Sweet Temptations : How Does Reading a Fotonovela About Diabetes Affect Dutch Adults with Different Levels of Literacy?
Health Communication
Ruth Koops van't Jagt, Aletta Jacobs, John C.J. Hoeks, Evelien Duizer, Melvin Baron, Gregory B. Molina, Jennifer B. Unger, C.J.M. Jansen
2017
Recent studies suggest that health-related fotonovelas—booklets that portray a dramatic story using photographs and captions—may be effective health communication tools, especially for readers with a low level of literacy. In this experiment, effects on knowledge and behavioral intentions were assessed of a fotonovela originally developed for a Latin-American audience. Dutch readers from a low literacy group (N = 89) and a high literacy group (N = 113) were randomly assigned to one of three conditions: a fotonovela condition (all captions translated into Dutch), a traditional brochure condition (also in Dutch), and a control condition. On knowledge about diabetes, participants in the fotonovela condition outperformed participants in both other conditions. This finding was consistent across literacy levels. On behavioral intentions, however, readers of the fotonovela did not score significantly higher than participants in the other conditions. We also evaluated hypotheses proposed in the Entertainment Overcoming Resistance Model (EORM; Moyer-Gusé, 2008) on the possible mechanisms underlying persuasion through narratives. No support was found for the mechanisms proposed in the EORM. The outcomes of this study suggest that a fotonovela may be a valuable health education format for adults with varying levels of literacy, even if it was developed for a target group with a different cultural background.
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Comparing the Impact on Latinos of a Depression Brochure and an Entertainment-Education Depression Fotonovela
Psychiatric Services
Leopoldo J. Cabassa, Hans Oh, Jennifer L. Humensky, Jennifer B. Unger, Gregory B. Molina, Melvin Baron
2015
The purpose was to evaluate the impact of a depression fotonovela in increasing knowledge of depression symptoms and treatments and reducing stigma among Latinos. Data were from a randomized controlled trial in which Latinos from adult schools (N=132) were assigned to receive the fotonovela or a depression brochure and were assessed on knowledge and stigma measures before and after reading the material and one month later. Random-effects linear and logistic regression models assessed changes within and between groups. No significant differences were found between groups in symptom knowledge, social distance, and perceptions of dangerousness. Gains in depression treatment knowledge were significantly greater for the fotonovela than for the depression brochure group. Findings suggest that a depression fotonovela informed by an entertainment-education approach is a useful tool for improving depression treatment knowledge among Latinos but is limited in improving symptom knowledge and reducing stigma related to social distance and perceptions of dangerousness.
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Evaluation of a Fotonovela to Increase Depression Knowledge and Reduce Stigma Among Hispanic Adults
Journal of Immigrant and Minority Health
Jennifer B. Unger, Leopoldo J. Cabassa, Gregory B. Molina, Sandra Contreras, Melvin Baron
2012
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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