Clinical trial NCT06842004: Protocol to Improve the Representation of the Reproductive Process in Spanish Fiction.
Official title: Protocol to Improve the Representation of the Reproductive Process in Spanish Fiction: Sequential Transformative Approach, With Qualitative Predominance and Participatory Action.
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Sexual Health
Community Participation
Social Norms
Keywords: sexual health
motion pictures
community participation
social norms
Lead sponsor: Universitat de Lleida
Sponsor class: OTHER
First posted: 2025-02-24
Enrollment: 60
Sex: ALL
Minimum age (years): 18
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: NA
Intervention model: SEQUENTIAL
Intervention model description: The study will employ a sequential mixed-methods transformative design (DITRAS), with a predominantly qualitative approach and a strong emphasis on participatory action research. It will be structured into three distinct phases.

In the first phase, a quantitative approach will be used, involving a descriptive cross-sectional study based on a systematic search of film databases, digital platforms, and on-demand television.

The second phase will focus on exploring the perceptions of users and professionals regarding reproductive health processes through focus groups and interviews.

The third phase, the intervention phase, will adopt a participatory action research approach to co-create a good practice manual, which will be implemented in undergraduate and postgraduate communication and journalism training programs.
Primary purpose: OTHER

Brief summary: The aim of this study is to promote the inclusive and plural representation of reproductive processes in Spanish fiction, in order to generate knowledge, emotional well-being and improve the quality of life of people in similar situations. The question to be answered is

Will a handbook of good practices used in the training of scriptwriters and audiovisual creators, based on the testimonies of people experiencing reproductive processes and developed with the collaboration of experts (gynaecologists, midwives -ACL-, audiovisuals -Dones Visuals- and scriptwriters -Guionistes Associats-) promote the inclusive and updated representation of reproductive processes?

Focus groups with people involved in reproductive processes and in-depth interviews with professionals involved in these processes will be carried out. A manual of good practices will then be developed in collaboration with audiovisual experts and scriptwriters.

Detailed description: Introduction: Since the 1970s, representations of women in fiction have been the subject of interdisciplinary analysis to understand how cultural narratives perpetuate, challenge or transform patriarchal discourses.

Researchers such as Friedan, Faludi and Macdonald have shown how the media reproduce myths of femininity that reinforce gender inequalities. According to De Lauretis, gender is constructed through representation, while Ricoeur stresses that cultural narratives shape individual identities by linking personal histories with collective imaginaries.

In the area of motherhood, researchers such as Douglas and Michaels, Feasey and Kaplan have shown how the media reinforces conservative ideals such as 'new momism' and simplifies biological processes such as pregnancy and breastfeeding, while personal testimonies reveal tensions between cultural expectations and lived experiences, highlighting the need for more inclusive and diverse narratives.

Aim: The project analyzes the representation of reproductive processes-such as menstruation, pregnancy, abortion, and menopause-in contemporary Spanish audiovisual fiction, assessing how these narratives reflect or challenge socio-cultural structures and reconfigure traditional imaginaries.

Through an intersectional and interdisciplinary approach, the research team aims to understand how different audiences, particularly those related to reproductive health, perceive these narratives. The study will include an analysis of fiction, the perceptions of users and professionals, and collaboration with organizations such as the Catalan Association of Midwives (ACL) and audiovisual experts to co-produce a good practice guide that promotes inclusive, ethical, and patriarchy-free representations.

Material and method: The study will follow a sequential transformative mixed method design (DITRAS), with qualitative predominance and participatory action research, divided into three phases. In the first phase, a quantitative approach will be used with a descriptive cross-sectional study, based on a systematic search of film databases, digital platforms and on-demand television. In the second phase, users' and professionals' perceptions of reproductive health processes will be explored through focus groups and interviews. In the third phase, participatory action research will be applied to co-create a manual of good practices to be implemented in undergraduate and postgraduate training in communication and journalism.

Discussion: To our knowledge, this is the first study to analyze the representation of reproductive processes in Spanish fiction. According to Goffman, the way messages are framed in the media influences the audience's perception of problems and their solutions, leading to psychological, social, and political repercussions.

Through strategically designed narratives, the media has the power to shape attitudes and drive social change, as highlighted by the WHO in its guidelines for addressing sensitive issues such as suicide. Previous studies on the portrayal of childbirth suggest that fiction has distorted the perception of care quality, overrepresented white, heterosexual, non-disabled couples, and depicted women as passive participants in the process.

The findings of this study have the potential to enhance the representation of reproductive processes in the media, fostering a more inclusive and accurate perspective that could shape public perceptions and contribute to the development of more equitable policies.

Eligibility criteria: Inclusion Criteria Users:

* Participated in the group health education program at the primary sexual and reproductive health care centers (ASSIR), attended at least 3 sessions.
* Signed the informed consent form.

Exclusion Criteria Users:

- Language barrier (Spanish/Catalan) that limits their ability to have a relaxed conversation.

Inclusion Criteria Health Professionals:

* Employed by the Institut Català de la Salut, specifically within the obstetrics and gynecology team at the Hospital Universitari Arnau de Vilanova (HUAV) or primary health care (ASSIR)
* Signed the informed consent form.

Exclusion Criteria Health Professionals:

- No exclusion criteria were applied.

Primary outcomes:
measure: Use audiovisual works that promote diverse narratives about reproductive processes as case studies in undergraduate and master's programs for future audiovisual professionals
timeFrame: From the implementation of the manual of good practices in university communication and audiovisual studies to 5 years later.
Secondary outcomes:
measure: Creation of a database of fictional works on reproductive processes in Spain
timeFrame: In the 14 months prior to enrolling to participate.
measure: Profile and perceptions of users and professionals from focus group scripts or semi-structured interviews on the representation of reproductive processes in contemporary Spanish fiction.
timeFrame: An average of 6 months from the registration of participants (users and healthcare professionals) to the completion of the analysis of the interview / focus group.
measure: Manual of best practices and recommendations for audiovisual presentations of reproductive processes, based on data collected through focus groups and in-depth interviews with users and professionals.
timeFrame: From the registration of participants in the Participatory Action Intervention Working Group to the implementation of the tool in university communication and audiovisual studies, an average 6 months.
Other outcomes:
Locations:
city: Lleida
country: Spain
facility: Facultat d'Infermeria i Fisioteràpia
Study officials:
affiliation: Universitat de Lleida
name: Mariona Visa Barbosa, PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: Universitat de Lleida
name: Margarida Carnicé Mur, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Acosta Artiles FJ, Rodriguez Rodriguez-Caro CJ, Cejas Mendez MR. [Reporting on Suicide. WHO recommendations for the Media.]. Rev Esp Salud Publica. 2017 Oct 24;91:e201710040. Spanish.
citation: HAYS, Sharon. (1998). The cultural contradictions of motherhood. Yale University press
citation: KAPLAN, E. Ann. (2013). Motherhood and representation: The mother in popular culture and melodrama. Routledge.
citation: FEASEY, Rebecca. (2016). Mothers on mothers: maternal readings of popular television. Peter Lang
citation: FEASEY, Rebecca. (2012). From happy homemaker to desperate housewives: motherhood and popular television. London: Anthem Press.
citation: DOUGLAS, Susan y MICHAELS, Meredith. (2004). The Mommy Myth: The Mass Media and the Rise of the New Momism. The Free Press.
citation: MACDONALD, Myra (1995) Representing women myths of femininity in the popular media. Hodder Arnold
citation: FALUDI, Susan. (1991). Backlash: The undeclared war against women. London: Chatto & Windus
citation: Friedan B. The problem that has no name. The Feminine Mystique 1963. Am J Public Health. 2010 Sep;100(9):1582-4. doi: 10.2105/ajph.100.9.1582. No abstract available.