Costa Aráujo, A. C., Marcos Molano, M. del M. y de Sousa Lacerda, J.
Revista de Comunicación y Salud, 2023, 13, 63-74.
Editado por Cátedra de Comunicación y Salud
ISSN: 2173-1675
Enviado 07/06/2022
Aprobado 22/08/2022
Publicado 02/01/2023
ANÁLISIS DE LA CAMPAÑA DE LUCHA CONTRA LA SÍFILIS CONGÉNITA ‘VAMOS CUIDAR AGORA’ EN BRASIL DESDE LA PERSPECTIVA DEL INDICADOR DE ACEPTABILIDAD
Analysis of the Campaign Against Congenital Syphilis 'Vamos Cuidar Agora' in Brazil from the acceptability indicator perspective
Ana Cláudia Costa Araújo[1]: Universidad Complutense de Madrid. España. anaclaudiacostaaraujo@gmail.com
María del Mar Marcos Molano: Universidad Complutense de Madrid. España.
Juciano de Sousa Lacerda: Universidad Federal de Río Grande del Norte. Brasil.
juciano.lacerda@lais.huol.ufrn.br
Costa Aráujo, A. C., Marcos Molano, M. del M. y de Sousa Lacerda, J. (2023). Análisis de la campaña de lucha contra la sífilis congénita ‘Vamos Cuidar Agora’ en Brasil desde la perspectiva del indicador de aceptabilidad. Revista de Comunicación y Salud, 13, 63-74. https://doi.org/10.35669/rcys.2023.13.e314
Resumen
La sífilis es una infección de transmisión sexual que también puede transmitirse verticalmente, es decir, de la madre al bebé durante el embarazo. Según datos del Boletín Epidemiológico de Brasil (2021), la tasa de detección de sífilis en mujeres embarazadas es de 61.441 casos y 22.065 casos de sífilis congénita. En este sentido, aunque el Ministerio de Salud promueve acciones de vigilancia, prevención y control de la infección, recomendando a las mujeres embarazadas la realización de la prueba rápida de sífilis durante el control prenatal, la tasa de mujeres embarazadas y bebés infectados se considera todavía bastante alta. Teniendo en cuenta este escenario, planteamos un estudio que tiene como objetivo analizar cualitativamente la Campaña de Lucha contra la Sífilis Congénita “Vamos cuidar Agora” emitida de octubre a diciembre de 2021 en Instagram. Para ello, el análisis se realizará en la dimensión del indicador de aceptabilidad con el fin de evaluar la campaña en cuanto a imágenes, contenido, tono y relevancia de las piezas publicadas. A partir del análisis del corpus empírico de 21 mensajes publicados entre vídeos, imágenes y formatos de contenido variado, es posible identificar qué formatos son más relevantes para trabajar sobre temáticas importantes de la salud pública, además de ampliar el conocimiento del público objetivo sobre lo que es la sífilis congénita y sus formas de transmisión, diagnóstico y prevención.
Palabras clave: Sífilis Congénita, Campaña Sanitaria, Comunicación y Salud, Instagram, Redes Sociales, Publicidad y Aceptabilidad.
Abstract
Syphilis is a sexually transmitted infection that can also be transmitted vertically, i.e. from mother to child during pregnancy. According to data from the Brazilian Epidemiological Bulletin (2021), the detection rate of syphilis in pregnant women is 61,441 cases and 22,065 cases of congenital syphilis. In this sense, although the Ministry of Health promotes surveillance, prevention and infection control actions, recommending pregnant women to take the rapid syphilis test during prenatal care, the rate of infected pregnant women and babies is still considered quite high. Considering this scenario, we propose a study that aims to qualitatively analyse the Campaign to Fight Congenital Syphilis "Vamos Cuidar Agora" broadcast from October to December 2021 on Instagram. To this end, the analysis will be carried out in the dimension of the acceptability indicator in order to evaluate the campaign in terms of images, content, tone and relevance of the pieces published. From the analysis of the empirical corpus 21 messages published between videos, images and various content formats - it is possible to identify which formats are more relevant to work on important public health issues, as well as to expand the knowledge of the target audience about congenital syphilis and its forms of transmission, diagnosis and prevention.
Keywords: Congenital Syphilis, Health Campaign, Communication and Health, Instagram, Social Media, Advertising and Acceptability.
1. INTRODUCTION
According to the World Health Organization (WHO), there are six million new cases of syphilis worldwide each year (World Health Organization, 2016). Syphilis is a sexually transmitted infection (STI) caused by the bacterium Treponema Pallidum that can be transmitted through sexual contact (acquired syphilis), as well as during pregnancy or childbirth (congenital syphilis). Syphilis can manifest itself in three distinct stages: primary, secondary, latent and tertiary syphilis, indicating the level of severity of the infection in the infected individual's body. Therefore, when a positive diagnosis is made, treatment with benzathine penicillin is essential. This is the only way to treat the infection, as there is no vaccine to combat syphilis and the only form of prevention is the use of male or female condoms during sexual intercourse.
As far as congenital syphilis is concerned, babies can be born with malformation problems or die when syphilis is already at an advanced stage. According to data from the Brazilian Epidemiological Bulletin (2021), the detection rate of syphilis in pregnant women corresponds to 61,441 cases and 22,065 cases of congenital syphilis. Given the significant growth in the number of cases of congenital syphilis, it is necessary to carry out awareness campaigns that are aligned with the surveillance, prevention and infection control actions recommended by the Brazilian Ministry of Health.
Faced with this epidemic scenario, the Brazilian Ministry of Health, the Pan American Health Organization (PAHO) and the Laboratory of Technological Innovation in Health (LAIS) of the Federal University of Rio Grande do Norte (UFRN), created the Applied Research Project for Intelligent Integration Aimed at Strengthening Care Networks for Rapid Response to Syphilis - The "SYPHILIS NÃO" Project. The project is organised along four axes[2]: surveillance, management and governance, care and educommunication. Thus, the project continues to develop academic and medical research, as well as educational and communication actions aimed at reducing cases of congenital and acquired syphilis in Brazil.
It is through health communication campaigns that public health issues, such as the importance of preventing congenital syphilis and syphilis in pregnant women, are disseminated to society, especially to the most vulnerable part of the population. The campaigns aim to promote safe behaviours and healthy practices to improve the quality of life of the population (Noar, 2012). However, it is known that they are not enough when we still have a large part of society immersed in social norms full of prejudices, stigmas and taboos that are obstacles to the dissemination of a campaign (Wakefield et al., 2017).
Communication campaigns continue to be an important tool for promoting change, especially in the area of health behaviour change. A wide range of community, state and national organisations, such as the National Heart, Lung and Blood Institute, the American Cancer Society and state tobacco control agencies, have sponsored campaigns to promote health behaviour change. (Snyder et al., 2009, p. 1)
In this regard, we highlight the communication and health campaign 'Vamos Cuidar Agora' as one of the communication initiatives of the "Sífilis Não" project. The campaign was launched in October 2021, in reference to the National Day for the Fight against Syphilis and Congenital Syphilis[3], and its target audience is pregnant women and their sexual partners. It was disseminated through the website www.sifilisnao.com.br and also through the digital social networks Instagram, Facebook and Twitter.
Taking the above into account, this study aims to qualitatively analyse the pieces of the 'Vamos Cuidar Agora' campaign, aimed at combating congenital syphilis and raising awareness among specific audiences such as pregnant women, sexual partners, managers and health professionals. In this way, we analysed 21 publications in static card format and short videos to find out the level of acceptance by the target audience that came into contact with the campaign content.
2. OBJECTIVES
This study aims to qualitatively analyse the pieces of the Campaign to Combat Congenital Syphilis 'Vamos Cuidar Agora' broadcasted from October to December 2021 on the digital social network Instagram. That said, it is expected to investigate the acceptability indicator, based on the analysis of 21 publications, identifying which formats and content patterns stood out and showed a better level of engagement with the target audience.
3. METHODOLOGY
This is an exploratory (Gil, 2008) and descriptive research (Yin, 2001). In order to fulfil the objective proposed for this study, we conducted a qualitative analysis of the campaign disseminated on the digital social networks 'Vamos Cuidar Agora' in the period from October to December 2021. Faced with an empirical corpus made up of 42 publications, including videos and images, we realised the need to make a cut in the content analysed. Thus, the sample was reduced to 21 publications directly related to the proposal to combat congenital syphilis by raising awareness and clarifying the target population of pregnant women, health professionals and sexual partners.
For this purpose, the research procedure followed four phases: 1) Empirical selection; 2) Systematisation of data; 3) Analysis of the selected content; 4) Identification of the publications with the best level of acceptability. Phase 1 refers to the selection of the sample composed of 21 publications (5 videos and 16 files). All publications were published from October to December 2021. In phase 2, the data collected were systematised taking into account the following parameters: a) content coding; b) content format; c) content axis; d) target audience; e) reach; f) number of likes; g) shares and h) number of comments.
In possession of this data, phase 3 consists of analysing the content in terms of the "Acceptability" indicator, i.e. the indicator in charge of evaluating the images, content, tone and relevance of the campaign for the target audience (French et al., 2014; Andrasik et al., 2015). Finally, based on the results of the analysis, phase 4 identified the types of content that presented the best acceptability index during the campaign period.
4. RESULTS
4.1. Qualitative analysis of the 'Vamos Cuidar Agora' campaign
The 'Vamos Cuidar Agora' campaign, which was disseminated from October to December 2021, aims to reinforce the discourse on the prevention of congenital syphilis and vertical transmission, as well as its treatment when there is a positive diagnosis of the disease. The widespread of the campaign was carried out on the internet through the social networks Facebook, Twitter and Instagram. In the course of the diffusion, 42 publications were disseminated on the @sifilisnao profile, covering topics on prevention, rapid testing, prenatal care, diagnosis and consequences of cancer for the mother and baby. Thus, it is important to highlight that the cut-out made for this analysis included 21 publications directly related to the campaign (table 1), as the other publications only mentioned the campaign indirectly, also citing other content patterns.
Table 1. 'Vamos Cuidar Agora' campaign publications
|
Cod |
Contenido |
Forma |
Público |
Alcance |
|
1 |
Test rápido |
Card |
embarazada |
1.151.542 |
|
2 |
Test rápido |
Card |
embarazada; pareja sexual y profesional de la salud |
2.006 |
|
3 |
Prenatal |
Card |
pareja sexual |
581.969 |
|
4 |
Test rápido |
Carrusel |
profesional de la salud |
2.517.363 |
|
5 |
Sífilis congênita, test rápido e prevención |
Carrusel |
pareja |
2.395 |
|
6 |
Test rápido |
Reels |
embarazada |
308.876 |
|
7 |
Test rápido |
Carrusel |
embarazadas, pareja y profesional de la salud |
631.051 |
|
8 |
Prevención |
Carrosel |
embarazada, pareja sexual y profesional de la salud |
654.838 |
|
9 |
Sífilis Congénita |
Carrusel |
embarazada y profesional de la salud |
1.058.438 |
|
10 |
Consecuencias sífilis congénita |
Card |
pareja sexual |
1.180 |
|
11 |
Día Nacional de la lucha contra la sífilis y la sífilis congénita |
Card |
embarazada y profesional de la salud |
5.465.264 |
|
12 |
Test rápido e prenatal |
Reels |
profesional de la salud |
2.061 |
|
13 |
Prenatal y test rápido |
Carrusel |
embarazada |
1.256 |
|
14 |
Prevención |
Card |
Pareja sexual |
875 |
|
15 |
Tratamiento |
IGTV |
embarazada |
1907 |
|
16 |
Test rápido |
Carrusel |
embarazada, pareja sexual y profesional de la salud |
609 |
|
17 |
Tratamiento |
Card |
embarazada |
945 |
|
18 |
Prevención de la sífilis |
Reels |
profesional de la salud |
1.416 |
|
19 |
Prevención |
Carrusel |
embarazada, pareja sexual y profesional de la salud |
657 |
|
20 |
Test rápido |
Card |
profesional de la salud |
700 |
|
21 |
Test rápido |
Reels |
profesional de la salud |
1.610 |
Source: Own elaboration.
As a way of streamlining the widespread of content, the 'Vamos Cuidar Agora' campaign used various content formats to direct the complementary information guidelines on congenital syphilis to a specific target audience composed mainly of pregnant women, sexual partners and health professionals. In conducting this analysis, it was found that, among the 21 publications analysed, the formats used (Fig. 1) were Card (8); Carousel (8); Reels[4](4) and IGTV (1). The formats that predominated during the campaign were carousel, which contemplates the use of multiple images and/or videos, as well as single card.
Graph 1. Graph of campaign content formats
Source: Own elaboration.
The strategy designed for the campaign included dialogue with pregnant women, sexual partners and health professionals. Therefore, all the pieces aimed at this audience were played by characters representing health professionals, both fictional and real, as well as pregnant women alone or accompanied by their partners. In addition, the campaign differentiated itself from the others by assuming responsibility for care and prevention also to the pregnant woman's sexual partner with specific parts and discourse for dialogue with this target audience. Even so, according to Figure 2, the pregnant woman was the character who appeared the most during the campaign with 37%, health professionals in second place with 33% and lastly the sexual partner with 30%.
Graph 2. Percentages of the target audience
Source: Own elaboration.
Figure 3 systematises the content strands that were addressed during the campaign. Although the entire concept, objectives and strategies of the campaign are guided by the theme of congenital syphilis, it is the rapid test that appears as the most frequently mentioned theme in the publications. We note that the campaign addressed the following topics: rapid test (11); prevention (5); prenatal (3); congenital syphilis (3) and consequences of congenital syphilis (1). The topics were addressed separately or together in the same publication, always emphasising the importance of rapid testing as a way to prevent the mother and baby from the consequences of syphilis.
Graph 3. Content of the campaign
Source: Own elaboration.
4.2. Measuring the "acceptability" of the ‘Vamos cuidar agora’ campaign
The acceptability indicator refers to the evaluation of a given piece of content based on a joint assessment of factors including the identification of the target audience, the content of the message and the tone adopted for the campaign (French et al., 2014). To identify the publications with the best acceptability index, the five publications with the best engagement were verified in terms of the level of reach, which aims to estimate the target group that was exposed to the advertisement and interacted at least once during the campaign directly, or through social interaction between members of the same community (Huhman et al., 2009; Olejniczak & Tomorad, 2015; Andrasik et al., 2015).
Table 2 below compiled, in descending order, the publications with the highest reach index.
Table 2. Ranking of the publications with the greatest reach.
|
Cod |
Formato |
Público |
Alcance |
|
11 |
Card |
embarazada y pareja sexual |
5.465.264 |
|
4 |
Carrusel |
profesional de la salud |
2.517.363 |
|
1 |
Card |
embarazada |
1.151.542 |
|
9 |
Carrusel |
embarazada y profesional de la salud |
1.058.438 |
|
8 |
Carrusel |
embarazada, pareja sexual y profesional de la salud |
654.838 |
Source: Own elaboration.
The publication 'cod 11', published on 17 November 2021, in card format, features a pregnant black woman embracing her partner, a white-skinned man, in a hospital setting. The publication's message and caption reiterate that the sexual partner should also undergo rapid testing during the pregnant woman's prenatal period to prevent the baby from the future consequences of syphilis. To measure this acceptability, we analysed 1) reach; 2) identification of the target audience; and 3) appropriateness of the content.
The results indicate that the publication "cod 11" has a high level of acceptability. This publication had the highest reach of all publications, estimated at 5,465,264 people (five million, four hundred and sixty-five thousand, two hundred and sixty-four). The publication dialogues with the campaign's target audience, as it builds this identification with the audience by inserting protagonists aligned with the campaign's target audience. In terms of the content of the post, the content of the piece and the caption are objective and easy to understand, making it clear that it is substantial that the pregnant partner also has a role to play in the fight against congenital syphilis.
The 'cod 4' publication, published on 28 October 2021, in a carousel format, features a health professional and a pregnant woman. In total, four cards were used, addressed to the health professional, with essential information on rapid testing during antenatal care, in the first and third trimester of pregnancy and in the puerperium (or at delivery). In addition, the publication reinforces the health professional's responsibility to ensure that pregnant women complete treatment to ensure the health of mother and baby. The heading is objective and straightforward, emphasising that the health professional is a key player in actions to address congenital syphilis.
In the analysis, we identified that the publication "cod 4" denotes a high level of acceptability, as it meets all three criteria outlined for this study. In terms of reach, the content reached 2,517,363 (two million, five hundred and seventeen thousand, three hundred and sixty-three) people. The target audience has been identified, as one of the recipients of this publication is the health professional. The content is appropriate when it uses more "technical" terms used and understood by health professionals to raise the debate on congenital syphilis control. However, while the tone is appropriate for the target audience, it is important to remember that social media outreach also includes the lay public when the topic is syphilis.
The post "cod 1", published on 15 October 2021, in card format, features a pregnant woman as the protagonist of the prevention and care discourse. Once again, it reiterates the importance of taking the rapid test at the beginning of pregnancy in order to take care of your health. Once again, the caption of the piece reinforces the "Now" used in the campaign slogan as a way of drawing the attention of these mothers to confront syphilis in the early stages of pregnancy. The "cod 1" publication has a reach of 1,151,542 (one million, one hundred and fifty-one thousand, five hundred and forty-two). Identification with the target audience when it brings a pregnant woman as the protagonist of the piece. The content of the piece and the caption objectively show where it is possible to do the rapid test, as well as highlighting that it is free of charge. Given the fulfilment of the three parameters, we consider that the publication presented a high level of acceptability.
The post "cod 9", published on 5 November 2021, was made in a carousel format composed of 04 cards. The target audience of this post is pregnant women and health professionals. In this publication, the content focuses on a joint communication with the pregnant woman and the health professional, who is the protagonist of the piece from the second card onwards. Thus, the message mentions when during pregnancy it is recommended to test for syphilis. Although the pregnant woman appears in the piece, the message is addressed to the health professional.
The publication is acceptable due to the expressive reach rate estimated at 1,058,438 (one million, fifty-eight thousand, four hundred and thirty-eight people). In terms of the target audience, identification occurred, as both the pregnant woman and the health professional are mentioned. In terms of content, we considered it appropriate because the dialogue was aimed at both audiences.
Our analysis verified the content of the post "cod 8", published on 4 November 2021, in a carousel format composed of 05 cards and starring pregnant women, sexual partners and health professionals. The aim of the publication is to alert all audiences to the campaign, showing how each of them can act to collaborate in the fight against congenital syphilis. Publication 01 contextualised the epidemiological scenario of congenital syphilis in the world; publication 02 brought the pregnant woman into the spotlight, reinforcing once again her role in getting tested for syphilis; 03 referred to the role of sexual partners in addressing the grievance, 04 mentioned that health professionals should encourage pregnant women to undergo the rapid test and 05 concluded the carousel with the official campaign logo, reinforcing the slogan ‘Vamos Cuidar Agora’.
Although it had a lower reach rate (654,838 - six hundred and fifty-four thousand eight hundred and thirty-eight people), we found that the publication "cod 8" denotes acceptability by meeting all three parameters. We also observed that the publication took care to insert all the audiences in each of the carousel cards, also adjusting the content to each of the estimated audiences.
5. CONCLUSIONS
The ‘Vamos Cuidar Agora’ campaign dialogues with specific audiences such as health professionals, pregnant women and their sexual partners. Faced with such a specific audience, it was necessary to propose a visual and textual content that would dialogue specifically with this audience so that the content would have a wide reach, but also be accepted by the target audience. Having also reached audiences that were not expected, but who were hooked by the advertising's ability to "defocus" through "interdiscursive pertinence" (Verón, 2005).
Such interdiscursive relevance makes it possible to reach new audiences, as other audiences that are not directly or indirectly relevant are reached by the ability to defocus advertising, allowing the campaign to reach more people beyond the a priori established target. And therein lies the power of advertising, in preparing the public for subjects that are not necessarily addressed to them, but which become part of their imagination and memory, predisposing them for the future, when they will receive direct campaigns on similar subjects.
From the results found, it was also possible to understand which content patterns obtained a better diffusion, as shown by the expressive indexes of reach and acceptability. The publication "cod 11" was the best performer due to its expressive reach of more than five million people. In addition, it provided the main content guideline of the quick test, which was also the most frequently discussed topic during the campaign's dissemination. The other four publications ("cod 4"; "cod 1"; "cod 9" and "cod 8") with the highest reach mentioned the rapid test and prenatal screening, as well as focusing on other audiences such as health professionals and sexual partners.
Due to the fact that our analysis did not include all the pieces, we cannot affirm that the campaign has achieved total acceptance, but it is possible to verify that it reached considerable levels for a campaign that was only disseminated on social media and was promoted with a low budget. Therefore, it is suggested that in future studies an analysis of other publications should be carried out to identify which ones were more accepted by the public with the intention that these results help the development of the strategy of future campaigns on the same topic.
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AUTHOR CONTRIBUTIONS, FUNDING AND ACKNOWLEDGEMENTS
Conceptualisation: Araújo Costa Ana Cláudia y Molano Marcos Mar. Methodology: Araújo Costa Ana Cláudia, Molano Marcos Mar y Lacerda Sousa Juciano. Validation: Araújo Costa Ana Cláudia y Lacerda Sousa Juciano. Formal analysis: Araújo Costa Ana Cláudia, Molano Marcos Mar y Lacerda Sousa Juciano. Data curation: Araújo Costa Ana Cláudia. Writing-Preparation of the original draft: Araújo Costa Ana Cláudia, Molano Marcos Mar y Lacerda Sousa Juciano. Writing-Revision and Editing: Araújo Costa Ana Cláudia, Molano Marcos Mar y Lacerda Sousa Juciano. Visualisation: Araújo Costa Ana Cláudia, Molano Marcos Mar y Lacerda Sousa Juciano. Supervision: Molano Marcos Mar y Lacerda Sousa Juciano. Project management: Lacerda Sousa Juciano. Todos los autores han leído y aceptado la versión publicada del manuscrito.
AUTHORS
Ana Cláudia Costa de Araújo
PhD student linked to the Postgraduate Programme in Media Studies, in the line of Social Practices (PPgEM/UFRN), and to the PhD in Audiovisual Communication, Advertising and Public Relations at the Complutense University of Madrid (Cotutela). Master's Degree from the Postgraduate Programme in Production Engineering - UFRN (2018). Bachelor's Degree in Social Communication with specialisation in Advertising and Propaganda (UFRN). Member of the Pragmatics of Communication and Media Research Group (Pragma/UFRN/CNPq). She is a researcher of the innovation project Applied Research for Intelligent Integration Oriented to Strengthening Care Networks for Rapid Response to Syphilis (LAIS/SEDIS/NESC/UFRN/OPAS/MS 2018-2022).
Orcid ID: https://orcid.org/0000-0002-5128-6040
Google Scholar: https://scholar.google.com/citations?user=yJB2f1kAAAAJ&hl=pt-BR
ResearchID: https://publons.com/researcher/4070629/ana-claudia-costa/
Research Gate: https://www.researchgate.net/profile/Ana-Claudia-Costa
María Del Mar Marcos Molano
Lecturer at the Complutense University of Madrid (Faculty of Information Sciences) where she teaches Audiovisual Narrative and Acting Direction. She has given seminars on the analysis of the photographic and cinematographic image in national and international courses and conferences. In 2007 she incorporated the study of technologies into her research, studying video games from the fields of narrative, rhetoric, staging and connection with the user, publishing several articles on video games, narrative and education. She is currently the director of the CREAV Centre for the Support of Audiovisual and Digital Content Research for Teaching and Research, where she is developing her research project on the Dissemination of Science and Technology.
Orcid ID: https://orcid.org/0000-0002-8738-9244
Google Scholar: https://scholar.google.es/citations?user=f5koMb0AAAAJ&hl=es
ResearchID: https://publons.com/researcher/3150933/mar-marcos/
Juciano de Sousa Lacerda
Professor of the PhD in Media Studies at the Federal University of Rio Grande do Norte (UFRN), Brazil (2009-present). PhD in Communication Sciences at UNISINOS- Brazil (2004-08). Visiting Professor at the Autonomous University of Barcelona (UAB) with a grant from the Capes-Brazil Agency (Senior Stays Abroad Programme 2017-18). Researcher and fellow at the Laboratory for Technological Innovation in Health (LAIS/UFRN). He researches citizen communication processes and their relationship with advertising and public health. He has published and coordinated seven books and published more than 100 texts in scientific journals and book chapters, and scientific conferences. He has given courses and guest lectures at universities in Brazil and Spain.
Orcid ID: https://orcid.org/0000-0002-0876-377X
Google Scholar: https://scholar.google.com.br/citations?user=3SfvtwIAAAAJ&hl=pt-BR
ResearcherID: https://publons.com/researcher/ABA-8541-2020/
Research gate: https://www.researchgate.net/profile/Juciano-Lacerda
Revista de Comunicación y Salud, 2023, Vol. 13.