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Cho D, Wang C, Pierce J, Dawkins-Moultin L, Lu Q. Preliminary efficacy of a tailored narrative intervention to increase human papillomavirus vaccination intention among a multi-ethnic sample of female students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:2054-2061. [PMID: 35981315 DOI: 10.1080/07448481.2022.2103372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 05/24/2022] [Accepted: 07/12/2022] [Indexed: 06/15/2023]
Abstract
Objective. We investigated the preliminary efficacy of a tailored human papillomavirus (HPV) vaccination on-line intervention designed to increase HPV vaccination intention. Participants. Female college students (N = 101; 18-26 years), who have not received the HPV vaccine. Methods. Participants were randomized to either a control group to read standard Center for Disease Control information or a narrative intervention group to read two narrative messages about HPV/HPV vaccination that were tailored based on the individual's sexual history and told from the perspectives from a peer and an expert. Participants were assessed at baseline (T1) and immediately after the intervention (T2). Results. The narrative intervention group reported a greater increase from T1 to T2 in vaccination intention compared with control group. Both groups reported increases in knowledge, positive attitude, self-efficacy, social norm, and perceived susceptibility to HPV from T1 to T2. Conclusions. A narrative intervention is promising to effectively increase HPV vaccination intention.
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Affiliation(s)
- Dalnim Cho
- Department of Health Disparities Research, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Carol Wang
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Jace Pierce
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Lenna Dawkins-Moultin
- Department of Health Disparities Research, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Qian Lu
- Department of Health Disparities Research, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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2
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Barajas R, Barajas CB, Ramos YMR, Trillos SG, Sawhney S, Campos C, Hurtado-de-Mendoza A, Rotunno M, Gillanders E. Raising awareness and education of genetic testing and counseling through fotonovelas among Latina women at risk for hereditary breast and ovarian cancer. J Community Genet 2024:10.1007/s12687-024-00728-5. [PMID: 39240499 DOI: 10.1007/s12687-024-00728-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 08/15/2024] [Indexed: 09/07/2024] Open
Abstract
Latinas are less likely to receive genetic counseling and genetic testing (GCT) compared to non-Latina Whites because of systemic and patient-level barriers. We developed and tested fotonovelas to increase awareness of GCT among Latinas at-risk of hereditary breast and ovarian cancer (HBOC). Content for the fotonovelas was drawn from an existing culturally targeted narrative video focused on improving GCT use among Latinas at-risk of HBOC. Using mixed methods, we interviewed cancer patients (n = 10) and their relatives (n = 10) to assess the preliminary efficacy of the fotonovelas through pre-and post-fotonovela items assessing self-rated knowledge of GCT and willingness to discuss cancer with family. Health workers (n = 10) provided feedback on the fotonovela content. McNemar's test was used to examine differences in the proportions of the outcomes pre- and post-fotonovelas. Interviews were transcribed and coded in Dedoose using a consensual qualitative research approach. Reading the fotonovelas increased self-rated knowledge of GCT by 22% (p = 0.16), from 50 to 60% in patients and from 63 to 100% among relatives. Analogously, reading the fotonovela increased willingness to talk about cancer with family by 33% (p = 0.02), from 70 to 100% in patients and from 38 to 75% in relatives. We identified six themes, some centered around the fotonovela's message, feedback, and perceived barriers to GCT. Overall, participants liked the use of fotonovelas to increase GCT awareness and cancer conversations with family. Fotonovelas could potentially be used as educational tools to increase GCT awareness and cancer conversations among Latino families at-risk of HBOC.
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Affiliation(s)
- Rolando Barajas
- Georgetown University School of Medicine, Washington, DC, USA
- Division of Cancer Control and Population Sciences, Genomic Epidemiology Branch, National Health Institutes/National Cancer Institute, Bethesda, MD, USA
| | - Clara B Barajas
- Cancer Prevention and Control, Georgetown University, Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | | | - Sara Gómez Trillos
- Cancer Prevention and Control, Georgetown University, Lombardi Comprehensive Cancer Center, Washington, DC, USA
- Fischer Center for Hereditary Cancers, Washington, DC, USA
| | - Sabrina Sawhney
- Cancer Prevention and Control, Georgetown University, Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | | | - Alejandra Hurtado-de-Mendoza
- Cancer Prevention and Control, Georgetown University, Lombardi Comprehensive Cancer Center, Washington, DC, USA
- Fischer Center for Hereditary Cancers, Washington, DC, USA
| | - Melissa Rotunno
- Division of Cancer Control and Population Sciences, Genomic Epidemiology Branch, National Health Institutes/National Cancer Institute, Bethesda, MD, USA.
| | - Elizabeth Gillanders
- Division of Cancer Control and Population Sciences, Genomic Epidemiology Branch, National Health Institutes/National Cancer Institute, Bethesda, MD, USA
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3
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Shete M, Kocher M, Pratt R, Lee H, Zierhut H. Genetic counseling processes and strategies for racially and ethnically diverse populations: A systematic review. J Genet Couns 2024; 33:842-861. [PMID: 37743585 DOI: 10.1002/jgc4.1773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 06/26/2023] [Accepted: 08/12/2023] [Indexed: 09/26/2023]
Abstract
Genetic counseling outcomes are influenced by the processes and strategies used by counselors, yet little is known about how these strategies directly impact patients and populations. In particular, tailoring genetic counseling consultations to best meet the needs of cultural, racial, and ethnically diverse populations has been explored. This review aims to identify genetic counseling strategies tailored for a diversity of racial and ethnic populations with the goal to find ways to improve genetic counseling outcomes. Medline, Cochrane CENTRAL, Embase, PsychInfo, and CINAHL databases were searched for original research articles published in English that employed genetic counseling processes and strategies to improve genetic counseling outcomes, specifically for participants from ethnically or racially diverse populations. A review of 5300 titles and abstracts resulted in the identification of 36 articles that met the inclusion criteria. Three themes emerged: (1) community involvement in culturally tailoring genetic counseling, (2) creation and use of culturally tailored resources, and (3) modifications to the genetic counseling process. The effectiveness of genetic counseling strategies could not be evaluated due to lack of consistent outcome measures in the articles. The involvement of diverse ethnic and racial populations in developing inclusive genetic counseling tools and practices will help the profession provide better patient care in the future. More research connecting genetic counseling processes and outcomes will help to assess how well these modified approaches meet the needs of diverse populations.
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Affiliation(s)
- Mrunmayee Shete
- Department of Genetics, Cell Biology & Development, University of Minnesota-Twin Cities, Minneapolis, Minnesota, USA
| | - Megan Kocher
- University Libraries, University of Minnesota-Twin Cities, Minneapolis, Minnesota, USA
| | - Rebekah Pratt
- Department of Family Medicine and Community Health, University of Minnesota-Twin Cities, Minneapolis, Minnesota, USA
| | - Heewon Lee
- Department of Genetics, Cell Biology & Development, University of Minnesota-Twin Cities, Minneapolis, Minnesota, USA
| | - Heather Zierhut
- Department of Genetics, Cell Biology & Development, University of Minnesota-Twin Cities, Minneapolis, Minnesota, USA
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4
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Martei YM, Mokokwe L, Ngwako N, Kebuang K, Setlhako DI, Gabaatlhole G, Baaitse B, Segadimo T, Shulman LN, Barg F, Gaolebale BE. Development, acceptability and usability of culturally appropriate survivor narrative videos for breast cancer treatment in Botswana: a pilot study. BMJ Open 2024; 14:e073867. [PMID: 38296302 PMCID: PMC10828869 DOI: 10.1136/bmjopen-2023-073867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 12/14/2023] [Indexed: 02/03/2024] Open
Abstract
OBJECTIVES Narrative communication has demonstrated effectiveness in promoting positive health behaviours, delivering support and coping with complex decision-making. Formal research evaluating this intervention for cancer treatment in Africa is lacking. We aimed to develop, and assess acceptability and usability of survivor video narrative interventions for breast cancer treatment in Botswana. DESIGN A pilot study design. SETTING Single-centre, tertiary hospital, sub-Saharan Africa. PARTICIPANTS Eight women, ≥18 years old, with stages I-III breast cancer were enrolled for the video intervention. 106 women, ≥18 years old, with stages I-IV breast cancer viewed the narrative videos and 98 completed the acceptability and usability surveys. INTERVENTION Survivor narrative videos were developed using the theory of planned behaviour and using a purposive sample of Batswana, Setswana-speaking, breast cancer survivors, who had completed systemic treatment and surgery with high rates of adherence to the prescribed treatment plan. PRIMARY OUTCOMES We assessed acceptability and usability among prospectively enrolled patients presenting for routine breast cancer care at Princess Marina Hospital in Botswana, using a 13-item survey. RESULTS Participants expressed high acceptability and usability of the videos, including 99% (97/98) who strongly agreed/agreed that the video presentations were easy to understand, 92% (90/98) who would recommend to other survivors and 94% (92/98) who wished there were more videos. Additionally, 89% (87/98) agreed or strongly agreed that the one-on-one instruction on how to use the tablet was helpful and 87% (85/98) that the video player was easy to use. CONCLUSION Culturally appropriate survivor video narratives have high acceptability and usability among patients with breast cancer in Botswana. There is an opportunity to leverage this intervention in routine breast cancer care for treatment support. Future studies will test the implementation and effectiveness of narrative videos on a wider scale, including for patients being treated for other cancers.
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Affiliation(s)
- Yehoda M Martei
- Department of Medicine (Hematology - Oncology Division), University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lebogang Mokokwe
- Botswana University of Pennsylvania Partnership, Gaborone, Botswana
- University of Botswana, Gaborone, Botswana
| | | | | | | | | | | | | | - Lawrence N Shulman
- Department of Medicine (Hematology - Oncology Division), University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Frances Barg
- Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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5
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Gomez V, Kandahari N, Curiel D, Carter A, Somkin CP, Allen AM. Digital Storytelling as a Tool to Increase Colorectal Cancer Screening Intention in a Latinx Church Community. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:1825-1833. [PMID: 37434087 DOI: 10.1007/s13187-023-02338-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/02/2023] [Indexed: 07/13/2023]
Abstract
Although colorectal cancer screening (CRCS) rates have improved for all racial groups due to wider availability of screening, Latinx continue to have lower screening rates and are more likely to be diagnosed with later stages of colorectal cancer compared to non-Latinx whites. More culturally tailored educational interventions are needed to reach this population. This study introduced a digital storytelling (DST) intervention in a church community setting and explored its potential to influence CRCS intention and perception among Latinx and the acceptability of the DST intervention. Participants (n=20) between the ages of 50 and 75 who were not up-to-date with CRCS were recruited to view digital stories developed by fellow church members with previous CRCS experience. They completed surveys assessing their intention to complete CRCS before and after the viewing and were asked to participate in focus groups to understand, qualitatively, how the digital stories influenced their perceptions and intentions related to CRCS. Analysis of participant narratives revealed three overarching themes related to their perceptions and intentions of CRCS after the DST intervention: (1) the duality of the faith-health connection and fatalism, (2) willingness to consider other screening methods, and (3) the push-pull of individual barriers and interpersonal facilitators. Participants felt the DST intervention humanized the CRCS process and that it would be acceptable and well received in other church settings. The introduction of a community-based DST intervention within a church setting is a novel strategy with the potential to influence members of the Latinx church population to complete CRCS.
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Affiliation(s)
- Vicky Gomez
- San José State University, Public Health and Recreation Department, One Washington Square, San José, CA, 95192, USA.
| | - Nazineen Kandahari
- University of California, San Francisco, School of Medicine, 533 Parnassus Ave, San Francisco, CA, 94143, USA
| | - Daniela Curiel
- San José State University, Public Health and Recreation Department, One Washington Square, San José, CA, 95192, USA
| | - Andrew Carter
- San José State University, Public Health and Recreation Department, One Washington Square, San José, CA, 95192, USA
| | - Carol P Somkin
- Kaiser Permanente Division of Research, 2000 Broadway, Oakland, CA, 94612, USA
| | - Amani M Allen
- University of California, Berkeley School of Public Health, Divisions of Community Health Sciences and Epidemiology, 2121 Berkeley Way #5302, Berkeley, CA, 94708, USA
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Xu J. A Meta-Analysis Comparing the Effectiveness of Narrative vs. Statistical Evidence: Health vs. Non-Health Contexts. HEALTH COMMUNICATION 2023; 38:3113-3123. [PMID: 36278821 DOI: 10.1080/10410236.2022.2137750] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
This study is a meta-analysis of primary studies that make a direct comparison between narrative and statistical evidence in both health- and non-health-related communication contexts. The meta-analysis included 50 studies with 65 experimental pairs (k = 65) based on 13,113 (20-1270) participants. We examined the overall persuasiveness of evidence type by computing the correlations (r's) for all pairs, based on the random-effects model, which revealed an effect size of 0.016 (95% CI, -0.014 to 0.045, p = 0.296). Two types of evidence did not significantly differ in effectiveness under either communicative context. The moderation analysis indicated that narrative evidence had a significant advantage over statistical evidence for health messages advocating for prevention behaviors. Compared to non-student samples, the narrative evidence trumped statistical evidence for health-related issues. As communication research continues to investigate the implications for message persuasiveness derived by narrative and statistical appeals, our study suggests that the relative effectiveness is likely a complicated and nuanced matter. Practical implications and limitations have also been outlined.
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Affiliation(s)
- Jie Xu
- Department of Communication, Villanova University
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7
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Kline KN, Rangel ML, Bulsara S, Chenier R, Escobar B, Montealegre J, Weiss MJ. Using Culturally Adapted Theater Outreach to Promote Cancer Screening Among Medically Underserved Minority Communities. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01871-4. [PMID: 38010482 DOI: 10.1007/s40615-023-01871-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/23/2023] [Accepted: 11/12/2023] [Indexed: 11/29/2023]
Abstract
Black, Hispanic, and Asian individuals, the three largest US racial/ethnic minorities, continue to suffer disproportionately from breast, cervical, and colon cancers largely because cancer screening continues to be underutilized even after decades of availability. This study examined the utility of theoretically grounded and culturally adapted in-person theater monologues aimed at promoting early detection screening among the three highest population racial/ethnic groups in Harris County, Houston, TX. Nine monologues were created to promote cancer screening and early detection for breast, cervical, and colorectal cancers in three different languages (English, Spanish, Vietnamese) and targeting underserved Black, Hispanic, and Vietnamese adult Harris County residents. From January 2014 to March 2020, 265 live monologue outreach events were held with 110 focused on prevention and screening for breast cancer, 75 for colorectal cancer, and 80 for cervical cancer. A total of 5989 individuals attended these outreach events and 86.3% completed the post-performance evaluation survey. Overall for all monologues, 6.6% of participants reported a positive change in their intent to screen from 75.7 to 82.3% after intervention (p < 0.001) and audience member scores on knowledge questions for all three cancers were mostly positive. Importantly, early detection questions for all three cancers were over 90% correct for all respondents, and well over 70% for the various groups. The findings revealed opportunities for improving monologue content to cultivate cancer early detection and screening knowledge. Results suggest that a theater-based approach may be an effective strategy to disseminate cancer screening education, improve knowledge, and increase intent to obtain screening among medically underserved communities.
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Affiliation(s)
- Kimberly N Kline
- Department of Communication, The University of Texas at San Antonio, One UTSA Circle, San Antonio, TX, 78249, USA
| | - Maria Lizette Rangel
- Section of Epidemiology and Population Sciences, Department of Medicine, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.
| | - Shaun Bulsara
- Biostatistics, Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA
| | - Roshanda Chenier
- Center for Health Promotion & Prevention Research, The University of Texas Health Science at Houston, School of Public Health, 7000 Fannin, Suite 2066, Houston, TX, 77030, USA
| | - Betsy Escobar
- Office of Outreach and Health Disparities, Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA
| | - Jane Montealegre
- Office of Outreach and Health Disparities, Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA
| | - Maria Jibaja Weiss
- Office of Outreach and Health Disparities, Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA
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Chen ACC, Kim SW, Ou L, Todd M, Larkey L. Digital Storytelling Intervention to Promote Human Papillomavirus Vaccination Among At-Risk Asian Immigrant Populations: Pilot Intervention Study. JMIR Form Res 2023; 7:e46951. [PMID: 36877658 PMCID: PMC10585432 DOI: 10.2196/46951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 08/15/2023] [Accepted: 08/30/2023] [Indexed: 03/07/2023] Open
Abstract
BACKGROUND The high morbidity, mortality, and economic burden attributed to cancer-causing human papillomavirus (HPV) calls for researchers to address this public health concern through HPV vaccination. Despite disparities in HPV-associated cancers in Korean Americans and Vietnamese Americans, their vaccination rates remain low. Evidence points to the importance of developing culturally and linguistically congruent interventions to improve HPV vaccination rates. Digital storytelling (a specific form of cultural narrative) shows promise as an effective culture-centric health promotion strategy. OBJECTIVE The aim of this quasi-experimental single-group study was to assess the feasibility, acceptability, and preliminary effects of a culturally and linguistically congruent digital storytelling intervention on Korean American and Vietnamese American mothers' attitudes and intention in vaccinating their children against HPV. We also examined if the association between attitudes and intention differed by their child's sex (boy vs girl) and by ethnicity (Korean American vs Vietnamese American). METHODS Participants were recruited via multiple avenues (eg, ethnic minority community organizations, social media, and flyers posted in local Asian supermarkets and nail salons). Web-based, valid, and reliable measures were administered to collect data preintervention and postintervention. Descriptive statistics, paired and independent sample t tests, the chi-square test, and the McNemar test were used to describe the distributions of variables and to examine the differences between subgroups and changes in key variables over time. Logistic regression models were used to examine associations of mothers' HPV- and vaccine-related attitudes with vaccination intention and to explore if the association between attitudes and vaccination intention differed by the target children's sex or ethnicity. RESULTS In our sample of 50 Korean American mothers (mean age 42.8, SD 4.8 years) and 114 Vietnamese American mothers (mean age 41.5, SD 5.4 years), 36% (18/50) of Korean American and 51% (58/114) of Vietnamese American mothers reported that their children received free or reduced-price lunches at school. After the intervention, mothers' attitudes toward HPV and the vaccine (t163=2.49, P=.01) and intention to vaccinate their children improved significantly (X21=18.38, P<.001). The measure of mothers' negative attitudes toward HPV and the vaccine was significantly associated with higher vaccination intention (odds ratio 0.27, 95% CI 0.14-0.51; P<.001), adjusting for background variables (sociodemographic characteristics) and other HPV-related variables (family cancer history, prior HPV education, and HPV communication with health care providers). Findings did not suggest that a child's sex or ethnicity moderated the association between attitudes and vaccination intention. CONCLUSIONS This remotely delivered intervention using digital stories was feasible and acceptable, and showed preliminary effects on promoting Korean American and Vietnamese American mothers' intention to vaccinate their children against HPV. Future research that uses a randomized controlled trial design with a larger and more diverse sample and includes children's vaccination status will help understand the effect of the intervention.
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Affiliation(s)
| | - Sunny Wonsun Kim
- Edson College of Nursing & Health Innovation, Arizona State University, Phoenix, AZ, United States
| | - Lihong Ou
- Edson College of Nursing & Health Innovation, Arizona State University, Phoenix, AZ, United States
| | - Michael Todd
- Edson College of Nursing & Health Innovation, Arizona State University, Phoenix, AZ, United States
| | - Linda Larkey
- Edson College of Nursing & Health Innovation, Arizona State University, Phoenix, AZ, United States
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Cadenhead VH. Storytelling: An Educational Intervention for Oral Learners. J Christ Nurs 2023; 40:253-259. [PMID: 35533288 DOI: 10.1097/cnj.0000000000000981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT This state of the science review synthesizes the current literature and theoretical background of storytelling as a health communication tool for oral learners. Storytelling is globally applicable in a variety of settings and formats. Cultural considerations are important. Both theoretical and biblical examples explain how storytelling can influence knowledge, behaviors, attitudes, and outcomes. Although further research is needed, evidence indicates storytelling is an effective tool that nurses can use to fulfill their essential duty of health teaching.
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Affiliation(s)
- Virginia H Cadenhead
- Virginia H. Cadenhead, PhD, MSN, RN, CNM , is an assistant professor of nursing at California Baptist University, Riverside, CA. She has more than 23 years of transcultural nursing experience as a missionary in North Africa and Central America
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Hwang J, Cooley A, Cooley S, Hinck R. The Effects of the Culturally Tailored Narratives on COVID-19 Vaccine Confidence Among Hispanics: A Randomized Online Experiment. JOURNAL OF HEALTH COMMUNICATION 2023; 28:168-181. [PMID: 37006173 DOI: 10.1080/10810730.2023.2191225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Guided by the health belief model (HBM), cultural sensitivity approach, and the theory of situated cognition, this study compares the effects of culturally tailored narratives and generic narratives on the COVID-19 vaccine confidence among Hispanics. It also examines an array of cognitive responses (perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and perceived side effects) associated with the COVID-19 vaccine confidence, and the interaction of these cognitive responses with the two narrative types of messaging. The findings suggest that Hispanics exposed to culturally tailored narratives are more confident in the COVID-19 vaccine compared to Hispanics exposed to generic narratives. The study provides support for the HBM, as the perceived benefit was positively related to vaccine confidence, and the perceived barrier was negatively associated with vaccine confidence. Finally, vaccine confidence was the strongest among Hispanics who had high perceived susceptibility and were exposed to culturally tailored narratives.
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Affiliation(s)
- Juwon Hwang
- School of Media and Strategic Communication, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Asya Cooley
- School of Media and Strategic Communication, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Skye Cooley
- School of Media and Strategic Communication, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Robert Hinck
- Air War College, Air University, Montgomery, Alabama, USA
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Lohr AM, Vickery KD, Hernandez V, Ford BR, Gonzalez C, Kavistan S, Patten CA, Njeru JW, Novotny PJ, Larkey LK, Singh D, Wieland ML, Sia IG. Stories for change protocol: A randomized controlled trial of a digital storytelling intervention for Hispanic/Latino individuals with type 2 diabetes. Contemp Clin Trials 2023; 126:107093. [PMID: 36682492 PMCID: PMC9998363 DOI: 10.1016/j.cct.2023.107093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 01/21/2023]
Abstract
BACKGROUND Hispanic/Latino adults are disproportionately impacted by type 2 diabetes mellitus (T2D). The Stories for Change (S4C) Diabetes digital storytelling intervention promotes T2D self-management among Hispanic/Latino people. We describe the S4C protocol and participant baseline characteristics. METHODS Study eligibility criteria: Hispanic or Latino, age 18-70 years, ≥1 office visit within a year at a participating clinic, T2D diagnosis for ≥6 months, HbA1c ≥ 8%, and intention to continue care at the recruitment clinic. We used a two-group, parallel randomized controlled trial design and an intervention derived through a community-based participatory research approach. All participants received usual diabetes care and two cards describing how to engage healthcare teams and access diabetes-related resources. At baseline, the intervention group additionally viewed the 12-min, intervention video (four stories about diabetes self-management). To encourage subsequent video viewing, participants received five monthly text messages. The messages prompted them to self-rate their motivation and self-efficacy for T2D management. The control group received no additional intervention. Bilingual (English/Spanish) staff collected data at baseline, six weeks, three months, and six months including biometric measurements and a survey on diabetes self-management outcomes, theory-based measures, and the number of video views. We reviewed the number of diabetes-related appointments attended using electronic medical record data. RESULTS Participants (n = 451; 70% women, mean age = 53 years) had an average HbA1C ≥9%. Intervention participants reported identifying with the storytellers and engaging with the stories. CONCLUSION We present a digital storytelling intervention protocol that provides a template for future health promotion interventions prioritizing health disparity populations. CLINICALTRIAL gov#NCT03766438.
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Affiliation(s)
- Abby M Lohr
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA; Center for Clinical and Translational Science, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA.
| | - Katherine Diaz Vickery
- Health, Homelessness & Criminal Justice Lab, Hennepin Healthcare Research Institute, 730 S 8th St, Minneapolis, MN 55415, USA
| | | | - Becky R Ford
- Health, Homelessness & Criminal Justice Lab, Hennepin Healthcare Research Institute, 730 S 8th St, Minneapolis, MN 55415, USA
| | - Crystal Gonzalez
- Mountain Park Health Center, 635 E Baseline Rd, Phoenix, AZ 85042, USA
| | - Silvio Kavistan
- Health, Homelessness & Criminal Justice Lab, Hennepin Healthcare Research Institute, 730 S 8th St, Minneapolis, MN 55415, USA
| | - Christi A Patten
- Center for Clinical and Translational Science, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA; Department of Psychiatry and Psychology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
| | - Jane W Njeru
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
| | - Paul J Novotny
- Division of Biomedical Statistics and Informatics, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
| | - Linda K Larkey
- Edson College of Nursing and Health Innovation, Arizona State University, 550 N 3rd Street Ac, Phoenix, AZ 85004, USA
| | - Davinder Singh
- Mountain Park Health Center, 635 E Baseline Rd, Phoenix, AZ 85042, USA
| | - Mark L Wieland
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA; Center for Clinical and Translational Science, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
| | - Irene G Sia
- Center for Clinical and Translational Science, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA; Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
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Garcini LM, Pham TT, Ambriz AM, Lill S, Tsevat J. COVID-19 diagnostic testing among underserved Latino communities: Barriers and facilitators. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e1907-e1916. [PMID: 34719072 PMCID: PMC8652902 DOI: 10.1111/hsc.13621] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 09/09/2021] [Accepted: 10/18/2021] [Indexed: 06/07/2023]
Abstract
In the U.S., Latinos are disproportionately affected by the COVID-19 pandemic. A critical step to reduce the spread of COVID-19 is diagnostic testing. Yet, for testing to be effective, barriers must be reduced or eliminated and facilitators promoted. Guided by principles of community-based participatory research, we collected data from 64 community health workers and Promotor/as (CHW/Ps) in Texas to identify relevant personal, community-level, and testing-related barriers and facilitators to diagnostic testing for COVID-19 among underserved Latino communities. Data were collected through an online survey and focus groups. A large majority of CHW/Ps (90.6%) reported that they perceived diagnostic testing to be important for their communities; however, only 42.2% believed that their communities understand the use of testing. Personal barriers to diagnostic testing included mistrust and fear, including fear of: becoming infected and infecting others, job/income loss, discrimination/stigmatisation, uncovering other diseases, and mishandling of personal information. Community-level barriers to testing included fear-inducing myths and beliefs. Test-related factors included cost and accuracy of testing, testing procedures, inadequate and insufficient information, and logistics pertaining to testing sites. Facilitators to testing included building trust between communities and those administering testing, along with receiving culturally and contextually appropriate testing information. Diagnostic testing for COVID-19 among underserved Latino communities is complex and suboptimal. Targeted efforts are needed to overcome personal, community and test-related barriers in a culturally and contextually sensitive manner in order to prevent harm and to reduce further risk among underserved communities.
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Affiliation(s)
- Luz M Garcini
- Center for Research to Advance Community Health (ReACH), University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Department of Medicine, Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Department of Psychiatry and Behavioral Sciences, Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Tommy Tam Pham
- Department of Medicine, Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Arlynn M Ambriz
- Department of Medicine, Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Sarah Lill
- Center for Research to Advance Community Health (ReACH), University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Joel Tsevat
- Center for Research to Advance Community Health (ReACH), University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Department of Medicine, Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
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13
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Lohr AM, Raygoza Tapia JP, Valdez ES, Hassett LC, Gubrium AC, Fiddian-Green A, Larkey L, Sia IG, Wieland ML. The use of digital stories as a health promotion intervention: a scoping review. BMC Public Health 2022; 22:1180. [PMID: 35698097 PMCID: PMC9192132 DOI: 10.1186/s12889-022-13595-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 05/31/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND It is challenging to develop health promotion interventions created in collaboration with communities affected by inequities that focus beyond individual behavior change. One potential solution is interventions that use digital stories (DS). Digital storytelling (DST) is an opportunity for reflection, connection with others, and the elevation of voices often absent from daily discourse. Consequently, public health researchers and practitioners frequently employ the DST workshop process to develop messaging that promotes health and highlights concerns in partnership with historically marginalized communities. With participants' permission, DS can reach beyond the storytellers through behavior or attitude change interventions for health promotion among communities who share the targeted health concern. Our goal was to synthesize the literature describing interventions that use DS for health promotion to identify gaps. METHODS We conducted a scoping review. Our inclusion criteria were articles that: 1) described empirical research; 2) used DS that were developed using the StoryCenter DST method; 3) assessed an intervention that used DS to address the health promotion of viewers (individuals, families, community, and/or society) impacted by the targeted health issue 4) were written in English or Spanish. To synthesize the results of the included studies, we mapped them to the health determinants in the National Institute of Minority Health and Health Disparities (NIMHD) research framework. We assessed the number of occurrences of each determinant described in the results of each article. RESULTS Ten articles met the eligibility criteria. All the included articles highlighted health equity issues. Our mapping of the articles with definitive results to the NIMHD research framework indicates that interventions that use DS addressed 17 out of 20 health determinants. All mapped interventions influenced intentions to change health behaviors (NIMHD level/domain: Individual/Behavioral), increased health literacy (Individual/Health Care System), and/or stimulated conversations that addressed community norms (Community/Sociocultural Environment). CONCLUSIONS Interventions that use DS appear to positively affect the health promotion of participants across a range of health issues and determinants. Future research is needed in the Interpersonal, Community, and Societal levels and within the Biological, Physical/Built Environment, and Sociocultural Environment domains.
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Affiliation(s)
- Abby M Lohr
- Department of Community Internal Medicine, Mayo Clinic, Rochester, USA.
| | | | - Elizabeth Salerno Valdez
- Department of Community Health Education, School of Public Health and Health Sciences, University of Massachusetts, Amherst, USA
| | | | - Aline C Gubrium
- Department of Community Health Education, School of Public Health and Health Sciences, University of Massachusetts, Amherst, USA
| | - Alice Fiddian-Green
- School of Nursing and Health Professions, University of San Francisco, San Francisco, USA
| | - Linda Larkey
- College of Nursing and Health Innovation, Arizona State University, Tempe, USA
| | - Irene G Sia
- Department of Infectious Diseases, Mayo Clinic, Rochester, USA
| | - Mark L Wieland
- Department of Community Internal Medicine, Mayo Clinic, Rochester, USA
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14
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Chen ACC, Kim WS, Todd M, Larkey L. A Digital Storytelling Intervention for Vietnamese American Mothers to Promote Their Children's HPV Vaccination. Cancer Prev Res (Phila) 2022; 15:465-472. [PMID: 35314854 DOI: 10.1158/1940-6207.capr-21-0618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/04/2022] [Accepted: 03/16/2022] [Indexed: 11/16/2022]
Abstract
Despite higher rates of human papillomavirus (HPV)-associated cancer in Vietnamese Americans (VAs), their vaccination rate remains low. Culturally grounded narratives incorporating culture-specific beliefs and practices may be a promising approach to promote HPV vaccination and potentially mitigate HPV-associated cancer disparities experienced by VAs. We co-developed personal, audiovisual digital stories about HPV vaccination with VA mothers of vaccinated children, and examined the effects of the digital storytelling (DST) intervention on vaccination intention among VA mothers of unvaccinated children aged 11-14. The stories (3 minutes each) were produced in both English and Vietnamese through a two-day workshop in collaboration with two VA first-generation immigrant mothers. A community sample of 114 VA mothers of unvaccinated children viewed the stories and filled out an anonymous survey before and after the intervention. Of these mothers (mean age = 41.5 years; SD = 5.4), 35.2% were immigrants, and about half (51%) reported having a child who received free or reduced-price lunch at school. After the intervention, changes in two items indicating mothers' positive attitudes toward HPV vaccination were significant. Mothers' intention to vaccinate their children increased from 53% to 74%; the difference was large (OR = 9.12; Cohen' g = .40) and statistically significant, X2(1, N = 114) = 17.63, p < .001. Mothers' scores on the Narrative Quality Assessment scale were high, suggesting high levels of identification and engagement with the stories. This brief intervention using digital stories was feasible and showed preliminary effects on promoting VA mothers' intention to vaccinate their children against HPV.
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Affiliation(s)
- Angela Chia-Chen Chen
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona
| | - Wonsun Sunny Kim
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona
| | - Michael Todd
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona
| | - Linda Larkey
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona
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15
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Larkey L, Kim W, James D, Kishida M, Vizcaino M, Huberty J, Krishnamurthi N. Mind-Body and Psychosocial Interventions May Similarly Affect Heart Rate Variability Patterns in Cancer Recovery: Implications for a Mechanism of Symptom Improvement. Integr Cancer Ther 2021; 19:1534735420949677. [PMID: 32783546 PMCID: PMC7425257 DOI: 10.1177/1534735420949677] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background: Advancements in early detection and treatment of cancer have led to increased survival rates and greater need to identify effective supportive care options for resolving symptoms of survivorship. Many non-pharmacological approaches to symptom management during and after cancer treatment involve emotional self-regulation as a central strategy for improving well-being. Identifying commonalities among these strategies’ mechanisms of action may facilitate understanding of what might be useful for optimizing intervention effects. Heart rate variability (HRV) parameters are indicative of improved autonomic nervous system (ANS) balance and resiliency and reduced emotional distress and are thus identified as a mechanism to discuss as a marker of potential for intervention efficacy and a target for optimization. Methods: HRV data from 2 studies, 1 examining a mind-body intervention and 1 examining a psychosocial intervention, are presented as a point of discussion about preliminary associations between the interventions, change in HRV, and emotional distress reduction. Results: HRV significantly decreased in sympathetic activity in response to a mind-body intervention (Qigong/Tai Chi), and increased vagal tone in response to a psychosocial (storytelling) intervention. In both, these changes in HRV parameters were associated with improved emotional states. Conclusion: Our preliminary data suggest that HRV may serve as an important marker of underlying changes that mediate emotional regulation; this observation deserves further investigation. If identified as a worthy target, focusing on interventions that improve HRV within the context of interventions for cancer patients may be important to key outcomes and clinical practice.
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Affiliation(s)
- Linda Larkey
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Wonsun Kim
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Dara James
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Moé Kishida
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | | | - Jennifer Huberty
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
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16
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Hamilton JB. Storytelling: a Cultural Determinant of Health Among African American Cancer Patients. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:211-213. [PMID: 33624204 DOI: 10.1007/s13187-021-01978-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Jill B Hamilton
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Rd, Atlanta, GA, 30322, USA.
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17
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Jiang LC. Effects of narrative persuasion in promoting influenza vaccination in Hong Kong: A randomized controlled trial. PATIENT EDUCATION AND COUNSELING 2021; 104:800-807. [PMID: 33032868 DOI: 10.1016/j.pec.2020.09.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 09/14/2020] [Accepted: 09/16/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES The study examined the effectiveness of narrative persuasion in promoting influenza vaccination in Hong Kong. METHODS The study conducted a randomized controlled trial with a sample of 440 Hong Kong adults who were either at high risk or had a high-risk family member. The participants were randomly assigned to watch a narrative video, an informational video, or no message, and were assessed for perceived threats, perceived efficacy, and vaccination intent, and were followed up three months later for actual vaccination. RESULTS Experimental conditions produced significant differences on perceived threats of influenza but not on perceived efficacy, vaccination intent, and actual vaccination. When compared to informational messages delivered containing equivalent amount of information, narrative messages were more persuasive in promoting perceptions about influenza, equally effective in enhancing vaccination intention and actual behaviors, and equally ineffective in changing efficacy beliefs. The persuasiveness of narratives in promoting threat perceptions was found to work better for individuals with lower literacy levels. CONCLUSIONS Incorporating authentic sociocultural beliefs and experiences in message design can effectively enhance threats perceptions related to influenza. PRACTICE IMPLICATIONS Narratives presented in short-video stories could be an effective tool for promoting health threats especially among high-risk individuals with limited health literacy.
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Affiliation(s)
- Li Crystal Jiang
- Department of Media and Communication, City University of Hong Kong, Hong Kong SAR, China.
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18
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Hurtado-de-Mendoza A, Gómez-Trillos S, Graves KD, Carrera P, Campos C, Anderson L, Gronda A, Orellana H, Peshkin BN, Schwartz MD, Cupertino P, Ostrove N, Luta G, Gonzalez N, Sheppard VB. Process evaluation of a culturally targeted video for Latinas at risk of hereditary breast and ovarian cancer. J Genet Couns 2020; 30:730-741. [PMID: 33222313 DOI: 10.1002/jgc4.1361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 10/12/2020] [Accepted: 10/14/2020] [Indexed: 12/26/2022]
Abstract
This paper presents a process evaluation of a culturally targeted narrative video about hereditary breast and ovarian cancer (HBOC) for Latina women at risk for HBOC. Spanish-speaking Latina women at risk for HBOC participated in a single arm study (n = 40). Participants watched the video developed by the authors and responded to surveys. We used mixed methods to assess theoretical constructs that are hypothesized mediators of narrative interventions (i.e., transportation or engagement, identification with characters, emotions) and implementation outcomes (e.g., acceptability). Descriptive statistics summarized theoretical constructs and implementation outcomes. We conducted Mann-Whitney U tests to assess the differences in theoretical and implementation outcomes between participants who were affected versus. unaffected and participants with different levels of education and health literacy. We used the consensual qualitative research framework to analyze qualitative data. Participants' mean age was 47.1 years (SD = 9.48). Most participants were high school graduates or less (62.5%). Acceptability of the video was extremely high (Md = 10.0, IQR = 0.2, scale 1-10). Most (82.5%) suggested video dissemination be through social media. Participants were highly engaged (Md = 5.7, IQR = 1.5, scale 1-7), strongly identified with the main character (Md = 8.7, IQR = 2.6, scale 1-10), and reported experiencing mostly positive emotions (Md = 9.5, IQR = 2.8, scale 1-10). Participants with low health literacy and affected participants reported a significantly higher identification with the main character (p<.05). Qualitative data reinforced the quantitative findings. Women reported gaining knowledge, correcting misconceptions, and feeling empowered. Our culturally targeted video is highly acceptable and targets mechanisms of behavior change for narrative interventions. The video is easily disseminable and can be used as an education tool for patients including affected and unaffected women and patients with different education and health literacy levels. Future studies should test the impact of the video in enhancing genetic counseling and testing uptake.
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Affiliation(s)
- Alejandra Hurtado-de-Mendoza
- Department of Oncology, Georgetown University Medical Center, Washington, DC, USA.,Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Cancer Genomics, Washington, DC, USA
| | - Sara Gómez-Trillos
- Department of Oncology, Georgetown University Medical Center, Washington, DC, USA.,Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Cancer Genomics, Washington, DC, USA
| | - Kristi D Graves
- Department of Oncology, Georgetown University Medical Center, Washington, DC, USA.,Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Cancer Genomics, Washington, DC, USA
| | - Pilar Carrera
- Department of Social Psychology and Methodology, Universidad Autónoma de Madrid, Madrid, Spain
| | | | - Lyndsay Anderson
- School of Nursing, College of Health and Human Services, California State University, Sacramento, CA, USA
| | - Andrés Gronda
- Department of Oncology, Georgetown University Medical Center, Washington, DC, USA
| | - Halyn Orellana
- Department of Oncology, Georgetown University Medical Center, Washington, DC, USA
| | - Beth N Peshkin
- Department of Oncology, Georgetown University Medical Center, Washington, DC, USA.,Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Cancer Genomics, Washington, DC, USA
| | - Marc D Schwartz
- Department of Oncology, Georgetown University Medical Center, Washington, DC, USA.,Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Cancer Genomics, Washington, DC, USA
| | - Paula Cupertino
- Cancer Prevention and Control Program, John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ, USA
| | | | - George Luta
- Department of Oncology, Georgetown University Medical Center, Washington, DC, USA.,Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Cancer Genomics, Washington, DC, USA.,Department of Biostatistics, Bioinformatics and Biomathematics, Georgetown University Medical Center, Washington, DC, USA
| | | | - Vanessa B Sheppard
- Department of Health Behavior Policy, Virginia Commonwealth University, Richmond, VA, USA
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19
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McCall B, Shallcross L, Wilson M, Fuller C, Hayward A. Storytelling as a research tool and intervention around public health perceptions and behaviour: a protocol for a systematic narrative review. BMJ Open 2019; 9:e030597. [PMID: 31796479 PMCID: PMC6924770 DOI: 10.1136/bmjopen-2019-030597] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 08/26/2019] [Accepted: 10/16/2019] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION There is a growing trend to use storytelling as a research tool to extract information and/or as an intervention to effect change in the public knowledge, attitudes and behaviour (KAB) in relation to public health issues, primarily those with a strong element of disease prevention. However, evidence of its use in either or both capacities is limited. This protocol proposes a systematic narrative review of peer-reviewed, published literature on the use of storytelling as a research tool within the public health arena. METHODS AND ANALYSIS Medline, EMBASE, PsycINFO, ERIC (Educational Resources Information Center), Web of Science, Art and Humanities database (ProQuest), Scopus and Google Scholar will be searched for studies that look at the use of storytelling in the research of pressing current public health issues, for example, vaccinations, antimicrobial resistance, climate change and cancer screening. The review will synthesise evidence of how storytelling is used as a research tool to (a) gain insights into KAB and (b) to effect change in KAB when used as an intervention. Included studies will be selected according to carefully defined criteria relevant to public health issues of interest, and data from qualitative, quantitative and mixed-methods studies will be extracted with a customised data extraction form. A narrative synthesis will be performed according to Economic and Social Research Council guidance from Popay, J, 2006.The study protocol follows the recommendations by the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). ETHICS AND DISSEMINATION Formal ethical approval is not required for this study, as no primary data will be collected. Dissemination will involve publishing results of this study in relevant peer-reviewed journal(s). Where possible, the study results will also be presented as posters or talks at relevant medical conferences and meetings. PROSPERO REGISTRATION NUMBER CRD42019124704.
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Affiliation(s)
- Becky McCall
- Institute of Health Informatics, University College London, London, UK
| | - Laura Shallcross
- Institute of Health Informatics, University College London, London, UK
| | - Michael Wilson
- School of the Arts, English and Drama, University of Loughborough, Loughborough, UK
| | | | - Andrew Hayward
- Institute of Epidemiology and Health, University College London, London, UK
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20
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Hurtado-de-Mendoza A, Graves KD, Gómez-Trillos S, Carrera P, Campos C, Anderson L, Luta G, Peshkin BN, Schwartz MD, Cupertino AP, Gonzalez N, Sheppard VB. Culturally Targeted Video Improves Psychosocial Outcomes in Latina Women at Risk of Hereditary Breast and Ovarian Cancer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4793. [PMID: 31795362 PMCID: PMC6926842 DOI: 10.3390/ijerph16234793] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 11/21/2019] [Accepted: 11/23/2019] [Indexed: 12/17/2022]
Abstract
Latina women at risk of hereditary breast and ovarian cancer (HBOC) have lower awareness, knowledge, and use of genetic counseling and testing services (GCT) than non-Latina Whites. Few interventions have been developed to reduce these disparities among at-risk Latinas. This pilot study assessed the impact of a culturally targeted narrative video developed by our team. The study included 40 Latina immigrants living in the United States who were at risk of HBOC, including affected and unaffected women. We assessed pre-post differences in psychosocial outcomes. Participants were 47.35 years old on average (SD = 9.48). Most (70%) were unaffected with cancer, had an annual income of $40,000 or less (65%), an education of High School or less (62.5%), and were uninsured (77.5%). The video significantly enhanced knowledge (p < 0.001), positive attitudes (p < 0.05), anticipatory positive emotions (p < 0.05), and intentions to participate in counseling (p < 0.001). Importantly, the video also significantly reduced negative attitudes (p < 0.05), and attitudinal ambivalence (p < 0.001). The culturally targeted video shows preliminary evidence in improving psychosocial outcomes related to GCT uptake in Latinas at risk for HBOC. This intervention is a promising easily-disseminable strategy to address disparities in GCT utilization.
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Affiliation(s)
- Alejandra Hurtado-de-Mendoza
- Department of Oncology, Georgetown University Medical Center, 3300 Whitehaven Street, Suite 4100, Washington, DC 20007, USA; (K.D.G.); (S.G.-T.); (G.L.); (B.N.P.); (M.D.S.)
- Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Genomics Research, 3300 Whitehaven Street, Suite 4100, Washington, DC 20007, USA
| | - Kristi D. Graves
- Department of Oncology, Georgetown University Medical Center, 3300 Whitehaven Street, Suite 4100, Washington, DC 20007, USA; (K.D.G.); (S.G.-T.); (G.L.); (B.N.P.); (M.D.S.)
- Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Genomics Research, 3300 Whitehaven Street, Suite 4100, Washington, DC 20007, USA
| | - Sara Gómez-Trillos
- Department of Oncology, Georgetown University Medical Center, 3300 Whitehaven Street, Suite 4100, Washington, DC 20007, USA; (K.D.G.); (S.G.-T.); (G.L.); (B.N.P.); (M.D.S.)
- Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Genomics Research, 3300 Whitehaven Street, Suite 4100, Washington, DC 20007, USA
| | - Pilar Carrera
- Department of Social Psychology and Methodology, Universidad Autónoma de Madrid, 28049 Madrid, Spain;
| | - Claudia Campos
- Nueva Vida, DC Office—801 N Pitt St., Suite 113, Alexandria, VA 22314, USA;
| | - Lyndsay Anderson
- College of Health and Human Services, School of Nursing, California State University, Sacramento, CA 95819, USA;
| | - George Luta
- Department of Oncology, Georgetown University Medical Center, 3300 Whitehaven Street, Suite 4100, Washington, DC 20007, USA; (K.D.G.); (S.G.-T.); (G.L.); (B.N.P.); (M.D.S.)
- Department of Biostatistics, Bioinformatics and Biomathematics, 4000 Reservoir Rd., NW, Washington, DC 20057, USA
| | - Beth N. Peshkin
- Department of Oncology, Georgetown University Medical Center, 3300 Whitehaven Street, Suite 4100, Washington, DC 20007, USA; (K.D.G.); (S.G.-T.); (G.L.); (B.N.P.); (M.D.S.)
- Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Genomics Research, 3300 Whitehaven Street, Suite 4100, Washington, DC 20007, USA
| | - Marc D. Schwartz
- Department of Oncology, Georgetown University Medical Center, 3300 Whitehaven Street, Suite 4100, Washington, DC 20007, USA; (K.D.G.); (S.G.-T.); (G.L.); (B.N.P.); (M.D.S.)
- Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Genomics Research, 3300 Whitehaven Street, Suite 4100, Washington, DC 20007, USA
| | - Ana-Paula Cupertino
- Cancer Prevention and Control Program, John Theurer Cancer Center, Hackensack University Medical Center, 40 Prospect Avenue, Office number 316, Hackensack, NJ 07601, USA;
| | - Nathaly Gonzalez
- Capital Breast Care Center, 1000 New Jersey Ave, SE, Washington, DC 20003, USA;
| | - Vanessa B. Sheppard
- Department of Health Behavior Policy, Virginia Commonwealth University, Richmond, VA 23298, USA;
- Massey Cancer Center, Office of Health Equity and Disparities Research, Richmond, VA 23298, USA
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21
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Hurtado-de-Mendoza A, Graves KD, Gómez-Trillos S, Song M, Anderson L, Campos C, Carrera P, Ostrove N, Peshkin BN, Schwartz MD, Ficca N, Cupertino AP, Gonzalez N, Otero A, Huerta E, Sheppard VB. Developing a culturally targeted video to enhance the use of genetic counseling in Latina women at increased risk for hereditary breast and ovarian cancer. J Community Genet 2019; 11:85-99. [PMID: 31104207 DOI: 10.1007/s12687-019-00423-w] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 04/25/2019] [Indexed: 01/28/2023] Open
Abstract
Disparities for genetic cancer risk assessment (GCRA) for hereditary breast and ovarian cancer (HBOC) persist between Latina and non-Hispanic Whites. There are few tested culturally targeted interventions. We developed a culturally targeted video to enhance GCRA uptake in at-risk Latinas. Interviews with healthcare providers (n = 20) and at-risk Latinas (n = 20) were conducted as formative research to inform the development of the video. Findings from the formative research, health behavior conceptual models, and evidence-based risk communication strategies informed the messages for the script. Then, we conducted a focus group with at-risk Latinas (n = 7) to obtain feedback for final refinement of the script. The final video was piloted for acceptability and potential dissemination in a sample of Latino community health workers (CHWs) (n = 31). Providers and at-risk Latinas suggested using simple language and visual aids to facilitate comprehension. Participants in the focus group identified areas for further clarification (e.g., cost). The result was an 18-min video that illustrates "Rosa's" story. Rosa learns about HBOC risk factors and overcomes barriers to attend genetic counseling. CHWs reported high overall satisfaction with the video (M = 9.61, SD = .88, range 1-10). A culturally targeted video has the potential to reach underserved populations with low literacy and English proficiency.
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Affiliation(s)
- Alejandra Hurtado-de-Mendoza
- Department of Oncology, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, 3300 Whitehaven Street, Suite 4100, Washington, DC, 20007, USA. .,Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Cancer Genomics, Washington, DC, USA.
| | - Kristi D Graves
- Department of Oncology, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, 3300 Whitehaven Street, Suite 4100, Washington, DC, 20007, USA.,Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Cancer Genomics, Washington, DC, USA
| | - Sara Gómez-Trillos
- Department of Oncology, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, 3300 Whitehaven Street, Suite 4100, Washington, DC, 20007, USA.,Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Cancer Genomics, Washington, DC, USA
| | - Minna Song
- Department of Oncology, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, 3300 Whitehaven Street, Suite 4100, Washington, DC, 20007, USA
| | - Lyndsay Anderson
- Department of Nursing, California State University, Sacramento, USA
| | - Claudia Campos
- Nueva Vida, DC Office-Alexandria, 206 N. Washington St. Suite 300, Alexandria, VA, 22314, USA
| | - Pilar Carrera
- Department of Psychology, Universidad Autonoma de Madrid, Madrid, Spain
| | | | - Beth N Peshkin
- Department of Oncology, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, 3300 Whitehaven Street, Suite 4100, Washington, DC, 20007, USA.,Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Cancer Genomics, Washington, DC, USA
| | - Marc D Schwartz
- Department of Oncology, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, 3300 Whitehaven Street, Suite 4100, Washington, DC, 20007, USA.,Jess and Mildred Fisher Center for Hereditary Cancer and Clinical Cancer Genomics, Washington, DC, USA
| | - Nan Ficca
- National Conservatory of Dramatic Arts, Washington, DC, USA
| | - Ana-Paula Cupertino
- Cancer Prevention and Control Program, John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ, USA
| | - Nathaly Gonzalez
- Department of Oncology, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, 3300 Whitehaven Street, Suite 4100, Washington, DC, 20007, USA.,Capital Breast Cancer Center, 1000 New Jersey Ave, SE, Washington, DC, USA
| | - Andrea Otero
- Instituto de Medicina Oncológica y Molecular de Asturias (IMOMA), Av. Richard Grandío, 33193, Oviedo (Asturias), Spain
| | - Elmer Huerta
- Cancer Preventorium, Washington Cancer Institute, MedStar Washington Hospital Center, 110 Irving St, NW, Washington, DC, USA
| | - Vanessa B Sheppard
- Department of Health Behavior Policy, Virginia Commonwealth University, Richmond, VA, USA
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22
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Woudstra AJ, Suurmond J. How narratives influence colorectal cancer screening decision making and uptake: A realist review. Health Expect 2019; 22:327-337. [PMID: 31025444 PMCID: PMC6543268 DOI: 10.1111/hex.12892] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 02/19/2019] [Accepted: 03/24/2019] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Although narratives have been found to affect decisions about preventive behaviours, including participation in cancer screening, the underlying mechanisms of narratives remain unclear. OBJECTIVE The purpose of this study was to summarize and synthesize existing literature on narrative interventions in the context of colorectal cancer screening. Our main research question was as follows: How, when and for whom do narratives work context of decision making about colorectal cancer screening participation? METHODS We undertook a realist review to collect evidence on narratives in the context of colorectal cancer screening. A search of the literature was performed in Embase, MEDLINE/PubMed, Cinahl and PsycINFO. We included empirical evaluations (qualitative or quantitative) of narrative interventions. In total, 15 studies met the inclusion criteria. A content-based taxonomy of patient narrative types in decision aids formed the basis for our initial programme theory. MAIN RESULT We identified four mechanisms: (a) process narratives that address perceived barriers towards screening lead to improved affective forecasting, (b) experience narratives that demonstrate the screening procedure lead to increased self-efficacy, (c) experience narratives that depict experiences from similar others lead to more engagement and (d) outcome narratives that focus on outcomes of colorectal cancer (CRC) screening decision decrease or increase fear of colorectal cancer. The evidence was limited on which narrative type may facilitate or bias informed decision making in colorectal cancer screening. DISCUSSION AND CONCLUSION The findings indicate the importance of more detailed descriptions of narrative interventions in order to understand how mechanisms may facilitate or bias informed decision making in colorectal cancer screening.
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Affiliation(s)
- Anke Judith Woudstra
- Department of Public Health, Amsterdam Public Health Research Institute, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Jeanine Suurmond
- Department of Public Health, Amsterdam Public Health Research Institute, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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23
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Kennedy MG, McClish D, Jones RM, Jin Y, Wilson DB, Bishop DL. Effects of an entertaining, culturally targeted narrative and an appealing expert interview on the colorectal screening intentions of African American women. JOURNAL OF COMMUNITY PSYCHOLOGY 2018; 46:925-940. [PMID: 30565740 PMCID: PMC6343673 DOI: 10.1002/jcop.21983] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 03/22/2018] [Indexed: 05/24/2023]
Abstract
Universal screening for colorectal cancer (CRC) is recommended for individuals 50-75 years of age, but screening uptake is suboptimal and African Americans have suffered persistent racial disparities in CRC incidence and deaths. We compared a culturally tailored fictional narrative and an engaging expert interview on the ability to increase intentions to be screened for CRC among African American women. In a post-only experiment, women (N = 442) in face-to-face listening groups in African American churches heard audio recordings of either a narrative or an expert interview. Questionnaires were completed immediately afterward and 30 days later. Women who heard narratives reported stronger intentions to be screened with a home stool blood test than women who heard the interview; the effect lasted at least 30 days. Culturally tailored, fictional narratives appear to be an effective persuasive strategy for reducing racial disparities in CRC outcomes.
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Affiliation(s)
| | | | - Resa M Jones
- Virginia Commonwealth University School of Medicine
| | - Yan Jin
- Virginia Commonwealth University School of Medicine
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24
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Breast and Colorectal Cancer Screening Barriers Among Immigrants and Refugees: A Mixed-Methods Study at Three Community Health Centres in Toronto, Canada. J Immigr Minor Health 2018; 21:473-482. [DOI: 10.1007/s10903-018-0779-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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25
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Gavaruzzi T, Sarlo M, Giandomenico F, Rumiati R, Polato F, De Lazzari F, Lotto L. Assessing emotions conveyed and elicited by patient narratives and their impact on intention to participate in colorectal cancer screening: A psychophysiological investigation. PLoS One 2018; 13:e0199882. [PMID: 29953535 PMCID: PMC6023155 DOI: 10.1371/journal.pone.0199882] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 06/17/2018] [Indexed: 12/22/2022] Open
Abstract
In the context of colorectal cancer screening, we aimed to compare the effectiveness of different emotion-laden narratives, to investigate the specific emotions elicited at both subjective and physiological levels, and to test the effects of emotions explicitly expressed by the narrative character. Study 1 used a between-participants design comparing four conditions: relief-based narrative, regret-based narrative, control (test-uptake only) narrative, and standard invitation material (no-narrative condition). Study 2 used a mixed design, with the narrative content as a within-participants factor and whether emotions were expressed by the narrative character or not as between-participants factor. The main outcome measures were: intention to undergo testing (Studies 1 and 2), knowledge, risk perception, proportion of informed choices (Study 1), subjective emotional responses, changes in skin conductance, heart rate, and corrugator muscle activity (Study 2). In Study 1, relative to the non-narrative condition (51%), only the relief-based narrative significantly increased intention to undergo testing (86%). Relative to the standard invitation material, the narrative conditions did not decrease knowledge, alter risk perception, or decrease the proportion of informed choices. In Study 2, the relief-based narrative elicited the lowest self-reported negative affect, and received greater implicit attention, as suggested by the larger heart rate decrease. Making the emotions experienced by the narrative character explicit decreased negative affect, as indicated by the lower skin conductance and corrugator responses during reading. Our findings provide support for the use of a relief-based narrative with emotions expressed by the character in addition to the standard information material to promote colorectal cancer screening.
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Affiliation(s)
- Teresa Gavaruzzi
- Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy
- * E-mail:
| | - Michela Sarlo
- Department of General Psychology, University of Padova, Padova, Italy
- Padova Neuroscience Center, University of Padova, Padova, Italy
| | - Francesca Giandomenico
- Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy
| | - Rino Rumiati
- Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy
| | | | | | - Lorella Lotto
- Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy
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26
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Larkey L, Del Toro-Mejías L, DiFulvio G, Gubrium A. Narrative Influences on “Desire to Act in My Community” in Digital Storytelling Workshops for Latina Teens. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2018; 38:163-167. [DOI: 10.1177/0272684x18759927] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Linda Larkey
- College of Nursing and Health Innovation, Center for Health Promotion and Disease Prevention, Arizona State University, Phoenix, AZ, USA
| | | | - Gloria DiFulvio
- Health Promotion and Policy, University of Massachusetts Amherst, MA, USA
| | - Aline Gubrium
- Health Promotion and Policy, University of Massachusetts Amherst, MA, USA
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27
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Spina M, Arndt J, Landau MJ, Cameron LD. Enhancing Health Message Framing With Metaphor and Cultural Values: Impact on Latinas' Cervical Cancer Screening. Ann Behav Med 2018; 52:106-115. [PMID: 29538628 PMCID: PMC6361230 DOI: 10.1093/abm/kax009] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Background An integration of message framing and sociocultural literature suggests that ethnic health disparities may be reduced by incorporating minority groups' cultural values into persuasive health messages. Framing messages with metaphors represents one promising strategy for harnessing cultural values to change health outcomes. Still, the effectiveness of metaphoric health messages in minority populations has received virtually no empirical attention. Purpose To fill this gap, the present study tested whether a health message using a cancer-screening metaphor targeting collectivism and familism values would engage individual differences in these values to predict Papanicolaou (Pap) smear intentions among Latinas. Methods Latina women (N = 168) completed an online survey including measures of collectivism and familism. They were randomized to read a message about Pap smears featuring the metaphor the body is a family or no metaphor before reporting their Pap smear intentions. Results Regression analyses revealed a pattern of interactions suggesting metaphoric messages engage targeted cultural values: For Latinas reading the family metaphor message, collectivism and familism positively predicted Pap smear intentions, whereas for Latinas reading the no-metaphor message, these values did not predict intentions. Conclusions This study offers a foundation for further examination of the potential for metaphoric health messages that connect to cultural values to reduce ethnic health disparities. Implications and directions for future research are discussed.
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Affiliation(s)
- Melissa Spina
- Department of Counseling, San Francisco State University, CA, USA
| | - Jamie Arndt
- Department of Psychological Sciences, University of Missouri, MO, USA
| | - Mark J Landau
- Department of Psychology, University of Kansas, KS, USA
| | - Linda D Cameron
- Psychological Sciences, University of California Merced, CA, USA
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28
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Lairson DR, Kim J, Byrd T, Salaiz R, Shokar NK. Cost-Effectiveness of Community Interventions for Colorectal Cancer Screening: Low-Income Hispanic Population. Health Promot Pract 2017; 19:863-872. [PMID: 29290126 DOI: 10.1177/1524839917750815] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To assess the cost-effectiveness of interventions to increase colorectal cancer (CRC) screening among low-income uninsured Hispanics in El Paso, Texas. METHOD Participants 50 to 75 years old who were due for screening, were uninsured, and had a Texas address were randomized to promotora, video, or promotora and video interventions. High-risk participants were offered colonoscopy, while others were offered fecal immunochemical testing. A nonintervention comparison group was recruited from a similar Texas U.S.-Mexico border county. Screening was determined at 6 months postintervention. Resources were tracked prospectively to determine cost. Incremental cost-effectiveness ratios were assessed with "intention to treat" methods. Uncertainty in the estimates was analyzed with sensitivity analysis and nonparametric bootstrap methods. RESULTS The interventions achieved screening rates of between 75% and 87% compared to 10% in the comparison group. The cost per participant ranged from $72 for group sessions to $93 for individual video sessions with video and promotora. The group video sessions cost $104 per additional person screened. CONCLUSION The CRC screening interventions were effective for increasing CRC screening. Compared to the experience in the control county, the group-based video-only intervention was the most cost-effective CRC screening promotion intervention.
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Affiliation(s)
- David R Lairson
- 1 University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Junghyun Kim
- 1 University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Theresa Byrd
- 2 Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Rebekah Salaiz
- 3 Texas Tech University Health Sciences Center, El Paso, TX, USA
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29
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Kim WS, Shin CN, Kathryn Larkey L, Roe DJ. Development and Validation of the Narrative Quality Assessment Tool. J Nurs Meas 2017; 25:171-183. [PMID: 28395707 DOI: 10.1891/1061-3749.25.1.171] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE The use of storytelling in health promotion has grown over the past 2 decades, showing promise for moving people to initiate healthy behavior change. Given the increasingly prevalent role of storytelling in health promotion research and the need to more clearly identify what storytelling elements and mediators may better predict behavior change, there is a need to develop measures to specifically assess these factors in a cultural community context. The purpose of this study is to develop and preliminarily validate a narrative quality assessment tool for measuring elements of storytelling that are predicted to affect attitude and behavior change (i.e., narrative characteristics, identification, and transportation) within a cultural community setting using a culture-centric model. METHODS Reliability and validity of these scales were assessed with repeated administrations among 74 Latino men and women with a mean age of 39.6 years (SD = 11.47 years). RESULTS The confirmatory factor analysis in addition to internal consistency tests revealed preliminary evidence for reliability and validity of the narrative characteristics, identification, and transportation scales. Cronbach's alpha ranged from .92 to .94. Items revealed adequate factor loadings (.85-.98) and good model fit. CONCLUSION The new scales provide the first step in moving the assessment of narrative quality into a culturally relevant context for evaluation of story use in health promotion. The results present valuable information for nurse researchers to guide the development and testing of culturally grounded storytelling interventions' potential to predict attitude and behavior change for patients.
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30
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Floyd TD, DuHamel KN, Rao J, Shuk E, Jandorf L. Acceptability of a Salon-Based Intervention to Promote Colonoscopy Screening Among African American Women. HEALTH EDUCATION & BEHAVIOR 2017; 44:791-804. [PMID: 28877599 DOI: 10.1177/1090198117726571] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
African American women have the highest colorectal cancer incidence and mortality rates among women of any race/ethnicity in the United States. Colonoscopy screening is an efficacious procedure for the prevention and early detection of colorectal cancer, making it a promising tool in the effort to eliminate colorectal cancer disparities. Toward that end, the present qualitative study sought to assess acceptability of and preferences for a beauty salon-based intervention to promote colonoscopy screening among African American women. A total of 11 focus groups were conducted: 6 with staff from African American-serving salons ( n = 3 with salon owners, n = 3 with salon stylists) and 5 with African American salon clients. Theory-guided focus group questions were used to explore participants' beliefs, interests, and preferences associated with the proposed intervention. Results indicated that, across all subgroups, participants were highly supportive of the idea of a salon-based intervention to promote colonoscopy screening among African American women, citing reasons such as the commonplace nature of health discussions in salons and the belief that, with proper training, stylists could effectively deliver colorectal cancer-related health information to their clients. The greatest differences between salon staff and clients were found with respect to the specifics of the intervention. Staff focused more heavily on content-related issues, such as the specific information that should be stressed in the intervention, whereas clients focused largely on process-related issues, such as the preferred intervention formats and how stylists should present themselves to clients. The findings from this study offer both encouragement and important groundwork for the development of a salon-based, stylist-delivered intervention to promote colonoscopy screening among African American women.
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Affiliation(s)
| | | | - Jessica Rao
- 3 New York City Department of Health and Mental Hygiene, Long Island City, NY, USA
| | - Elyse Shuk
- 2 Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Lina Jandorf
- 4 Icahn School of Medicine at Mount Sinai, New York, NY, USA
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31
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Wieland ML, Njeru JW, Hanza MM, Boehm DH, Singh D, Yawn BP, Patten CA, Clark MM, Weis JA, Osman A, Goodson M, Porraz Capetillo MD, Hared A, Hasley R, Guzman-Corrales L, Sandler R, Hernandez V, Novotny PJ, Sloan JA, Sia IG. Pilot Feasibility Study of a Digital Storytelling Intervention for Immigrant and Refugee Adults With Diabetes. DIABETES EDUCATOR 2017; 43:349-359. [PMID: 28592205 DOI: 10.1177/0145721717713317] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose The purpose of this pilot feasibility project was to examine the potential effectiveness of a digital storytelling intervention designed through a community-based participatory research (CBPR) approach for immigrants and refugees with type 2 diabetes mellitus (T2DM). Methods The intervention was a 12-minute culturally and linguistically tailored video consisting of an introduction, 4 stories, and a concluding educational message. A structured interview was used to assess the intervention for acceptability, interest level, and usefulness among 25 participants with T2DM (15 Latino, 10 Somali) across 5 primary care clinical sites. After watching the video, participants rated their confidence and motivation about managing T2DM as a result of the intervention. Baseline A1C and follow-up values (up to 6 months) were abstracted from medical records. Results All participants reported that the intervention got their attention, was interesting, and was useful; 96% reported that they were more confident about managing their T2DM than before they watched the video, and 92% reported that the video motivated them to change a specific behavior related to T2DM self-management. The mean baseline A1C level for the intervention participants was 9.3% (78 mmol/mol). The change from baseline to first follow-up A1C level was -0.8% (-10 mmol/mol) ( P < .05). Conclusions Implementation of a digital storytelling intervention for T2DM among immigrant populations in primary care settings is feasible and resulted in self-rated improvement in psychosocial constructs that are associated with healthy T2DM self-management behaviors, and there was some evidence of improvement in glycemic control. A large-scale efficacy trial of the intervention is warranted.
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Affiliation(s)
- Mark L Wieland
- Division of Primary Care Internal Medicine, Mayo Clinic, Rochester, Minnesota (Dr Wieland, Dr Njeru)
| | - Jane W Njeru
- Division of Primary Care Internal Medicine, Mayo Clinic, Rochester, Minnesota (Dr Wieland, Dr Njeru)
| | - Marcelo M Hanza
- Department of Development, Mayo Clinic, Rochester, Minnesota (Mr Hanza)
| | - Deborah H Boehm
- Minneapolis Medical Research Foundation, Minneapolis, Minnesota (Dr Boehm, Ms Guzman-Corrales, Dr Sandler)
| | - Davinder Singh
- Mountain Park Health Center, Phoenix, Arizona (Dr Singh, Ms Hernandez)
| | - Barbara P Yawn
- Department of Research, Olmsted Medical Center, Rochester, Minnesota (Dr Yawn)
| | - Christi A Patten
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota (Dr Patten, Dr Clark)
| | - Matthew M Clark
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota (Dr Patten, Dr Clark)
| | - Jennifer A Weis
- Department of Research Administration, Mayo Clinic, Rochester, Minnesota (Ms Weis, Ms Goodson).,Center for Clinical and Translational Science, Mayo Clinic, Rochester, Minnesota (Ms Weis)
| | - Ahmed Osman
- Somali Community Resettlement Services, Rochester, Minnesota (Mr Osman, Mr. Hared)
| | - Miriam Goodson
- Department of Research Administration, Mayo Clinic, Rochester, Minnesota (Ms Weis, Ms Goodson)
| | | | - Abdullah Hared
- Somali Community Resettlement Services, Rochester, Minnesota (Mr Osman, Mr. Hared)
| | - Rachel Hasley
- Community Health Services, Inc, Rochester, Minnesota (Ms Hasley)
| | - Laura Guzman-Corrales
- Language Services, Mayo Clinic, Rochester, Minnesota (Ms Porraz- Capetillo).,Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota (Mr Novotny, Dr Sloan).,Minneapolis Medical Research Foundation, Minneapolis, Minnesota (Dr Boehm, Ms Guzman-Corrales, Dr Sandler)
| | - Rachel Sandler
- Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota (Dr Sia).,Minneapolis Medical Research Foundation, Minneapolis, Minnesota (Dr Boehm, Ms Guzman-Corrales, Dr Sandler)
| | | | - Paul J Novotny
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota (Mr Novotny, Dr Sloan)
| | - Jeff A Sloan
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota (Mr Novotny, Dr Sloan)
| | - Irene G Sia
- Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota (Dr Sia)
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32
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Robillard A, Padi A, Lewis K, Julious C, Troutman J. Advice for prevention from HIV-positive African-American women: 'My story is not just a story'. CULTURE, HEALTH & SEXUALITY 2017; 19:630-642. [PMID: 27796161 DOI: 10.1080/13691058.2016.1243732] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Large disparities in HIV incidence, prevalence and mortality exist for African-American women, especially in the southern region of the USA. Based on the culture-centric health promotion model, HIV-positive African American women can use their stories to support primary prevention. The purpose of this study was to document advice from HIV-positive African-American women (n = 25) to young African-American women, as described in their own cultural narratives collected through qualitative interviews. Content analysis of women's advice identified five common themes revolving broadly around: (1) advice for prevention, (2) support systems for prevention, (3) education, (4) empowerment/self-care and (5) potential barriers to prevention. Advice reflected recommendations based on personal experience and highlighted social determinants linked to HIV, such as stigma, access to education and healthcare, social support, and gender and power dynamics. Women also offered advice for coping with an HIV-positive diagnosis. Communication with parents, family and friends regarding education and social support emerged as an important interpersonal factor for participants, as were interactions with sexual/romantic partners. Stigma, at the community level, was consistently discussed as a hindrance to prevention. Narratives of HIV-positive women as community health agents of change can enhance the effectiveness of HIV prevention interventions for young US African-American women.
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Affiliation(s)
- Alyssa Robillard
- a Health Promotion, Education, and Behavior , University of South Carolina, Arnold School of Public Health , Columbia , USA
| | - Akhila Padi
- a Health Promotion, Education, and Behavior , University of South Carolina, Arnold School of Public Health , Columbia , USA
| | - Kaleea Lewis
- a Health Promotion, Education, and Behavior , University of South Carolina, Arnold School of Public Health , Columbia , USA
| | - Carmen Julious
- b Palmetto AIDS Life Support Services Inc , Columbia , USA
| | - Jamie Troutman
- a Health Promotion, Education, and Behavior , University of South Carolina, Arnold School of Public Health , Columbia , USA
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33
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Lee H, Kim M, Allison J, Kiang P. Development of a theory-guided storytelling narrative intervention to improve HPV vaccination behavior: Save our daughters from cervical cancer. Appl Nurs Res 2017; 34:57-61. [PMID: 28342625 DOI: 10.1016/j.apnr.2017.02.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 02/01/2017] [Indexed: 11/16/2022]
Affiliation(s)
- Haeok Lee
- College of Nursing & Health Sciences, University of Massachusetts Boston, Boston, MA, United States.
| | - Minjin Kim
- College of Nursing & Health Sciences, University of Massachusetts Boston, Boston, MA, United States
| | - Jeroan Allison
- University of Massachusetts Medical School, Worcester, MA, United States
| | - Peter Kiang
- University of Massachusetts Boston, Boston, MA, United States
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34
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Perrier MJ, Martin Ginis KA. Narrative interventions for health screening behaviours: A systematic review. J Health Psychol 2017; 22:375-393. [PMID: 26359288 DOI: 10.1177/1359105315603463] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Health information can be presented in different formats, such as a statistically-based or a story-based (e.g. narrative) format; however, there is no consensus on the ideal way to present screening information. This systematic review summarizes the literature pertaining to narrative interventions' efficacy at changing screening behaviour and its determinants. Five psychology and public health databases were searched; 19 studies, 18 focused on cancer and 1 on sexual health, met eligibility criteria. There is consistent evidence supporting the efficacy of narratives, but mixed evidence supporting an advantage for narratives over statistical interventions for screening behaviour and its determinants. Further investigation is warranted.
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35
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Laing CM, Moules NJ, Estefan A, Lang M. Stories That Heal: Understanding the Effects of Creating Digital Stories With Pediatric and Adolescent/Young Adult Oncology Patients. J Pediatr Oncol Nurs 2017; 34:272-282. [DOI: 10.1177/1043454216688639] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The purpose of this philosophical hermeneutic study was to determine if, and understand how, digital stories might be effective therapeutic tools to use with children and adolescents/young adults (AYA) with cancer, thus helping mitigate suffering. Sixteen participants made digital stories with the help of a research assistant trained in digital storytelling and were interviewed following the completion of their stories. Findings from this research revealed that digital stories were a way to have others understand their experiences of cancer, allowed for further healing from their sometimes traumatic experiences, had unexpected therapeutic effects, and were a way to reconcile past experiences with current life. Digital stories, we conclude, show great promise with the pediatric and AYA oncology community and we believe are a way in which the psychosocial effects of cancer treatment may be addressed. Recommendations for incorporating digital stories into clinical practice and follow-up programs are offered.
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Affiliation(s)
| | | | | | - Mike Lang
- University of Calgary, Calgary, Alberta, Canada
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36
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Briant KJ, Halter A, Marchello N, Escareño M, Thompson B. The Power of Digital Storytelling as a Culturally Relevant Health Promotion Tool. Health Promot Pract 2016; 17:793-801. [PMID: 27402721 DOI: 10.1177/1524839916658023] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Digital storytelling is an emergent method in health promotion. It addresses health inequities by combining technology with the voices of members of vulnerable, often underrepresented populations. The overall goal of this pilot project was to explore if digital storytelling could be a culturally relevant health promotion tool for Hispanics/Latinos to share their experiences with cancer, or other diseases. Promotores participated in a train-the-trainer workshop. Community members worked with trained promotores to create digital stories through community workshops. We conducted one-on-one interviews with digital story creators to elicit perspectives and assess their experience. One overarching theme among storytellers was the power of storytelling. Supporting subthemes that emerged in the interviews were (1) connection and communication, (2) lack of opportunities and barriers to telling stories, and (3) potential for disease prevention awareness and education. This study found digital storytelling to be culturally relevant for Hispanics/Latinos of Mexican origin. For these storytellers it was a uniquely valuable tool for sharing personal stories of overcoming or managing health issues. Participants found the digital story experience to be positive and beneficial. It provided a healing outlet to reflect on a difficult experience and find support within one's own community.
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Affiliation(s)
| | - Amy Halter
- University of Washington, Seattle, WA, USA
| | | | | | - Beti Thompson
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA University of Washington, Seattle, WA, USA
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37
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Perrier MJ, Martin Ginis KA. Changing health-promoting behaviours through narrative interventions: A systematic review. J Health Psychol 2016; 23:1499-1517. [PMID: 27387514 DOI: 10.1177/1359105316656243] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The objective of this review was to summarize the literature supporting narrative interventions that target health-promoting behaviours. Eligible articles were English-language peer-reviewed studies that quantitatively reported the results of a narrative intervention targeting health-promoting behaviours or theoretical determinants of behaviour. Five public health and psychology databases were searched. A total of 52 studies met inclusion criteria. In all, 14 studies found positive changes in health-promoting behaviours after exposure to a narrative intervention. The results for the changes in theoretical determinants were mixed. While narrative appears to be a promising intervention strategy, more research is needed to determine how and when to use these interventions.
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Cawkwell PB, Oshinsky D. Storytelling in the context of vaccine refusal: a strategy to improve communication and immunisation. MEDICAL HUMANITIES 2016; 42:31-35. [PMID: 26438615 DOI: 10.1136/medhum-2015-010761] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/14/2015] [Indexed: 06/05/2023]
Abstract
The December 2014 outbreak of measles in California impacted over 100 children and served as a reminder that this disease still plagues the USA, even 50 years following the first licensed vaccine. Refusal of vaccination is a complicated and multifaceted issue, one that clearly demands a closer look by paediatricians and public health officials alike. While medical doctors and scientists are trained to practice 'evidence-based medicine', and studies of vaccine safety and efficacy speak the language of statistics, there is reason to believe that this is not the most effective strategy for communicating with all groups of parents. Herein, we consider other methods such as narrative practices that employ stories and appeal more directly to parents. We also examine how doctors are trained to disseminate information and whether there are reasonable supplementary methods that could be used to improve vaccine communication and ultimately immunisation rates.
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Affiliation(s)
- Philip B Cawkwell
- Division of Medical Humanities, Department of Medicine, New York University School of Medicine, New York, New York, USA
| | - David Oshinsky
- Division of Medical Humanities, Department of Medicine, New York University School of Medicine, New York, New York, USA
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Gardner L, Leshner G. The Role of Narrative and Other-Referencing in Attenuating Psychological Reactance to Diabetes Self-Care Messages. HEALTH COMMUNICATION 2015; 31:738-751. [PMID: 26528578 DOI: 10.1080/10410236.2014.993498] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This study charts pathways through message resistance to enhance the persuasiveness of diabetes self-care messages. A 2 (narrative) × 2 (other-referencing) × 2 (message) × 4 (order) experiment with adult diabetics (N = 58) tested whether packaging overt recommendations as a story rather than an informational argument (i.e., narrative structure) and highlighting the impact of health decisions on family and friends rather than the individual (i.e., other-referencing) can effectively attenuate psychological reactance to messages encouraging healthy diet and physical activity. Narrative and other-referencing each led to lower perceived threat to choice, less state anger and counterarguing, less negative cognitive responses, more positive attitudes toward the ad and the behaviors promoted, and greater intended compliance with message recommendations. Findings illustrate two strategies that communicators may employ in order to benefit from clear, direct health messages while avoiding the reactance they may provoke. Moreover, findings inform message design for diabetes self-care education.
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Affiliation(s)
| | - Glenn Leshner
- b Gaylord College of Journalism & Mass Communication , University of Oklahoma
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Characterization of the Hispanic or latino population in health research: a systematic review. J Immigr Minor Health 2015; 16:429-39. [PMID: 23315046 DOI: 10.1007/s10903-013-9773-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The size and diversity of the Hispanic population in the United States has dramatically increased, with vast implications for health research. We conducted a systematic review of the characterization of the Hispanic population in health research and described its implications. Relevant studies were identified by searches of PubMed, Embase Scopus, and Science/Social Sciences Citation Index from 2000 to 2011. 131 articles met criteria. 56% of the articles reported only "Hispanic" or "Latino" as the characteristic of the Hispanic research population while no other characteristics were reported. 29% of the articles reported language, 27% detailed country of origin and 2% provided the breakdown of race. There is great inconsistency in reported characteristics of Hispanics in health research. The lack of detailed characterization of this population ultimately creates roadblocks in translating evidence into practice when providing care to the large and increasingly diverse Hispanic population in the US.
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Goddu AP, Raffel KE, Peek ME. A story of change: The influence of narrative on African-Americans with diabetes. PATIENT EDUCATION AND COUNSELING 2015; 98:1017-24. [PMID: 25986500 PMCID: PMC4492448 DOI: 10.1016/j.pec.2015.03.022] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 03/24/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To understand if narratives can be effective tools for diabetes empowerment, from the perspective of African-American participants in a program that improved diabetes self-efficacy and self-management. METHODS In-depth interviews and focus groups were conducted with program graduates. Participants were asked to comment on the program's film, storytelling, and role-play, and whether those narratives had contributed to their diabetes behavior change. An iterative process of coding, analyzing, and summarizing transcripts was completed using the framework approach. RESULTS African-American adults (n=36) with diabetes reported that narratives positively influenced the diabetes behavior change they had experienced by improving their attitudes/beliefs while increasing their knowledge/skills. The social proliferation of narrative - discussing stories, rehearsing their messages with role-play, and building social support through storytelling - was reported as especially influential. CONCLUSION Utilizing narratives in group settings may facilitate health behavior change, particularly in minority communities with traditions of storytelling. Theoretical models explaining narrative's effect on behavior change should consider the social context of narratives. PRACTICE IMPLICATIONS Narratives may be promising tools to promote diabetes empowerment. Interventions using narratives may be more effective if they include group time to discuss and rehearse the stories presented, and if they foster an environment conducive to social support among participants.
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Affiliation(s)
- Anna P Goddu
- Department of Medicine, University of Chicago, Chicago, USA; Center for Health and the Social Sciences, University of Chicago, Chicago, USA; Chicago Center for Diabetes Translation Research, Chicago, USA
| | - Katie E Raffel
- Pritzker School of Medicine, University of Chicago, Chicago, USA
| | - Monica E Peek
- Department of Medicine, University of Chicago, Chicago, USA; Center for Health and the Social Sciences, University of Chicago, Chicago, USA; Chicago Center for Diabetes Translation Research, Chicago, USA; Center for the Study of Race, Politics and Culture, University of Chicago, Chicago, USA.
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Hennelly MO, Sly JR, Villagra C, Jandorf L. Narrative message targets within the decision-making process to undergo screening colonoscopy among Latinos: a qualitative study. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2015; 30:268-276. [PMID: 25516413 DOI: 10.1007/s13187-014-0765-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Colorectal cancer (CRC) is a preventable yet leading cause of cancer mortality among Latinos in the USA. Cultural targeting and narrative messaging are two strategies to increase the low screening colonoscopy rates among Latinos. This study identifies key messages for educational interventions aiming to increase screening colonoscopy used among Latinos and proposes a model to understand the relationship between factors involved in colonoscopy decision-making. Individual in-depth interviews were conducted with 12 Latino participants primarily of Puerto Rican descent on the topics of CRC knowledge, barriers and facilitators to colonoscopy use, and the use of narrative in colorectal health messaging. Knowledge about colorectal anatomy and the anesthesia component of colonoscopy procedure is low. Fear of procedure-related pain and fear of treatment-related burden following a cancer diagnosis are significant barriers to colonoscopy. Fear of disease-related suffering and death following a cancer diagnosis and fear of regret are strong facilitators and can be augmented by cancer narratives. Storytelling is commonly used in Latino culture and is an acceptable method to educate the Latino community about CRC screening via colonoscopy. Machismo is a unique barrier to colonoscopy for Latino men via homophobia and reluctance to seek healthcare. A preliminary model to understand factors in colonoscopy decision-making among Latinos is presented. Counseling practices and educational interventions that use culturally targeted narrative health messaging to mediate fears and increase colonoscopy knowledge may increase screening colonoscopy use among Latinos.
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Affiliation(s)
- Marie Oliva Hennelly
- Department of Oncological Sciences, Division of Cancer Prevention and Control, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1130, New York, NY, 10029, USA,
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Murphy ST, Frank LB, Chatterjee JS, Moran MB, Zhao N, Amezola de Herrera P, Baezconde-Garbanati LA. Comparing the Relative Efficacy of Narrative vs Nonnarrative Health Messages in Reducing Health Disparities Using a Randomized Trial. Am J Public Health 2015; 105:2117-23. [PMID: 25905845 DOI: 10.2105/ajph.2014.302332] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We compared the relative efficacy of a fictional narrative film to a more traditional nonnarrative film in conveying the same health information. METHODS We used a random digit dial procedure to survey the cervical cancer-related knowledge, attitudes, and behavior of non-Hispanic White, Mexican American, and African American women, aged 25 to 45 years, living in Los Angeles, California, from 2011 to 2012. Participants (n = 704) were randomly assigned to view either a narrative or nonnarrative film containing the same information about how cervical cancer could be prevented or detected, and they were re-contacted 2 weeks and 6 months later. RESULTS At 2 weeks, both films produced a significant increase in cervical cancer-related knowledge and attitudes, but these effects were significantly higher for the narrative film. At 6 months, viewers of both films retained greater than baseline knowledge and more positive attitudes toward Papanicolaou (Pap) tests, but women who saw the narrative were significantly more likely to have had or scheduled a Pap test. The narrative was particularly effective for Mexican American women, eliminating cervical cancer screening disparities found at baseline. CONCLUSIONS Narratives might prove to be a useful tool for reducing health disparities.
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Affiliation(s)
- Sheila T Murphy
- Sheila T. Murphy, Joyee S. Chatterjee, Nan Zhao, and Paula Amezola de Herrera are with the Annenberg School for Communication and Journalism, University of Southern California, Los Angeles. Lauren B. Frank is with the Department of Communication, Portland State University, Portland, OR. Meghan B. Moran is with the Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Lourdes A. Baezconde-Garbanati is with the Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California
| | - Lauren B Frank
- Sheila T. Murphy, Joyee S. Chatterjee, Nan Zhao, and Paula Amezola de Herrera are with the Annenberg School for Communication and Journalism, University of Southern California, Los Angeles. Lauren B. Frank is with the Department of Communication, Portland State University, Portland, OR. Meghan B. Moran is with the Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Lourdes A. Baezconde-Garbanati is with the Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California
| | - Joyee S Chatterjee
- Sheila T. Murphy, Joyee S. Chatterjee, Nan Zhao, and Paula Amezola de Herrera are with the Annenberg School for Communication and Journalism, University of Southern California, Los Angeles. Lauren B. Frank is with the Department of Communication, Portland State University, Portland, OR. Meghan B. Moran is with the Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Lourdes A. Baezconde-Garbanati is with the Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California
| | - Meghan B Moran
- Sheila T. Murphy, Joyee S. Chatterjee, Nan Zhao, and Paula Amezola de Herrera are with the Annenberg School for Communication and Journalism, University of Southern California, Los Angeles. Lauren B. Frank is with the Department of Communication, Portland State University, Portland, OR. Meghan B. Moran is with the Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Lourdes A. Baezconde-Garbanati is with the Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California
| | - Nan Zhao
- Sheila T. Murphy, Joyee S. Chatterjee, Nan Zhao, and Paula Amezola de Herrera are with the Annenberg School for Communication and Journalism, University of Southern California, Los Angeles. Lauren B. Frank is with the Department of Communication, Portland State University, Portland, OR. Meghan B. Moran is with the Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Lourdes A. Baezconde-Garbanati is with the Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California
| | - Paula Amezola de Herrera
- Sheila T. Murphy, Joyee S. Chatterjee, Nan Zhao, and Paula Amezola de Herrera are with the Annenberg School for Communication and Journalism, University of Southern California, Los Angeles. Lauren B. Frank is with the Department of Communication, Portland State University, Portland, OR. Meghan B. Moran is with the Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Lourdes A. Baezconde-Garbanati is with the Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California
| | - Lourdes A Baezconde-Garbanati
- Sheila T. Murphy, Joyee S. Chatterjee, Nan Zhao, and Paula Amezola de Herrera are with the Annenberg School for Communication and Journalism, University of Southern California, Los Angeles. Lauren B. Frank is with the Department of Communication, Portland State University, Portland, OR. Meghan B. Moran is with the Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Lourdes A. Baezconde-Garbanati is with the Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California
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Larkey LK, McClain D, Roe DJ, Hector RD, Lopez AM, Sillanpaa B, Gonzalez J. Randomized controlled trial of storytelling compared to a personal risk tool intervention on colorectal cancer screening in low-income patients. Am J Health Promot 2015; 30:e59-70. [PMID: 25615708 DOI: 10.4278/ajhp.131111-quan-572] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
PURPOSE Screening rates for colorectal cancer (CRC) lag for low-income, minority populations, contributing to poorer survival rates. A model of storytelling as culture-centric health promotion was tested for promoting CRC screening. DESIGN A two-group parallel randomized controlled trial. SETTING Primary care, safety-net clinics. SUBJECTS Low-income patients due for CRC screening, ages 50 to 75 years, speaking English or Spanish. INTERVENTION Patients were exposed to either a video created from personal stories composited into a drama about "Papa" receiving CRC screening, or an instrument estimating level of personal cancer risk. Patients received a health care provider referral for CRC screening and were followed up for 3 months to document adherence. MEASURES Behavioral factors related to the narrative model (identification and engagement) and theory of planned behavior. ANALYSIS Main effects of the interventions on screening were tested, controlling for attrition factors, and demographic factor associations were assessed. Path analysis with model variables was used to test the direct effects and multiple mediator models. RESULTS Main effects on CRC screening (roughly half stool-based tests, half colonoscopy) did not indicate significant differences (37% and 42% screened for storytelling and risk-based messages, respectively; n = 539; 33.6% male; 62% Hispanic). Factors positively associated with CRC screening included being female, Hispanic, married or living with a partner, speaking Spanish, having a primary care provider, lower income, and no health insurance. Engagement, working through positive attitudes toward the behavior, predicted CRC screening. CONCLUSION A storytelling and a personalized risk-tool intervention achieved similar levels of screening among unscreened/underscreened, low-income patients. Factors usually associated with lower rates of screening (e.g., no insurance, being Hispanic) were related to more adherence. Both interventions' engagement factor facilitated positive attitudes about CRC screening associated with behavior change.
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Baezconde-Garbanati LA, Chatterjee JS, Frank LB, Murphy ST, Moran MB, Werth LN, Zhao N, Amezola de Herrera P, Mayer D, Kagan J, O'Brien D. Tamale Lesson: A case study of a narrative health communication intervention. ACTA ACUST UNITED AC 2014. [DOI: 10.1179/1753807614y.0000000055] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Palacios JF, Salem B, Hodge FS, Albarrán CR, Anaebere A, Hayes-Bautista TM. Storytelling: A Qualitative Tool to Promote Health Among Vulnerable Populations. J Transcult Nurs 2014; 26:346-53. [PMID: 24829264 DOI: 10.1177/1043659614524253] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Storytelling is a basic cultural phenomenon that has recently been recognized as a valuable method for collecting research data and developing multidisciplinary interventions. The purpose of this article is to present a collection of nursing scholarship wherein the concept of storytelling, underpinned by cultural phenomena, is explored for data collection and intervention. A conceptual analysis of storytelling reveals key variables. Following a brief review of current research focused on storytelling used within health care, three case studies among three vulnerable populations (American Indian teen mothers, American Indian cancer survivors, and African American women at risk for HIV/AIDS) demonstrate the uses of storytelling for data collection and intervention. Implications for transcultural nursing regarding storytelling are discussed.
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Affiliation(s)
| | - Benissa Salem
- University of California-Los Angeles, School of Nursing CA, USA
| | | | | | - Ann Anaebere
- University of California-Los Angeles, School of Nursing CA, USA
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Development of a post-intensive care unit storytelling intervention for surrogates involved in decisions to limit life-sustaining treatment. Palliat Support Care 2014; 13:451-63. [PMID: 24524736 DOI: 10.1017/s1478951513001211] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Surrogates involved in decisions to limit life-sustaining treatment for a loved one in the intensive care unit (ICU) are at increased risk for adverse psychological outcomes that can last for months to years after the ICU experience. Post-ICU interventions to reduce surrogate distress have not yet been developed. We sought to (1) describe a conceptual framework underlying the beneficial mental health effects of storytelling, and (2) present formative work developing a storytelling intervention to reduce distress for recently bereaved surrogates. METHOD An interdisciplinary team conceived the idea for a storytelling intervention based on evidence from narrative theory that storytelling reduces distress from traumatic events through emotional disclosure, cognitive processing, and social connection. We developed an initial storytelling guide based on this theory and the clinical perspectives of team members. We then conducted a case series with recently bereaved surrogates to iteratively test and modify the guide. RESULTS The storytelling guide covered three key domains of the surrogate's experience of the patient's illness and death: antecedents, ICU experience, and aftermath. The facilitator focused on the parts of a story that appeared to generate strong emotions and used nonjudgmental statements to attend to these emotions. Between September 2012 and May 2013, we identified 28 eligible surrogates from a medical ICU and consented 20 for medical record review and recontact; 10 became eligible, of whom 6 consented and completed the storytelling intervention. The single-session storytelling intervention lasted from 40 to 92 minutes. All storytelling participants endorsed the intervention as acceptable, and five of six reported it as helpful. SIGNIFICANCE OF RESULTS Surrogate storytelling is an innovative and acceptable post-ICU intervention for recently bereaved surrogates and should be evaluated further.
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Unger JB, Cabassa LJ, Molina GB, Contreras S, Baron M. Evaluation of a fotonovela to increase depression knowledge and reduce stigma among Hispanic adults. J Immigr Minor Health 2014; 15:398-406. [PMID: 22485012 DOI: 10.1007/s10903-012-9623-5] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Fotonovelas-small booklets that portray a dramatic story using photographs and captions-represent a powerful health education tool for low-literacy and ethnic minority audiences. This study evaluated the effectiveness of a depression fotonovela in increasing depression knowledge, decreasing stigma, increasing self-efficacy to recognize depression, and increasing intentions to seek treatment, relative to a text pamphlet. Hispanic adults attending a community adult school (N = 157, 47.5 % female, mean age = 35.8 years, 84 % immigrants, 63 % with less than high school education) were randomly assigned to read the fotonovela or a low-literacy text pamphlet about depression. They completed surveys before reading the material, immediately after reading the material, and 1 month later. The fotonovela and text pamphlet both produced significant improvements in depression knowledge and self-efficacy to identify depression, but the fotonovela produced significantly larger reductions in antidepressant stigma and mental health care stigma. The fotonovela also was more likely to be passed on to family or friends after the study, potentially increasing its reach throughout the community. Results indicate that fotonovelas can be useful for improving health literacy among underserved populations, which could reduce health disparities.
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Affiliation(s)
- Jennifer B Unger
- Institute for Health Promotion and Disease Prevention Research, University of Southern California Keck School of Medicine, 2001N Soto Street, MC 9239, Los Angeles, CA 90089-9239, USA.
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Hausärztliche Prävention zwischen Evidenz und Narration - Eine Quadratur des Kreises? ZEITSCHRIFT FUR EVIDENZ FORTBILDUNG UND QUALITAET IM GESUNDHEITSWESEN 2014; 108:203-7. [DOI: 10.1016/j.zefq.2014.03.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Revised: 02/28/2014] [Accepted: 03/21/2014] [Indexed: 11/18/2022]
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Comparing tailored and narrative worksite interventions at increasing colonoscopy adherence in adults 50-75: a randomized controlled trial. Soc Sci Med 2013; 104:31-40. [PMID: 24581059 DOI: 10.1016/j.socscimed.2013.12.003] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Revised: 10/25/2013] [Accepted: 12/04/2013] [Indexed: 02/07/2023]
Abstract
Research has identified several communication strategies that could increase adherence to colorectal cancer screening recommendations. Two promising strategies are tailoring and narrative-based approaches. Tailoring is the personalization of information based on individual characteristics. Narrative-based approaches use stories about similar others to counter perceived barriers and cultivate self-efficacy. To compare these two approaches, a randomized controlled trial was carried out at 8 worksites in Indiana. Adults 50-75 (N = 209) received one of four messages about colorectal cancer screening: stock, narrative, tailored, tailored narrative. The primary outcome was whether participants filed a colonoscopy claim in the 18 months following the intervention. Individuals receiving narrative messages were 4 times more likely to screen than those not receiving narrative messages. Tailoring did not increase screening behavior overall. However, individuals with higher cancer information overload were 8 times more likely to screen if they received tailored messages. The results suggest that narrative-based approaches are more effective than tailoring at increasing colorectal cancer screening in worksite interventions. Tailoring may be valuable as a strategy for reaching individuals with high overload, perhaps as a follow-up effort to a larger communication campaign.
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