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Wieland ML, Vickery KD, Hernandez V, Ford BR, Gonzalez C, Kavistan S, Iteghete S, Patten CA, Njeru JW, Lohr AM, O’Byrne J, Novotny PJ, Singh DP, Larkey LK, Goodson M, Capetillo GP, Sia IG. Digital Storytelling Intervention for Hemoglobin A1c Control Among Hispanic Adults With Type 2 Diabetes: A Randomized Clinical Trial. JAMA Netw Open 2024; 7:e2424781. [PMID: 39093566 PMCID: PMC11297376 DOI: 10.1001/jamanetworkopen.2024.24781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 05/30/2024] [Indexed: 08/04/2024] Open
Abstract
Importance Hispanic adults with type 2 diabetes (T2D) are more likely to develop complications and die from the disease than the US general population. Digital storytelling interventions are narrative-based videos elicited through a community-based participatory research approach to surface the authentic voices of participants overcoming obstacles to health-promoting behaviors that perpetuate health inequities; research on the effect of digital storytelling on T2D outcomes among Hispanic adults is lacking. Objective To assess the impact of a digital storytelling intervention on glycemic control and its acceptability among Hispanic patients with poorly controlled T2D. Design, Setting, and Participants This was a multicenter, randomized clinical trial conducted within 2 primary care networks in Minnesota and Arizona among Hispanic adults with poorly controlled T2D (hemoglobin A1c level ≥8%). Enrollment and follow-up were conducted between February 14, 2019, and November 1, 2023. Intervention The intervention group viewed a 12-minute digital storytelling video. The video included 4 Spanish-language stories that reinforced 4 diabetes self-management behavioral goals (healthful diet for diabetes, physical activity, medication adherence, and glucose self-monitoring). The control group received printed, culturally tailored T2D education materials. Main Outcomes and Measures The primary outcome was the mean change from baseline to 3 months for hemoglobin A1c levels, adjusting for baseline hemoglobin A1c, age, gender, education, and income. Acceptability and narrative quality of the intervention were assessed through questionnaires. Results There were 451 study participants, with 227 (mean [SD] age, 54.3 [9.3] years; 158 [69.3%] women) randomized to the intervention group and 224 (mean [SD] age, 54.5 [9.1] years; 156 [69.3%] women) to the control group. Of these, 390 completed 3-month follow-up of the primary outcome (86% retention). There was a small improvement in the mean (SD) hemoglobin A1c level in the intervention group compared with the control group in the adjusted model (9.1% [1.7] to 8.4% [1.6] vs 9.4% [1.8] to 8.8% [2.0]; P = .04] but not in the unadjusted model. Acceptability and narrative quality of the intervention were high. Conclusions and Relevance In this randomized clinical trial, a digital storytelling intervention developed with and for Hispanic adults with T2D was highly acceptable and feasibly implemented within primary care settings and resulted in a modest improvement of glycemic control. This was a highly scalable intervention that may be integrated into clinical practice as part of a longitudinal diabetes self-management program for Hispanic adults. Trial Registration ClinicalTrials.gov Identifier: NCT03766438.
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Affiliation(s)
- Mark L. Wieland
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, Minnesota
| | - Katherine Diaz Vickery
- Health, Homelessness & Criminal Justice Lab, Hennepin Healthcare Research Institute, Minneapolis, Minnesota
| | | | - Becky R. Ford
- Health, Homelessness & Criminal Justice Lab, Hennepin Healthcare Research Institute, Minneapolis, Minnesota
| | | | | | | | - Christi A. Patten
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - Jane W. Njeru
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, Minnesota
| | - Abby M. Lohr
- Division of Epidemiology, Mayo Clinic, Rochester, Minnesota
| | - Jamie O’Byrne
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota
| | - Paul J. Novotny
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota
| | | | - Linda K. Larkey
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix
| | - Miriam Goodson
- Alliance of Chicanos, Hispanics, and Latin Americans, Rochester, Minnesota
| | | | - Irene G. Sia
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, Minnesota
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Lee H, Mtengezo JT, Makin MS, Shi L, Malata A, Fitzpatrick J, Ngoma J, Zhang L, Larkey L, Stuart-Shor E, Mlombe Y, Kim D. Mobile health-delivered narrative intervention to increase cervical cancer screening among Malawian women living with HIV: A pilot randomized controlled trial. Asia Pac J Oncol Nurs 2024; 11:100448. [PMID: 38784066 PMCID: PMC11111816 DOI: 10.1016/j.apjon.2024.100448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 03/18/2024] [Indexed: 05/25/2024] Open
Abstract
Objective This study aimed to develop and evaluate a mobile health (mHealth)-delivered, theory-guided, culturally tailored storytelling narrative (STN) intervention to increase cervical cancer screening among Malawian women living with human immunodeficiency virus (HIV). Methods This study involved two phases: Phase 1: development of a theory-guided and culturally adapted STN intervention and Phase 2: a pilot randomized controlled trial was conducted. Participants were randomly assigned to one of three arms: Arm 1: tablet-based video (mHealth) with STN (n = 60); Arm 2: mHealth with a video of nonnarrative educational materials (n = 59); and Arm 3: control group with only reading nonnarrative educational materials in person (n = 60). Cervical cancer screening was measured using visual inspection with acetic acid (VIA) uptakes by self-report and health passport record review at 2 and 6 months after intervention. Results Both arms 1 and 2 had nearly twice the rate of VIA uptakes than those in Arm 3 (51.0% and 50.0%, respectively, vs. 35.0%, P = 0.01) at 2 months follow-up, but there were no differences among groups from 2- to 6-month follow-ups. All groups demonstrated significant improvement of knowledge about risk factors, intention, and VIA uptakes. Conclusions The findings demonstrate the preliminary effectiveness of the intervention on cervical cancer screening behavior and the feasibility of the study regarding recruitment, retention, treatment fidelity, and acceptability of the single 30-min session. The feasibility and the preliminary results of the effectiveness of the proposed study indicate scaling up the STN intervention to a larger population of women to increase cervical cancer screening uptake to prevent deaths due to cervical cancer in Malawi.
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Affiliation(s)
- Haeok Lee
- Rory Meyers College of Nursing, New York University, New York City, NY, USA
| | | | | | - Ling Shi
- Manning Colleges of Nursing and Health Sciences, University of Massachusetts Boston, Boston, USA
| | - Address Malata
- Malawi University of Science and Technology, Thylolo, Malawi
| | | | | | - Lingling Zhang
- Manning Colleges of Nursing and Health Sciences, University of Massachusetts Boston, Boston, USA
| | - Linda Larkey
- College of Nursing and Health Innovation, Arizona State University, Phoenix, USA
| | - Eileen Stuart-Shor
- Manning Colleges of Nursing and Health Sciences, University of Massachusetts Boston, Boston, USA
| | - Yohannie Mlombe
- Hematology Unit, Pathology Department, School of Medicine and Oral Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Deogwoon Kim
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, USA
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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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Dudley MZ, Squires GK, Petroske TM, Dawson S, Brewer J. The Use of Narrative in Science and Health Communication: A Scoping Review. PATIENT EDUCATION AND COUNSELING 2023; 112:107752. [PMID: 37068426 DOI: 10.1016/j.pec.2023.107752] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 04/08/2023] [Accepted: 04/11/2023] [Indexed: 05/09/2023]
Abstract
BACKGROUND Many people deny science and reject health recommendations despite widely distributed facts and statistics. Didactic science and health communication is often dry, and relies on the false assumption that people make purely evidence-based decisions. Stories can be a powerful teaching tool by capturing attention and evoking emotion. OBJECTIVE We explore the impact and appeal of, and describe best practices for, using narrative (storytelling) versus didactic methods in science and health communication. PATIENT INVOLVEMENT No patients were involved in the review process. METHODS We searched PubMed and Web of Science for articles either: assessing effectiveness of narrative science/health communication; assessing acceptability of (or preference for) narrative science/health communication; giving advice on how best to use narrative; and/or providing science-based explanations for how/why narrative succeeds. RESULTS Narrative science/health communication is effective and appealing for audiences across a variety of topics and mediums, with supporting evidence across fields such as epidemiology, neuroscience, and psychology. Whether narrative or didactic messaging is most effective depends on the topic, audience, and objective, as well as message quality. However, combining narrative with didactic methods is likely to be more effective than using either strategy alone. DISCUSSION Narrative science/health communication merits wider implementation and further research. Narrative communication creates openness to information by delaying the formulation of counterarguments. PRACTICAL VALUE Science and health communicators should collaborate with cultural and storytelling experts, work directly with their target audiences throughout the message development and testing processes, and rely on popular story elements (e.g., first-person point of view, relatable protagonists) to improve the comprehension, engagement, and thoughtful consideration of their intended audience. FUNDING This work was funded by Thirty Meter Telescope, with which two authors (GKS and SD) were affiliated. Otherwise, the funding organization had no role in the study and/or submission.
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Affiliation(s)
- Matthew Z Dudley
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, w5041, Baltimore, MD 21205, USA; Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, w5041, Baltimore, MD 21205, USA.
| | - Gordon K Squires
- California Institute of Technology / IPAC, 1200 E California Blvd, 315 Keith Spalding, Pasadena, CA 91125, USA
| | | | - Sandra Dawson
- Thirty Meter Telescope International Observatory, Pasadena, CA, USA
| | - Janesse Brewer
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, w5041, Baltimore, MD 21205, USA; Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, w5041, Baltimore, MD 21205, USA
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Larkey L, Szalacha LA, Bucho-Gonzalez J, Menon U. Recruitment Challenges of a Colorectal Cancer Screening Dissemination Study. Nurs Res 2023; 72:E8-E15. [PMID: 36287144 DOI: 10.1097/nnr.0000000000000630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Dissemination strategies to reach underserved and minority populations to promote screening for colorectal cancer (CRC) are key to reducing disparities. We conducted a study to examine a tailored messaging approach to navigate individuals from communities (i.e., lower income, less access to care, and underscreened) to clinics to receive CRC screening. We encountered several political, demographic, and secular trend issues that required reconsideration and redesign of implementation strategies. OBJECTIVES Through study implementation from 2012 to 2017, changes in medical reimbursement and immigration policies-at the state level and later at the national level-affected healthcare delivery systems that had initially committed to supporting the study and our recruitment methods. Although our selected zip codes and sites had previously yielded high rates of CRC screening nonadherence, within a few years, these sites showed substantially higher screening adherence rates-yielding limited numbers of eligible participants. In addition, state immigration policy trends created mistrust and fear, leading to lower participation rates than anticipated. This report documents and provides valuable insights on how we and the community network developed creative strategies to overcome these challenges. METHODS New relationships with community partners were extended to tap advisory board input to meet the challenges. Criteria for clinic participation widened from originally selected Federally Qualified Health Centers (FQHCs) to various nonprofit, hybrid, and privately insured reimbursement types. Recruitment site options were creatively redefined to reach community participants where they live, work, and receive services. RESULTS Strategies that engage community members in identifying alternative healthcare delivery structures and that link recruitment efforts to community-based service organizations were found to be critical to recapturing community trust in the face of unfavorable political environments. Widening the type of clinic partners from FQHCs to stand-alone nonprofits and private clinics and identifying unusual types of recruitment sites provided alternative solutions for successful study implementation. DISCUSSION In prevention-based studies that face unplanned system and political barriers to recruitment, embedding the study in the community may aid in reestablishing trust levels to improve engagement and recruitment of clinic partners and eligible participants.
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Kim WS, Langer S, Todd M, Larkey L, Jo S, Bangerter LR, Khera N. Feasibility of a Digital Storytelling Intervention for Hematopoietic Cell Transplant Patients. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:1275-1285. [PMID: 33389660 DOI: 10.1007/s13187-020-01948-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/21/2020] [Indexed: 06/12/2023]
Abstract
Patients undergoing hematopoietic cell transplantation (HCT) are at risk for psychological and social impairment given the rigors and multiple sequelae of treatment. The purpose of this pilot study was to test the feasibility of a digital storytelling (DS) intervention for HCT patients, and to examine limited efficacy of the intervention relative to control arm on psychological distress and perceived social support. Adult HCT patients (n = 40, M age = 59.2 years) were enrolled immediately post-HCT and randomly assigned to either DS intervention or information control (IC). DS participants viewed four 3-min personal, emotionally rich digital stories, and IC condition participants viewed four videos containing information about post-HCT care. Feasibility regarding recruitment, enrollment efforts, and change scores from pre- to post-intervention (Δs) on depression, anxiety, and perceived social support were tracked. Fifty-four (51.4%) of 105 eligible patients consented. Forty (74%) patients completed the intervention. All but one completed the post-intervention assessments demonstrating that HCT patients can be recruited and retained for this intervention. On average, perceived social support increased for the DS group (Δ = 0.06) but decreased for the IC group (Δ = - 0.05). Anxiety and depression improved over time in both conditions. Viewing digital stories with content evoking emotional contexts similar to one's own health challenges may improve perceptions of social support among HCT patients. How DS can improve perceived social support for both short-term and longer-term sustained effects in a longitudinal study is an area ripe for additional investigation.
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Affiliation(s)
- Wonsun Sunny Kim
- Edson College of Nursing and Health Innovation, Arizona State University, 500 N. 3rd St. MC. 3020, Phoenix, AZ, 85004, USA.
| | - Shelby Langer
- Edson College of Nursing and Health Innovation, Arizona State University, 500 N. 3rd St. MC. 3020, Phoenix, AZ, 85004, USA
| | - Michael Todd
- Edson College of Nursing and Health Innovation, Arizona State University, 500 N. 3rd St. MC. 3020, Phoenix, AZ, 85004, USA
| | - Linda Larkey
- Edson College of Nursing and Health Innovation, Arizona State University, 500 N. 3rd St. MC. 3020, Phoenix, AZ, 85004, USA
| | - Soojung Jo
- Edson College of Nursing and Health Innovation, Arizona State University, 500 N. 3rd St. MC. 3020, Phoenix, AZ, 85004, USA
| | | | - Nandita Khera
- College of Medicine, Mayo Clinic of Arizona, Phoenix, AZ, USA
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Skeen SJ, Jones SS, Cruse CM, Horvath KJ. Integrating Natural Language Processing and Interpretive Thematic Analyses to Gain Human-Centered Design Insights on HIV Mobile Health: Proof-of-Concept Analysis. JMIR Hum Factors 2022; 9:e37350. [PMID: 35862171 PMCID: PMC9353680 DOI: 10.2196/37350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 06/13/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND HIV mobile health (mHealth) interventions often incorporate interactive peer-to-peer features. The user-generated content (UGC) created by these features can offer valuable design insights by revealing what topics and life events are most salient for participants, which can serve as targets for subsequent interventions. However, unstructured, textual UGC can be difficult to analyze. Interpretive thematic analyses can preserve rich narratives and latent themes but are labor-intensive and therefore scale poorly. Natural language processing (NLP) methods scale more readily but often produce only coarse descriptive results. Recent calls to advance the field have emphasized the untapped potential of combined NLP and qualitative analyses toward advancing user attunement in next-generation mHealth. OBJECTIVE In this proof-of-concept analysis, we gain human-centered design insights by applying hybrid consecutive NLP-qualitative methods to UGC from an HIV mHealth forum. METHODS UGC was extracted from Thrive With Me, a web app intervention for men living with HIV that includes an unstructured peer-to-peer support forum. In Python, topics were modeled by latent Dirichlet allocation. Rule-based sentiment analysis scored interactions by emotional valence. Using a novel ranking standard, the experientially richest and most emotionally polarized segments of UGC were condensed and then analyzed thematically in Dedoose. Design insights were then distilled from these themes. RESULTS The refined topic model detected K=3 topics: A: disease coping; B: social adversities; C: salutations and check-ins. Strong intratopic themes included HIV medication adherence, survivorship, and relationship challenges. Negative UGC often involved strong negative reactions to external media events. Positive UGC often focused on gratitude for survival, well-being, and fellow users' support. CONCLUSIONS With routinization, hybrid NLP-qualitative methods may be viable to rapidly characterize UGC in mHealth environments. Design principles point toward opportunities to align mHealth intervention features with the organically occurring uses captured in these analyses, for example, by foregrounding inspiring personal narratives and expressions of gratitude, or de-emphasizing anger-inducing media.
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Affiliation(s)
- Simone J Skeen
- Department of Social, Behavioral, and Population Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States.,Department of Psychology, Hunter College, City University of New York, New York, NY, United States
| | - Stephen Scott Jones
- Department of Psychology, Hunter College, City University of New York, New York, NY, United States
| | - Carolyn Marie Cruse
- Department of Psychology, Hunter College, City University of New York, New York, NY, United States
| | - Keith J Horvath
- Department of Psychology, San Diego State University, San Diego, CA, United States
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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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Borah P, Xiao X, Lai Lee DK. Narrative messages, information seeking and COVID-19 vaccine intention: The moderating role of perceived behavioral control. Am J Health Promot 2022; 36:923-933. [PMID: 35081757 PMCID: PMC8960749 DOI: 10.1177/08901171221075019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Purpose The main purposes of the current study are to examine 1) the influence of narrative vs statistics messages on COVID-19 related information seeking and COVID-19 vaccine intention and 2) the moderating role of perceived behavioral control (PBC). Design Data for a between-subject randomized experiment were collected online. The manipulation messages were presented as screenshots from the CDC’s Facebook page. Setting The participants were recruited from Amazon MTurk. Subjects A total of 300 subjects participated in the study, who were 18 years and above (M = 38.40). Measures Intention to seek information, COVID-19 vaccine intention, and PBC. Analysis To test the hypotheses, we utilized Hayes’s (2014) PROCESS for SPSS (Model 1). For intention to seek information, the main effect of the message manipulation (narrative vs statistics) [b = −2.10, t (300) = −4.14, P < .001] and the interaction [b = .41, t (300) = 3.88, P < .001] were significant. For vaccine intention, the main effects of message manipulation [b = 1.64, t (300) = −2.61, P < .005] and the interaction [b = .34, t (300) = 2.64, P < .005] were significant. Results Our research found that narrative messages were more persuasive for both information seeking and vaccine intention. But this was true only in the case of individuals whose PBC was low. Conclusions Our findings have critical implications for vaccine promotion research.
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Affiliation(s)
| | - Xizhu Xiao
- School of Journalism and Communication12593Qingdao University
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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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Ramli NS, Manaf MRA, Hassan MR, Ismail MI, Nawi AM. Effectiveness of Colorectal Cancer Screening Promotion Using E-Media Decision Aids: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158190. [PMID: 34360481 PMCID: PMC8345994 DOI: 10.3390/ijerph18158190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 07/30/2021] [Accepted: 07/30/2021] [Indexed: 12/09/2022]
Abstract
Colorectal cancer (CRC)-screening reduces mortality, yet remains underutilized. The use of electronic media (e-media) decision aids improves saliency and fosters informed decision-making. This systematic review aimed to determine the effectiveness of CRC-screening promotion, using e-media decision aids in primary healthcare (PHC) settings. Three databases (MEDLINE, Web of Science, and the Cochrane Library) were searched for eligible studies. Studies that evaluated e-media decision aids compared to usual care or other conditions were selected. Quality was assessed by using Cochrane tools. Their effectiveness was measured by CRC-screening completion rates, and meta-analysis was conducted to calculate the pooled estimates. Ten studies involving 9393 patients were included in this review. Follow-up durations spanned 3–24 months. The two types of decision-aid interventions used were videos and interactive multimedia programs, with durations of 6–15 min. Data from nine feasible studies with low or some risk of bias were synthesized for meta-analysis. A random-effects model revealed that CRC-screening promotion using e-media decision aids were almost twice as likely to have screening completion than their comparisons (OR 1.62, 95% CI: 1.03–2.62, p < 0.05). CRC-screening promotion through e-media has great potential for increasing screening participation in PHC settings. Thus, its development should be prioritized, and it should be integrated into existing programs.
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Affiliation(s)
- Nur Suhada Ramli
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaakob Latif, Cheras, Kuala Lumpur 56000, Malaysia; (N.S.R.); (M.R.A.M.); (M.R.H.)
- Ministry of Health, Malaysia, Federal Government Administrative Centre, Putrajaya 62514, Malaysia
| | - Mohd Rizal Abdul Manaf
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaakob Latif, Cheras, Kuala Lumpur 56000, Malaysia; (N.S.R.); (M.R.A.M.); (M.R.H.)
| | - Mohd Rohaizat Hassan
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaakob Latif, Cheras, Kuala Lumpur 56000, Malaysia; (N.S.R.); (M.R.A.M.); (M.R.H.)
| | - Muhamad Izwan Ismail
- Department of Surgery, Hospital Sultanah Aminah, Jalan Persiaran Abu Bakar Sultan, Johor Bahru 80100, Malaysia;
| | - Azmawati Mohammed Nawi
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaakob Latif, Cheras, Kuala Lumpur 56000, Malaysia; (N.S.R.); (M.R.A.M.); (M.R.H.)
- Correspondence:
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Slade M, Rennick-Egglestone S, Llewellyn-Beardsley J, Yeo C, Roe J, Bailey S, Smith RA, Booth S, Harrison J, Bhogal A, Penas Morán P, Hui A, Quadri D, Robinson C, Smuk M, Farkas M, Davidson L, van der Krieke L, Slade E, Bond C, Nicholson J, Grundy A, Charles A, Hare-Duke L, Pollock K, Ng F. Recorded Mental Health Recovery Narratives as a Resource for People Affected by Mental Health Problems: Development of the Narrative Experiences Online (NEON) Intervention. JMIR Form Res 2021; 5:e24417. [PMID: 34042595 PMCID: PMC8193481 DOI: 10.2196/24417] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 11/06/2020] [Accepted: 11/12/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The internet enables sharing of narratives about health concerns on a substantial scale, and some digital health narratives have been integrated into digital health interventions. Narratives describing recovery from health problems are a focus of research, including those presented in recorded (eg, invariant) form. No clinical trial has been conducted on a web-based intervention providing access to a collection of Recorded Recovery Narratives (RRNs). OBJECTIVE This study presents knowledge produced through the development of the Narrative Experiences Online (NEON) Intervention, a web-based intervention incorporating the algorithmic recommendation of RRNs. METHODS Knowledge was gathered through knowledge integration (KI) activities. KI1 synthesized previous studies to produce the NEON Impact Model describing how accessing RRNs produces health-related outcomes. KI2 developed curation principles for the NEON Collection of RRNs through consultation with the NEON Lived Experience Advisory Panel and the curation of a preliminary collection. KI3 identified harm minimization strategies for the NEON Intervention through consultation with the NEON International Advisory Board and Lived Experience Advisory Panel. The NEON Intervention was finalized through 2 research studies (RS). In RS1, mental health service users (N=40) rated the immediate impact of randomly presented narratives to validate narrative feedback questions used to inform the recommendation algorithm. In RS2, mental health service users (n=25) were interviewed about their immediate response to a prototype of the NEON Intervention and trial procedures and then were interviewed again after 1 month of use. The usability and acceptability of the prototype and trial procedures were evaluated and refinements were made. RESULTS KI1 produced the NEON Impact Model, which identifies moderators (recipient and context), mechanisms of connection (reflection, comparison, learning, and empathy), processes (identification of change from narrative structure or content and internalization of observed change), and outcomes (helpful and unhelpful). KI2 identified 22 curation principles, including a mission to build a large, heterogeneous collection to maximize opportunities for connection. KI3 identified seven harm minimization strategies, including content warnings, proactive and reactive blocking of narratives, and providing resources for the self-management of emotional distress. RS1 found variation in the impact of narratives on different participants, indicating that participant-level feedback on individual narratives is needed to inform a recommender system. The order of presentation did not predict narrative feedback. RS2 identified amendments to web-based trial procedures and the NEON Intervention. Participants accessed some narratives multiple times, use reduced over the 4-week period, and narrative feedback was provided for 31.8% (105/330) of narrative accesses. CONCLUSIONS RRNs can be integrated into web-based interventions. Evaluating the NEON Intervention in a clinical trial is feasible. The mixed methods design for developing the NEON Intervention can guide its extension to other clinical populations, the design of other web-based mental health interventions, and the development of narrative-based interventions in mental health.
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Affiliation(s)
- Mike Slade
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Stefan Rennick-Egglestone
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Joy Llewellyn-Beardsley
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Caroline Yeo
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - James Roe
- National Institute for Health Research, ARC East Midlands, University of Nottingham, Nottingham, United Kingdom
| | - Sylvia Bailey
- NEON Lived Experience Advisory Panel, Nottingham, United Kingdom
| | | | - Susie Booth
- NEON Lived Experience Advisory Panel, Nottingham, United Kingdom
| | - Julian Harrison
- NEON Lived Experience Advisory Panel, Nottingham, United Kingdom
| | - Adaresh Bhogal
- NEON Lived Experience Advisory Panel, Nottingham, United Kingdom
| | - Patricia Penas Morán
- Department of Personality, Assessment and Psychological Treatment, University of Deusto, Bilbao, Spain
| | - Ada Hui
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Dania Quadri
- GKT School of Medical Education, King's College London, London, United Kingdom
| | - Clare Robinson
- Centre for Primary Care & Public Health, Pragmatic Clinical Trials Unit, Queen Mary University of London, London, United Kingdom
| | - Melanie Smuk
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Marianne Farkas
- College of Health and Rehabilitation Sciences, Boston University, Boston, MA, United States
| | - Larry Davidson
- Yale School of Medicine, Yale University, New Haven, CT, United States
| | - Lian van der Krieke
- University Medical Center Groningen, University Center of Psychiatry, University of Groningen, Groningen, Netherlands
| | - Emily Slade
- Department of Computer Science, University of Oxford, Oxford, United Kingdom
| | - Carmel Bond
- Nottingham University Business School, University of Nottingham, Nottingham, United Kingdom
| | - Joe Nicholson
- School of Humanities, University of Nottingham, Nottingham, United Kingdom
| | - Andrew Grundy
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Ashleigh Charles
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Laurie Hare-Duke
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Kristian Pollock
- School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Fiona Ng
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
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Wang C, Bakhet M, Roberts D, Gnani S, El-Osta A. The efficacy of microlearning in improving self-care capability: a systematic review of the literature. Public Health 2020; 186:286-296. [PMID: 32882481 DOI: 10.1016/j.puhe.2020.07.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 06/29/2020] [Accepted: 07/03/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To determine the effectiveness of microlearning in improving an individual's capability for self-care. STUDY DESIGN Systematic review of the literature. BACKGROUND The routine adoption of health seeking self-care behaviours can prevent or delay the appearance of various lifestyle diseases including type 2 diabetes and cardiovascular disease. Microlearning delivers complex knowledge in fragments or bite-size 'nuggets' of information and has been applied as a novel intervention to improve individual's self-care capabilities. The aim of this research was to systematically review the literature to determine the effectiveness of microlearning in improving individual self-care capability. METHODS A search was conducted on 15 July 2019 across five electronic bibliographic databases: EMBASE, MEDLINE, PsycINFO, CINAHL and Scopus. Randomised and non-randomised controlled trials, controlled before-after studies and interrupted time series studies, published between 1 January 1990 and 15 July 2019 and looking at individuals of all ages were included in the search. The search strategy included a keyword search and a string of "(modality) AND (learning) AND (micro)", which broadly described microlearning to cover all available articles that have used microformat learning interventions. The search was combined with keywords and Medical Subject Headings (MeSH) terms for self-care to identify studies of interests. Studies were screened by two reviewers independently and reported using a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart. Data from included articles were extracted using Cochran Data Collection Form. Risk of bias was assessed using Version 2 of the Cochrane Risk-of-bias or Risk Of Bias In Non-Randomised Studies of Interventions (ROBINS-I). RESULTS 1310 articles were identified in the initial search. A total of 26 manuscripts were included in the narrative synthesis after title and abstract and full text screening was performed by two reviewers. Outcomes of studies were categorised. A total of 23 studies measured cognitive level self-care capabilities-related changes, and 91% showed statistically significant improvements. Only 11 studies measured actual self-care behaviour changes, from which only 36% showed statistically significant results. From the 26 manuscripts included, 25 articles were evaluated as having moderate-to-high risk of bias. CONCLUSION Under certain conditions, or when combined with monitoring such as tracking daily medicine intake, microlearning can be effective in improving actual self-care behaviours. Microlearning can also positively influence individuals' cognitive self-care capabilities but was largely ineffective in triggering actual self-care behaviour change. More studies are needed to investigate the effectiveness of microlearning in improving self-care capabilities amongst the general population at scale.
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Affiliation(s)
- C Wang
- Self-Care Academic Research Unit (SCARU), Department of Primary Care & Public Health, School of Public Heath, Imperial College London, Charing Cross Hospital, London W6 8RF, UK
| | - M Bakhet
- Self-Care Academic Research Unit (SCARU), Department of Primary Care & Public Health, School of Public Heath, Imperial College London, Charing Cross Hospital, London W6 8RF, UK
| | - D Roberts
- Self-Care Academic Research Unit (SCARU), Department of Primary Care & Public Health, School of Public Heath, Imperial College London, Charing Cross Hospital, London W6 8RF, UK
| | - S Gnani
- Self-Care Academic Research Unit (SCARU), Department of Primary Care & Public Health, School of Public Heath, Imperial College London, Charing Cross Hospital, London W6 8RF, UK
| | - A El-Osta
- Self-Care Academic Research Unit (SCARU), Department of Primary Care & Public Health, School of Public Heath, Imperial College London, Charing Cross Hospital, London W6 8RF, UK.
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Kim M, Lee H, Kiang P, Allison J. Development and acceptability of a peer-paired, cross-cultural and cross-generational storytelling HPV intervention for Korean American college women. HEALTH EDUCATION RESEARCH 2019; 34:483-494. [PMID: 31298268 PMCID: PMC6758644 DOI: 10.1093/her/cyz022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Accepted: 06/18/2019] [Indexed: 05/04/2023]
Abstract
Although Korean American women have a higher risk of developing cervical cancer, currently there are limited culturally relevant intervention strategies for improving primary prevention of cervical cancer by promoting HPV vaccination in this population. This study reports the development of a cross-cultural, cross-generational storytelling HPV intervention using a peer-paired method, in which two storytellers interactively share their stories, as a particular innovation that might resonate with Korean American young women. The acceptability of the intervention was assessed by self-reported satisfaction and endorsement with the intervention in a pilot randomized control trial (RCT). We compared participants' responses to the intervention by their generation and cultural identity. One hundred and four Korean college women between the ages of 18-26 were recruited from the Northeastern US Participants randomized to the intervention group received a storytelling video (n = 54); the comparison group received written information (n = 50). The acceptability of the intervention was measured immediately post-intervention. The intervention group had significantly greater satisfaction than the comparison group (P < 0.05). Participants reported greater endorsement for videos that reflected their cultural and generational experiences. Future study is needed to examine the impact of such interventions on objective follow-up on HPV vaccination in a large-scale RCT.
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Affiliation(s)
- Minjin Kim
- Division of Preventive Medicine and Behavior, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School
- Correspondence to: M. Kim. E-mail:
| | - Haeok Lee
- College of Nursing and Health Sciences, University of Massachusetts Boston
| | - Peter Kiang
- School for Global Inclusion and Social Development, University of Massachusetts Boston
| | - Jeroan Allison
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
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Kim W, Bangerter LR, Jo S, Langer S, Larkey L, Griffin J, Khera N. Feasibility and Acceptability of a 3-Day Group-Based Digital Storytelling Workshop among Caregivers of Allogeneic Hematopoietic Cell Transplantation Patients: A Mixed-Methods Approach. Biol Blood Marrow Transplant 2019; 25:2228-2233. [PMID: 31265918 DOI: 10.1016/j.bbmt.2019.06.030] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 05/13/2019] [Accepted: 06/26/2019] [Indexed: 11/19/2022]
Abstract
Family caregivers are essential partners for patients undergoing hematopoietic cell transplantation (HCT). The caregiving role is emotionally, physically, and financially demanding. Intervention efforts to provide relief for caregiver stress during HCT are highly warranted. Storytelling interventions are accruing evidence for efficacy in therapeutic contexts. The purpose of this study was to conduct a 3-full consecutive day digital storytelling (DST) workshop to build knowledge on caregivers' lived experiences during HCT, to pilot test DST with a small group of HCT caregivers, and to demonstrate feasibility and acceptability using qualitative and quantitative measures. Six adult caregivers of allogeneic HCT recipients (mean age, 60.2 years) attended a 3-day DST program (66% female, 83% white). All successfully created their personal audiovisual digital story (2 to 3 minutes long) and completed a survey. All participants rated the DST workshop as highly acceptable and therapeutic (mean score 5, on a scale of 1 to 5). Group discussions and interviews with participants further demonstrated high satisfaction and acceptability of the workshop format, setting, process, and structure. The survey results showed decreases in anxiety and depression from before to after the DST workshop with all participants showing change in the expected direction. This study demonstrates the feasibility and acceptability of a 3-day DST workshop as a distress-relieving tool for HCT caregivers. Future research is needed to test the efficacy of DST relative to a control condition.
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Affiliation(s)
- Wonsun Kim
- College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona; Mayo Clinic College of Medicine, Phoenix, Arizona.
| | - Lauren R Bangerter
- Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Rochester, Minnesota
| | - Soojung Jo
- College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona
| | - Shelby Langer
- College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona; Mayo Clinic College of Medicine, Phoenix, Arizona
| | - Linda Larkey
- College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona; Mayo Clinic College of Medicine, Phoenix, Arizona
| | - Joan Griffin
- Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Rochester, Minnesota
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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: 3] [Impact Index Per Article: 0.5] [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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Heilemann MV, Martinez A, Soderlund PD. A Mental Health Storytelling Intervention Using Transmedia to Engage Latinas: Grounded Theory Analysis of Participants' Perceptions of the Story's Main Character. J Med Internet Res 2018; 20:e10028. [PMID: 29720357 PMCID: PMC5956154 DOI: 10.2196/10028] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Revised: 03/06/2018] [Accepted: 03/08/2018] [Indexed: 12/12/2022] Open
Abstract
Background Transmedia storytelling was used to attract English-speaking Latina women with elevated symptoms of depression and anxiety to engage in an intervention that included videos and a webpage with links to symptom management resources. However, a main character for the storyline who was considered dynamic, compelling, and relatable by the target group was needed. Objective We conducted interviews with 28 English-speaking Latinas (target group) with elevated symptoms of depression or anxiety who participated in an Internet-accessible transmedia storytelling intervention. The objective of this study was to examine participants’ perceptions of the lead character of the story. Development of this character was informed by deidentified data from previous studies with members of the target group. Critique of the character from a panel of therapists informed editing, as did input from women of the target group. Methods All interviews were conducted via telephone, audio-recorded, and transcribed. Data analysis was guided by grounded theory methodology. Results Participants embraced the main character, Catalina, related to her as a person with an emotional life and a temporal reality, reported that they learned from her and wanted more episodes that featured her and her life. Grounded theory analysis led to the development of one category (She “just felt so real”: relating to Catalina as a real person with a past, present, and future) with 4 properties. Properties included (1) relating emotionally to Catalina’s vulnerability, (2) recognizing shared experiences, (3) needing to support others while simultaneously lacking self-support, and (4) using Catalina as a springboard for imagining alternative futures. Participants found Catalina’s efforts to pursue mental health treatment to be meaningful and led them to compare themselves to her and consider how they might pursue treatment themselves. Conclusions When creating a story-based mental health intervention to be delivered through an app, regardless of type, careful development of the main character is valuable. Theoretical guidance, previous deidentified data from the target group, critique from key stakeholders and members of the target group, and preliminary testing are likely to enhance the main character’s relatability and appropriateness, which can increase sustained engagement.
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Affiliation(s)
- MarySue V Heilemann
- School of Nursing, University of California, Los Angeles, Los Angeles, CA, United States
| | - Adrienne Martinez
- School of Nursing, University of California, Los Angeles, Los Angeles, CA, United States
| | - Patricia D Soderlund
- School of Nursing, University of California, Los Angeles, Los Angeles, CA, United States
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18
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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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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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Heilemann MV, Soderlund PD, Kehoe P, Brecht ML. A Transmedia Storytelling Intervention With Interactive Elements to Benefit Latinas' Mental Health: Feasibility, Acceptability, and Efficacy. JMIR Ment Health 2017; 4:e47. [PMID: 29051135 PMCID: PMC5668652 DOI: 10.2196/mental.8571] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 09/25/2017] [Accepted: 09/27/2017] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Latinos report higher rates of depression and anxiety than US whites but are less likely to receive care. Transmedia storytelling interventions accessible on the Internet via smartphones, tablets, and computers hold promise for reducing reluctance to explore or get help for symptoms because they are private, convenient, and can reach large numbers of people, including Latinas with mental health needs. OBJECTIVE The purpose of this study was to examine the feasibility, acceptability, and preliminary efficacy of a mental health transmedia intervention for Latinas with elevated symptoms of depression, anxiety, or both. METHODS A total of 28 symptomatic English-speaking Latina women aged 21 to 48 years participated in a 6-week study using a within-group design. All aspects of the study were completed via telephone or Internet. Participants used their personal devices to engage the Web-based transmedia intervention (in English) that included story-based videos, a data-informed psychotherapeutic video, an interactive video sequence, and a blog written from the point of view of one of the characters with links to mental health resources. Perceived confidence to get help and perceived importance for seeking immediate help were both measured using single-item questions. Participants completed surveys at baseline (via telephone) and 1 and 6 weeks after media engagement that measured various factors, including depression (Patient Health Questionnaire; PHQ-9 and PHQ-8) and anxiety (Generalized Anxiety Disorder scale; GAD-7). A telephone interview was conducted within 72 hours of media engagement. Action taken or intentions to get help (single-item question) and talking about the videos with others (single-item question) were measured 1 and 6 weeks after media engagement. Repeated measures analysis of variance was used to assess change in depression (PHQ-8) and anxiety (GAD-7) before transmedia engagement and 1 and 6 weeks after. Spearman correlations evaluated the association of confidence and importance of getting help with action taken, anxiety, and depression. RESULTS All 28 Latinas (English speakers) who engaged with the transmedia remained in the 6-week study. Within 1 week of transmedia engagement, 39% of women took action to get help, and 82% discussed the media with others. Symptoms of depression (F2,54=9.0, P<.001) and anxiety (F2,54=18.7, P<.001) significantly reduced across time. Higher levels of confidence were significantly associated with actions taken at 1 (P=.005) and 6 weeks (P=.04), and higher levels of importance were significantly associated with actions taken at 1 (P=.009) and 6 weeks (P=.003). Higher levels of confidence were associated with lower levels of depression (P=.04) and anxiety (P=.01) at 6 weeks. CONCLUSIONS Preliminary findings indicate a culturally tailored mental health transmedia intervention is a feasible approach that holds promise for engaging large numbers of symptomatic English-speaking Latina women to begin the process of seeking help, as well as decreasing symptoms of anxiety and depression.
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Affiliation(s)
- MarySue V Heilemann
- School of Nursing, University of California, Los Angeles, Los Angeles, CA, United States
| | - Patricia D Soderlund
- School of Nursing, University of California, Los Angeles, Los Angeles, CA, United States
| | - Priscilla Kehoe
- School of Nursing, University of California, Irvine, Irvine, CA, United States
| | - Mary-Lynn Brecht
- School of Nursing, University of California, Los Angeles, Los Angeles, CA, United States
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Maxwell AE, Crespi CM, Arce AA, Bastani R. Exploring the effects of longstanding academic-community partnerships on study outcomes: A case study. Prev Med Rep 2017; 8:101-107. [PMID: 28948137 PMCID: PMC5601301 DOI: 10.1016/j.pmedr.2017.09.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 09/05/2017] [Accepted: 09/07/2017] [Indexed: 11/13/2022] Open
Abstract
While sustained academic and community partnerships can improve relationships between research partners, they could also influence study outcomes. Research on this issue is limited. We conducted a trial (2010–15) to test two implementation strategies for an evidence-based intervention to promote colorectal cancer (CRC) screening at community organizations in Los Angeles (N = 17). For both strategies, trained community health advisors (CHAs) recruited Filipino Americans (N = 673) who were non-adherent to CRC screening guidelines. The main study outcome was CRC screening status of participants at 6-month follow-up. This case study compares outcomes among organizations that had participated in our prior effectiveness trial and new organizations with which we had no prior relationship. Using multilevel logistic regression with multiple imputation for missing outcomes, we compared CRC screening rates among previous versus new partners controlling for study condition and organizational, CHA and participant characteristics. Screening rates were substantially higher among participants of previous versus new partner organizations in unadjusted analysis (77% versus 55%, OR 2.8, p = 0.12), after adjusting for organization-level variables (81% versus 42%, OR 7.5, 95% CI [2.0–28.7], p = 0.003) and after additionally adding CHA and participant level factors to the model (79% versus 47%, OR 5.9, CI [1.3–27.3], p = 0.02). Analyses using complete cases and assuming not-screened for missing outcomes indicated similar differences in screening rates (30 and 33 percentage points, respectively). Study outcomes that are achieved with long-term community partners may not be generalizable to new partners. However, inclusion of new community partners is important for external validity of dissemination efforts in community settings. NCT01351220 (ClinicalTrials.gov) Long-term partnerships between academia and community can affect study outcomes. Study outcomes achieved with long-term community partners may not be generalizable. Inclusion of new partners may improve external validity of dissemination efforts. We recommend further examination of this issue in future studies. Inclusion of this construct in theoretical formulations should be considered.
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Affiliation(s)
- Annette E Maxwell
- Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California Los Angeles, UCLA Kaiser Permanente Center for Health Equity, Los Angeles, United States
| | - Catherine M Crespi
- Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California Los Angeles, UCLA Kaiser Permanente Center for Health Equity, Los Angeles, United States
| | - Anthony A Arce
- Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California Los Angeles, UCLA Kaiser Permanente Center for Health Equity, Los Angeles, United States
| | - Roshan Bastani
- Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California Los Angeles, UCLA Kaiser Permanente Center for Health Equity, Los Angeles, United States
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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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23
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Larkey L, Szalacha L, Herman P, Gonzalez J, Menon U. Randomized controlled dissemination study of community-to-clinic navigation to promote CRC screening: Study design and implications. Contemp Clin Trials 2017; 53:106-114. [PMID: 27940183 PMCID: PMC6386159 DOI: 10.1016/j.cct.2016.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 11/30/2016] [Accepted: 12/03/2016] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Regular screening facilitates early diagnosis of colorectal cancer (CRC) and reduction of CRC morbidity and mortality. Screening rates for minorities and low-income populations remain suboptimal. Provider referral for CRC screening is one of the strongest predictors of adherence, but referrals are unlikely among those who have no clinic home (common among poor and minority populations). METHODS/STUDY DESIGN This group randomized controlled study will test the effectiveness of an evidence based tailored messaging intervention in a community-to-clinic navigation context compared to no navigation. Multicultural, underinsured individuals from community sites will be randomized (by site) to receive CRC screening education only, or education plus navigation. In Phase I, those randomized to education plus navigation will be guided to make a clinic appointment to receive a provider referral for CRC screening. Patients attending clinic appointments will continue to receive navigation until screened (Phase II) regardless of initial arm assignment. We hypothesize that those receiving education plus navigation will be more likely to attend clinic appointments (H1) and show higher rates of screening (H2) compared to those receiving education only. Phase I group assignment will be used as a control variable in analysis of screening follow-through in Phase II. Costs per screening achieved will be evaluated for each condition and the RE-AIM framework will be used to examine dissemination results. CONCLUSION The novelty of our study design is the translational dissemination model that will allow us to assess the real-world application of an efficacious intervention previously tested in a randomized controlled trial.
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Affiliation(s)
- Linda Larkey
- Arizona State University, College of Nursing and Health Innovation, 550 N 3rd Street, Phoenix, AZ 85004, United States.
| | - Laura Szalacha
- The University of Arizona, College of Nursing, 1305 N. Martin, Tucson, AZ 85721, United States
| | - Patricia Herman
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90407-2138, United States
| | - Julie Gonzalez
- Arizona State University, College of Nursing and Health Innovation, 550 N 3rd Street, Phoenix, AZ 85004, United States
| | - Usha Menon
- The University of Arizona, College of Nursing, 1305 N. Martin, Tucson, AZ 85721, United States
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24
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Davis SN, Christy SM, Chavarria EA, Abdulla R, Sutton SK, Schmidt AR, Vadaparampil ST, Quinn GP, Simmons VN, Ufondu CB, Ravindra C, Schultz I, Roetzheim RG, Shibata D, Meade CD, Gwede CK. A randomized controlled trial of a multicomponent, targeted, low-literacy educational intervention compared with a nontargeted intervention to boost colorectal cancer screening with fecal immunochemical testing in community clinics. Cancer 2016; 123:1390-1400. [PMID: 27906448 DOI: 10.1002/cncr.30481] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 11/03/2016] [Accepted: 11/08/2016] [Indexed: 01/22/2023]
Abstract
BACKGROUND The objective of the current study was to improve colorectal cancer (CRC) screening uptake with the fecal immunochemical test (FIT). The current study investigated the differential impact of a multicomponent, targeted, low-literacy educational intervention compared with a standard, nontargeted educational intervention. METHODS Patients aged 50 to 75 years who were of average CRC risk and not up-to-date with CRC screening were recruited from either a federally qualified health center or a primary care community health clinic. Patients were randomized to the intervention condition (targeted photonovella booklet/DVD plus FIT kit) or comparison condition (standard Centers for Disease Control and Prevention brochure plus FIT kit). The main outcome was screening with FIT within 180 days of delivery of the intervention. RESULTS Of the 416 participants, 54% were female; the participants were racially and ethnically diverse (66% white, 10% Hispanic, and 28% African American), predominantly of low income, and insured (the majority had county health insurance). Overall, the FIT completion rate was 81%, with 78.1% of participants in the intervention versus 83.5% of those in the comparison condition completing FIT (P = .17). In multivariate analysis, having health insurance was found to be the primary factor predicting a lack of FIT screening (adjusted odds ratio, 2.10; 95% confidence interval, 1.04-4.26 [P = .04]). CONCLUSIONS The multicomponent, targeted, low-literacy materials were not found to be significantly different or more effective in increasing FIT uptake compared with the nontargeted materials. Provision of a FIT test plus education may provide a key impetus to improve the completion of CRC screening. The type of educational material (targeted vs nontargeted) may matter less. The findings of the current study provide a unique opportunity for clinics to adopt FIT and to choose the type of patient education materials based on clinic, provider, and patient preferences. Cancer 2017;123:1390-1400. © 2016 American Cancer Society.
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Affiliation(s)
- Stacy N Davis
- Health Education and Behavioral Science, Rutgers School of Public Health, Piscataway, New Jersey.,Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Shannon M Christy
- Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.,Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Enmanuel A Chavarria
- Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.,Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Rania Abdulla
- Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Steven K Sutton
- Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.,Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Alyssa R Schmidt
- Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Susan T Vadaparampil
- Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Gwendolyn P Quinn
- Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.,Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Vani N Simmons
- Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.,Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, Florida
| | | | | | - Ida Schultz
- Premier Community HealthCare Group Inc, Dade City, Florida
| | - Richard G Roetzheim
- Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.,Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - David Shibata
- Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.,Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, Florida.,Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Cathy D Meade
- Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.,Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Clement K Gwede
- Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.,Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, Florida
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25
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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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26
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López-Torres Hidalgo J, Rabanales Sotos J, Simarro Herráez MJ, López-Torres López J, Campos Rosa M, López Verdejo MÁ. Effectiveness of three interventions to improve participation in colorectal cancer screening. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2016; 108:315-22. [PMID: 27055722 DOI: 10.17235/reed.2016.4048/2015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE Participation in colorectal cancer (CRC) screening varies widely among different countries and different socio-demographic groups. Our objective was to assess the effectiveness of three primary-care interventions to increase CRC screening participation among persons over the age of 50 years and to identify the health and socio-demographic-related factors that determine greater participation. METHODS We conducted a randomized experimental study with only one post-test control group. A total of 1,690 subjects were randomly distributed into four groups: written briefing; telephone briefing; an invitation to attend a group meeting; and no briefing. Subjects were evaluated 2 years post-intervention, with the outcome variable being participation in CRC screening. RESULTS A total of 1,129 subjects were interviewed. Within the groups, homogeneity was tested in terms of socio-demographic characteristics and health-related variables. The proportion of subjects who participated in screening was: 15.4% in the written information group (95% confidence interval [CI]: 11.2-19.7); 28.8% in the telephone information group (95% CI: 23.6-33.9); 8.1% in the face-to-face information group (95% CI: 4.5-11.7); and 5.9% in the control group (95% CI: 2.9-9.0), with this difference proving statistically significant (p < 0.001). Logistic regression showed that only interventions based on written or telephone briefing were effective. Apart from type of intervention, number of reported health problems and place of residence remained in the regression model. CONCLUSIONS Both written and telephone information can serve to improve participation in CRC screening. This preventive activity could be optimized by means of simple interventions coming within the scope of primary health-care professionals.
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