnessing the violence, and saying, ‘we will not tolerate this and we will not go away.’
One of our writers, who was an executive producer of the TV show Touch on Fox, came back and wrote this into a storyline for their 3rd episode of season 1.
When these shows air, they’re exported to over 100 countries around the world, so they reach hundreds of millions of viewers.
How do you choose your focus topics?
We address almost any topic writers approach us with: women in the military, sexual assault, cross-border immigrant love relationships, addiction, mental illness... you name it. We never turn an inquiry away, but funding determines which topics we can address proactively.
That is, our services are free to the contact creators. That's our stakeholders group. If an expert or a group with expertise in a particular area is interested in having a meeting or project address their topic, then they would come to us with a grant and say, 'We want to give you some funding, what could you do for this amount of funding, to reach the (entertainment) industry?’ And we then put a content paper together and go from there.
How much reach have you achieved seen so far?
In three years, we’ve been involved in 565 storylines that aired on 91 TV shows across 35 networks – and those were all topics of health and well-being. That was my work before I came to UCLA (I was at USC previously). Now I’ve been here 18 months and we’re creating this whole GMI center… now focused on both health and social justice.
Wow, that’s impressive reach. And you’ve aired some of these clips in Congress, to help inform legislators on upcoming votes?
Yes. The Patient Navigator Act was one instance, addressing people with cancer who needed a navigator to help them figure out what's the best course of action and how to take it. A clip from the series ER was shown on Capitol Hill, and you know that bill was voted into law by Congress.
And does all this viewing translate into any action taken on the part of viewers at home?
We know that when progressive social policy and real-life issues intersect with powerful storytelling, transformative action happens naturally.
In other words, when a storyline intrigues viewers, they’ll take action. So if we know, for example, that Law & Order SVU is doing a storyline on the rape kit backlog in this country, we’ll reach out to the networks’ digital platforms (NBC.com, ABC.com, CW.com, etc.) and suggest links to credible information and action steps for viewers that they can post on their home page and on Facebook, and also some tweets that the show can tweet to their fan base about the topic.
We actually measure the impact of storylines on viewers. So for example, 10.3% of viewers of an organ transplantation storyline on the show Numbers reported signing up to become organ donors.
How do you go about researching the actions people take as a result of seeing these storylines?
Being university-based, we do pre and post tests. We request the script ahead of time from the writers. If they are willing to part with it, under extreme confidentiality, we do a content analysis and develop a questionnaire that measures knowledge, attitudes, and behavior on all the topics of social value in the script. Then we contract a private research firm to administer the questionnaire a week before the story airs. This measures knowledge, attitudes, and behavior. And then within days after the story airs, we administer a post-test, and we can measure increase in those constructs.
The surveys are done via phone or email, depending on the research firm. They generally have a panel of regular viewers of primetime TV that have agreed to answer questions for surveys, a bit like the Nielsen method of creating TV ratings.
Tell us about your team at GMI…
I used to have a team of 10 in my old shop. Now we're in startup mode here at UCLA. So I have two full-time people, and a group of 8-10 graduate students part-time. I also have a lot of faculty collaborators at the school, so we do a lot of our own research.
We’ve trained the students in coding, media mapping, and tracking scripts so we can do what we call a "media scan" – mapping what people are currently being exposed to, and where the gaps are, so we can help direct to producers to the best content. Right now we're tracking all the content in the top 30 scripted shows for 12-24 year olds that address youth sexuality, reproductive health and rights.
What are some of the biggest challenges or roadblocks you’ve run into in this work?
One of the things that's a challenge is getting writers interested in prevention of any kind -- because good storytelling requires some conflict to be resolved. And prevention is a virtue rather than a conflict.
And we've learned so much in doing this work. The writers have so many different kinds of elements trying to influence them every day that we really have to position ourselves as a free resource.
What would you consider your biggest successes so far?
Oh, my gosh, there have been so many things -- I think you would probably judge that, based on what topics are of most importance to you. You know, for example, that the lead character of the show Homeland has bipolar disorder. That means he's going to have it as long as the show is going, because it doesn't go away. So they consulted with us to get that right. And in the award-winning show Breaking Bad, the main character had lung disease. It was maybe a bit unrealistic that he was able to have the energy to run around and do all the things he was doing, but other than that, all the information discussed about the treatment when they were in the hospital was totally accurate.
And then we had a bipolar disorder storyline on the show 90210. We saw huge peaks in young people going to the landing page we had provided to the show where they could get help. And the traumatic brain injury storyline on Army Wives was an eight-week story arch. We helped create Facebook content on traumatic brain injury for the show and then we connected that to the CDC's Head's Up brain injury page, and so many viewers would go to the CDC site and self-diagnose. And CDC had experts weighing in to help connect them.
With CSI New York’s organ transplantation storyline, 9.8% of viewers signed up to become organ donors.
And another show I’m proud of is Doc McStuffins on Disney Junior Channel. I worked on that very closely for the first three years. Every episode had medical content for young kids and we had every single one reviewed for accuracy. Almost all of it was about prevention, so this is a huge exception to that rule. It was all about healthy living, healthy diet, getting enough sleep, wearing sunscreen, how to treat your friends, etc.
There was also the way that HIV was dealt with in The Bold and The Beautiful. That motivated the highest peak in callers all year to the CDC's HIV/AIDS hotline number.
I think these are all enormous successes.
Tell us about the work you did on the Army Wives series "story arch" on diabetes?
That was in my earlier work, in Season 3, 2009. There was a six-week story arch (about wife Claudia Joy, who was diagnosed with diabetes). It was really well done. It went through symptoms and described why this character who was seemingly in great shape and in perfect health started having those symptoms.
And she went through the whole denial thing of, “Well, I can't have diabetes. I'm not overweight…” In the diagnosis scene where she's consulting with her doctor, a lot of information is provided. Then there was a lot of discussion around stigma; she didn't want her friends to know.
Some dramatic things happened when her friends and family did find out, and it really addressed how when an adult is diagnosed with diabetes, that impacts the entire family system and the whole social network.
The way the story arch ends is the whole family and friends pull together and let this women know how much they love and support her. It really showed this social cohesiveness and how much that helped this woman -- and how much it helped the people who loved her to be asked to help and to be involved finally.
Do you know of any other organizations or universities working on similar stuff?
There are not many groups that do this kind of work. Very few. There are a lot of special interest groups for example that do some outreach to the industry, but what happens with that is if the group is identified with a single issue, they might get one single exposure to that show. But because we're identified with this huge range of topics, we can get in the show over and over again, and it gives us an opportunity to drop topics in that they might not even be thinking about.
On that note, why isn’t the American Diabetes Association, JRDF, or another big diabetes advocacy org giving you guys money? I don’t understand that, since they’re always talking about the critical need to inform and engage the media…
Well, we’re not necessarily about pushing to raise awareness, like a celebrity spokesperson does. We simply inspire and inform, so it's maybe a subtle difference, but it's a very important one. And the most important thing with our work is trust. The writers have to trust us. That's how the doors open.
By that do you mean that GMI can have more impact than individual advocacy organizations?
Yes. It goes back to trust, credibility and being a diverse resource for the industry.
You’ve had some incredible impact on action for other disease states, right?
Yes. There was a breast cancer storyline on 90210 (about getting tested for a new gene), this show for young people who are not normally thinking about breast cancer risk -- not at that age.
We had a private research firm administer the questionnaire for us, and we also posted on the social media sites of the show. And what we discovered is that the sample with the research firm tended to be older female viewers, almost all American, U.S.-based, and the respondents of the surveys posted on social media tended to be a younger audience who were super-fans of the show. They watched every single episode, whereas that other sample did not. And they tended to be very international, so they were not necessarily based in the U.S. They were watching online from other countries. But we found very similar trend lines. Overall, 11.9% of viewers called their doctors to schedule screening appointments.
Obviously to get these results, you do some sort of proactive outreach to these Hollywood professionals…
Yes, we track which shows are most popular right now, so… if it's a topic of importance to teens, we would reach out to shows that have a huge following of young people.
We basically pitch experts to them, like, ‘We've got this amazing expert in town on breast cancer from the Centers for Disease Control and Prevention and they're going to be here for one day and we'd love to bring them by the show and brief your writers.’ Some of them will say yes, and some of them will say no, but eventually we have a fit.
Sometimes the ‘fit’ has had monumental consequences on medical topics, right?
Yes! For example, I invited Dr. Atul Gawande, who is a full-time staff writer for the New Yorker magazine and also a Harvard surgeon, to speak with the writers of ER. This was right at the end of their 14-year run, and he works with the World Health Organization on the Surgical Safety Checklist. It’s a little list, so that before initiating a surgical procedure, everybody in the operating room -- the doctors, the attendants, the anesthesiologists, the nurses -- all stop and do some basics for safety. It takes no more than two minutes to do. They all say their name and their function, and they check to make sure it's the right patient, the right procedure, the right location on the patient, and whether the antibiotics been started. It’s been proven to reduce medical errors by 50%!
But doctors worldwide have been very resistant to doing this, for various reasons. So the ER writers got very inspired by Atul Gawande's briefing. He was just a masterful storyteller. It was impossible to resist. And they ended up creating a storyline about it and the night after it aired, 150 surgeons gathered at a hospital in New York City and the head surgeon made them watch the entire hour-long episode and then they voted to adopt the checklist for their orthopedics practice.
And then three days later, we got a lot of press coverage on this -- journals and newspapers reaching out to me to find out how we got this storyline on the show. One of the Canadian newspapers did a piece on it, which the country of France picked up on because it was in French. And three days after that I get an email from the head of surgical safety for the country of France -- from the French National Health Authority, saying, ‘Madam Buffington, we must have a copy of this clip! We're having our annual state cultures meeting, and we must show it.’ So, it's amazing how these shows can also impact national policy.
In cases where you've noticed certain health conditions or social issues being covered in a not-so-accurate or not-so-capable way, are you able to intervene?
Well, we wouldn't know exactly what's in the works in a writer's room so you don't really know until something airs. But that said, a lot of writers reach out to us proactively, saying things like, ‘You know we've got this character and we want him to pull a poison out of a medicine cabinet, have the person drink it, and fall down dead -- and leave no trace in the blood. Can you help us find that poison?’
It gives us a chance to say, ‘Well, in a situation like this, yes there's a drug that would be realistic, and also the person who finds the body would call the poison control center, you see.’ So we're dropping in something that would be of social value into a storyline that might not have been done otherwise. And the reason it's helpful to the writer is that it makes the story more compelling, because it's more realistic.
So what can the Diabetes Community do to work with you, to get Hollywood to tune in (accurately) to this super-prevalent disease?
What the Diabetes Community could do with us is partner with some of the groups, such as the CDC, for example, because they have a whole division that deals with diabetes. There may be other government agencies of interest too, and you could contact those and say, ‘We want you to fund a special project with the Global Media Center to reach out to Hollywood on diabetes.’ And we would get a small grant that would allow us to undertake activities.
Like we would maybe set up a Story Tour and take writers and producers in to meet people with diabetes, go to state-of-the-art treatment facilities, and maybe to a place where people are being diagnosed for the first time and getting orientation. We would maybe do a panel at the writer's guild on diabetes and make it really exciting and interesting and bring real people with dramatic stories and success stories. That's the way we would do it.
Thank you, thank you Sandra! I’m making it my personal mission to push our community to tap into this powerful resource you’ve created.