Overcome the Fear (Vencer el Miedo) : using entertainment education to impact adolescent sexual and reproductive health and parent-child communication in Mexico

Background Adolescents in Mexico experience high pregnancy and birth rates. A collaboration with Grupo Televisa led to the development of an entertainment-education telenovela intervention, Overcome the Fear (OTF) , which aired in 2020 to a national audience and addressed adolescent sexual and reproductive health (SRH) topics. This study details the development and evaluation of OTF ’s impact on adolescent contraceptive practices and parent-adolescent SRH communication in Mexico. Methods We conducted cross-sectional survey interviews (street-intercept and telephone) with 12–19-year-olds ( n = 1640) and parents of adolescent children ( n = 820) post-broadcast across Mexico’s five most-populated metropolitan zones. Quotas were implemented for gender, zone, and OTF viewership (viewer vs. non-viewer). Bivariate statistics and multivariable binary logistic regression models assessed the relationship between OTF viewership (including parent-adolescent co-viewing) and adolescent contraceptive practices and parent-adolescent SRH communication. Adolescent and parent data are not dyadic and were analyzed separately. Results Nearly half of adolescents (47.9%) and parents (47.7%) were viewers. Among adolescents, bivariate analyses suggest that viewers had less negative attitudes towards contraception ( p < .001). Logistic regression models suggest that adolescent viewers were more likely to seek out information about contraception ( p < .001) and unhealthy romantic relationships ( p = .019), and to use contraception other than condoms ( p = .027) and dual contraception ( p = .042) in the last 3 months. Among parents, bivariate analyses suggest that non-viewers had more positive attitudes towards abstinence ( p = .045) and more negative attitudes towards contraception and communication with adolescents about sex ( p = .001). Logistic regression models suggest that parent viewers were more likely to have talked with adolescent children about sexual relations ( p < .001), contraceptive methods ( p = .01), condoms ( p = .002), and abstinence ( p = .002) in the last 3 months. Parent-adolescent co-viewing of OTF was also significantly related to certain outcomes in bivariate analyses. Conclusions This study suggests that viewership of a high-quality entertainment-education telenovela informed by extensive formative research is related to adolescent health outcomes and to parent-adolescent SRH communication on a country-wide scale in Mexico. Entertainment-education remains an underutilized public health strategy, despite its promise to engage viewers and motivate healthful behaviors.