Hip Hop Public Health created “20 Seconds or More” to help mitigate the spread of COVID19 by providing evidence-based and culturally-relevant public health messages that demonstrate and motivate proper handwashing.
We chose to focus on handwashing because it is one of the most important defenses we have against contracting the virus. According to the CDC, washing hands for 15-30 seconds removes more germs than washing hands for shorter periods of time, and proper handwashing can reduce respiratory infections by 21% (Aiello et al 2008). We touch our faces up to 23 times an hour and due to the unconscious nature of face touching, it is much easier to have people wash their hands more regularly than to stop touching their faces.
The science upon which “20 Seconds or More” was created is based on the Multisensory Multilevel Health Education Model (MMHEM) developed by Hip Hop Public Health founder Dr. Olajide Williams and his Research Scientist, Dr. Ewelina Swierad (Williams O & Swierad, 2019). MMHEM incorporates three key domains important for motivating behavior change:
- Art: Multisensory and aesthetically sensitive health education that leverages visual, auditory, tactile, and kinesthetic sensory inputs in their design through the creative arts.
- Culture: This involves tailoring health education through programming that resonates with culturally accepted norms, beliefs, and values of the target audience.
- Science: Evidence-based educational approaches and programming that optimize cognitive processes linked to memory and learning.
“20 Seconds or More” incorporates principles of message stickiness (Chip Heath & Dan Heath, 2007) and contagiousness (Jonah Berger) by leveraging music’s powerful effects on brain function. Music enhances learning and memory in very effective and yet under-exploited ways – it increases attention to content and facilitates an emotional connection to the information. A universal example is the use of music to teach children their ABCs.
Hip-hop is a particularly effective learning tool due to its ability to incorporate multiple literary devices, such as rhymes and spaced repetition which are known to enhance learning and memory. It is also a cultural tool that enables tailoring to certain communities while incorporating credible messengers (hip hop icons, celebrities, etc.) in its delivery. Moreover, as the most popular genre in the US, hip-hop music has mass appeal.
“20 Seconds or More” instructs people to wash their hands 27 times, and to do so for at least 20 seconds 11 times. The song also mentions social distancing 4 times and describes proper handwashing techniques using clever and simple rhymes. It appeals to human emotions by emphasizing and personalizing the importance of handwashing through a fun upbeat tempo and lyrics like “you’re protecting everybody you love” and “wash your hands, save a life”. Although not its primary goal, “20 Seconds or More” also describes the most common symptoms of COVID19 and emphasizes the contagiousness of the virus in the context of social distancing.
In advertising, “effective frequency” refers to the number of times a person needs to be exposed to an advertising message before a viewer response occurs. In the case where there is a pre-existing strong emotional connection to the subject matter, a single exposure may be sufficient to motivate the desired behavior, but generally, it requires at least 3 exposures. The first exposure triggers curiosity, the second facilitates recognition, and the third motivates decision making (Herbert E. Krugman, 1965). Our goal is to expose the public to the “20 Seconds or More” video at least 3 times, with a focus on the hardest-hit communities of color.