BY Chandrea Miller
“I knew we had to do something,” said Jeremy Kagan , a professor who teaches graduate courses in directing at the USC School of Cinematic Arts. “Communities surrounding our campuses in South Los Angeles and East Los Angeles were getting vaccinated at lower rates.”
The internationally recognized director/writer/ producer of feature films and television was determined to find out why these communities were hesitant to get vaccinated and hoped he could change their minds.
Change making is kind of his thing.
Kagan is the founder the USC Change Making Media Lab which specializes in developing and creating Entertainment Education (EE) emphasizing the values of narrative dramas and comedies to successfully motivate behavior change.
“My interest is to see how film can be used to shift awareness and change behavior,” Kagan said. “Facts inform but stories transform.”
Professor Kagan was approached by Sheila Murphy a professor of communication at USC Annenberg School for Communication and Journalism and the VaccinateLA team to make films to encourage vaccinations.
“This pandemic is a crisis we’ve waiting for our whole lives,” Murphy said. “And we knew that narrative and storytelling was a powerful tool.”
But it was a health crisis after all–so professors Murphy and Kagan turned their attention two miles northeast from USC’s main campus at University Park to USC’s Health Sciences Campus.
“This pandemic, it’s a team sport–there’s no one group, one person or one discipline that’s really going to be able to get where we need and want to be,” said Michele D. Kipke, Professor of Pediatrics and Preventative Medicine at the Keck School of Medicine of USC. “It’s all-hands-on-deck, everybody coming together.”
Kipke also serves as the co-director of the Southern California Clinical and Translational Science Institute (SC CTSI) at USC.
“At the start of the pandemic, having that infrastructure in place allowed us to quickly jump on this,” Kipke said. “With that institute, we were actually able to make a hard pivot and just really focus on the pandemic.”
Aside from the life-saving work already being done at USC’s hospitals and research labs, SC CTSI quickly mobilized to fight the pandemic in a myriad of ways.
“At first, we developed community partnerships with educational offerings,” Kipke said. “Then we moved to a multi-media strategy that included the health and art campaign StayConnectedLA. This engaged local artists to develop art that would resonate with the community and then these messages were placed on billboards, bus benches and big banners.”
Next came VaccinateLA, which is a joint effort between USC and multiple hospitals and the community to increase access to the COVID vaccines for Los Angeles residents.
However, Kipke said the vaccination campaigns proved to be ever-evolving due to a moving target of changing opinions and attitudes, as evidenced in the waning vaccination rates in certain areas of Los Angeles.
“We now have different groups that have decided for one reason or another not to get vaccinated,” Kipke said. “We quickly realized that we needed culturally tailored messages, with the right messengers and right strategies for reaching different specific segments of the population.”
Professor Kagan suggested making two short films–one for the Latinx community and one for the African American community to confront and combat vaccine misinformation.
“I’d supervise but I wanted our students to represent their communities,” Kagan said. “They would know best what was creating the vaccine hesitancy.”
Roughly, 40 graduate students for USC Cinema produced, wrote and directed two short films to promote vaccination within their communities.
While Professor Kagan oversaw the production, Professor Murphy honed in on the messaging.
“We held 30 focus groups to understand what the issues were surrounding vaccine hesitancy in the African American and Latinx communities in South La and East Los Angeles,” Murphy said. “The feedback from these communities revealed that there were six key factors for vaccine hesitancy with one main reason being infertility—this is nothing new, it’s a very common myth stemming from most vaccines.”
Once the messaging from the focus groups was integrated into the scripts, production on the two films began.
Graduate students Santos Herrera and Jenniffer Gonzalez Martinez, both worked on the Latinx version of the film titled Of Reasons and Rumors. The English and Spanish versions of the film Of Reasons and Rumors (English version) Of Reasons and Rumors (Spanish Version) follow a tight-knit Latino family in East LA who disagree about the importance and safety of the COVID vaccination.
Martinez who was a script writer on the Latinx version of the films said she felt the weight of every potentially life-saving word that she wrote.
“When I was writing, I was thinking ‘you have the power to create a feeling, to make them feel and make them think,’” Martinez said. “My script may not save the world but it may save somebody.”
Somebody closely connected to the making of the film like the director and SCA graduate student, Santos Herrera.
“The impact was both professional and personal for me,” Herrera said. “My sister was hesitant to get the vaccine and after I showed her the film, she went and got vaccinated.”
MaryLanae Linen, who is a second-year graduate student at SCA, worked on the African American version of the short films titled Happy Birthday, Granny which follows an African American family in South LA celebrating their grandmother’s birthday. Except some family members are hesitant about getting their shot.
Linen credits Professor Kagan for the authenticity of the film’s messaging.
“He tapped Black and Brown filmmakers to create content that is directed towards us,” Linen said. “If you watch it, the language is written by a Black person for Black people and just like the Latinx film and the things they talked about, only they really know.”
The films were finished in July and posted on the VaccinateLA website. They were an instant hit among the targeted communities, which came as no surprise to films’ creators.
“We’d used narrative to successfully affect behavior before, so we know it works,” Murphy said. “We also have the research to back it up.”
In 2009, USC was approached by the National Institutes of Health (NIH) to do a random controlled trial of narrative and non-narrative campaigns and compare which works best to change behavior.
Professor Murphy said she felt especially prepared to participate in this comparative study.
“The NIH had never done a comparison like this before because at the time, the federal government wasn’t using narratives or stories to convey medical information,” Murphy said. “I felt qualified to do it because not only am I an expert in persuasion but I am also a public health researcher and social psychologist.”
In 2011, Professor Murphy and Professor Kagan produced a short film titled Tamale Lesson to encourage at risk women to get cervical screenings.
The short film received wide attention from the medical field and the comparative study was published in the American Journal of Public Health . The randomized controlled trial of 900 women—300 African American, 300 Latinx, and 300 European American women–showed that a narrative was much more likely to create a change in behavior versus a non-narrative. The results revealed that by the six-month follow-up that the Latinx respondents who viewed “Tamale Lesson” went from having the lowest rate of screening (32 percent) of the sample to the highest (82 percent being screened).
However, a decade later, they hoped to replicate the uptick in cervical screenings with an increase in COVID vaccinations.
“So, we decided to put the band back together,” Murphy said.
The band, so to speak, consisted of Professor Murphy, Professor Kagan and Dr. Lourdes Baezconde-Garbanati, professor in preventative medicine at the Keck School of Medicine of USC.
“A number of years ago, the three of us had worked on a health campaign together which ended up to be very effective,” said Baezconde-Garbanati. “We all have our expertise in things.”
One of Baezconde-Garbanati areas of expertise is securing grant money for vital projects, which she was able to do for these two films through the Keck Foundation. The funds were used to hire the cast and crew, rent equipment, secure filming locations and finance post production.
But once the films were finished, something very unexpected happened.
“The White House has seen them,” Kipke said. “And now, the world is seeing them.”
Baezconde-Garbanati is a member of the Covid-19 Community Corps for the Whitehouse which serves to amplify vaccine messaging within communities and combat skepticism and misinformation. She was able to show the films to the Community Corps members.
In addition, the short films have just been selected by the Association of Schools/Programs in Public Health (ASPPH) on all of their online forums and in their newsletter, which is read by Deans of Schools of Public Health across the country.
Also, the Latinx film was picked up by the Hispanic Alliance for Health that reaches more than 15 million people.
“It has brought the best of USC together from multiple schools and units with a shared vision and singular purpose: to save lives,” Kipke said. “And we are accomplishing that, we are saving lives.”
Currently, the short films are being seen in multiple cities throughout the U.S. and in Guatemala and Canada.
“Coming together as a university, as one body, to confront this disease is our armor–USC’s Trojan armor,” Baezconde-Garbanati said. “There is nothing stronger.”
Already in the works is a third film to promote child vaccinations.