Return-Path: <nifl-health@literacy.nifl.gov> Received: from literacy (localhost [127.0.0.1]) by literacy.nifl.gov (8.10.2/8.10.2) with SMTP id j28DoMC18599; Tue, 8 Mar 2005 08:50:23 -0500 (EST) Date: Tue, 8 Mar 2005 08:50:23 -0500 (EST) Message-Id: <s22d669e.076@smtp.aed.org> Errors-To: listowner@literacy.nifl.gov Reply-To: nifl-health@literacy.nifl.gov Originator: nifl-health@literacy.nifl.gov Sender: nifl-health@literacy.nifl.gov Precedence: bulk From: "William Smith" <BSMITH@smtp.aed.org> To: Multiple recipients of list <nifl-health@literacy.nifl.gov> Subject: [NIFL-HEALTH:4684] RE: Research on the use of Photonovellas? X-Listprocessor-Version: 6.0c -- ListProcessor by Anastasios Kotsikonas Content-Transfer-Encoding: 7bit Content-Type: text/plain; charset=US-ASCII X-Mailer: Novell GroupWise Internet Agent 6.5.1 Status: O Content-Length: 12168 Lines: 320 Evaluating fotonovelas. What would you evaluate and how would you do it? FotoN are like radio programs - they are a channel of communication. Some radio programs fail and others succeed, but radio doesn't succeed or fail. I have never seen anyone waste money on a case control study of fotonovelas, whioch be the gold standard. You would have to take one fotonovella, compare it against another fotonovel and then compare it against some other alternative format to determine what?....in a given population at a given moment fotonovella A was better(read more widely, understood?) than B or not as good as alternative C? What would that tell you that could generalize to different audience, subjects and times? I will check some international sources that do research on entertainment media - but I am very skeptical of finding any evaluation of fotonovells as stand alone, or as simple evaluations that would not really show you much becasue they were so case specific. What is it that you wopuld want an evaluation to tell you? I think what we know about communication suggests that your focus on formative research makes a great deal of sense for a channel like this. Obiviously a program would need to demonstrate that the reach and frequency of a footonovella was sufficient for a given population. In a given setting who reads fotonovelas? How often? What do they get out of them? And most important what part are they playing in a much broader strategy to accomplish a public health objective. Once you decide they are a viable channel for a specific audience - what content do you put through it (what are people going to learn from a fotonovel - facts, positioning, branding ?) We did a series of fotonovels in Ecuador to help fight the racism against rural Indians. The novel featured a super hero Indian who solved real problems with great street smarts. It was critical that the problems were perceived to be real and that he was not fighting aliens from outer space. Manual Santi was his name and he had to solve things like water rights problems to be credible. Manual Santi became a symbol of the smart savvy Indian that we used in a dozen other channels to address the existing stereotypes. We used photos and the lead character made personal appearances around the country. In another case we needed to get very specific information about how to mix a rehydration solution to mothers of newborns. There, the accuracy of the information was important and we knew that just reading the fotonovel would not be enough. We designed it as a school project. Kids got the fotonovel in school, read it in class and then took it home. It was the story of how a school kid had saved his baby sister's life by mixing oral rehydration properly. The kids took the fotonovel home---read it to his parents as a school assignment -- and had mom answer four test questions about ORS which the kid brought back to school as homework. The fotonovel became a reminder in the home of the mixing formula. The plot line was dramatic - with the child becoming more and more dehydrated etc. This was part of a much larger program that reduce infant mortality due to diarrhea by some 37% I think. But you could not say the fotonovel was the only reason. It was part of a broader strategy. The key evaluation issues are really formative. In designing a fotonovella you test whether it is compelling - whether the story is clear and NOT considered "learning". If they think it is a textbook it will loose its unique power. You want to test the drawings individually - actually we use photos in both caseas above because we found drawings too difficult to identify for our audience. We were targeting women age 18-35. Young boys loved the drawings better, but they were not our audience. This was an audience specific finding, not realy generalizable. There is a large literature on entertainment media and social change. The key motion ios to embed call for action and information within an entertainment format. My experience is that too many people test only whether people "liked it" and not did it have the intended behavioral effect. We have so little dollars for evaluation I always try to suggest using it during the format process. What I think experience shows is that fotonolas can be an effective channel for communication on topics that have an emotional appeal. They can be targeted to specific audiences through their distribution channels. We used traveling herbalists to sell our fotonovelas because that's where our mothers bought things like that. Putting them in stores would have gone no where. The final thing I will share is that the production quality of a fotonovel matters. We tested various formats with our audiences and found that unless it looked professional it was not taken seriously. Again this was all part of the formative testing. I know this does not answer the science question....do fotonvoleas work? But then do we have an answer to the question...does surgery work?....not to cure a cold it doesn't and not if it is done by a plummer. Surgery is a procedure with practice standards and fotonovelas are a channel with practice standards. Has anyone ever submitted surgery to a case control trial? Why not? Don't we need to know if it works? Even in the face of documented medical errors we don't submit surgery to case control trials. >>> CBaur@OSOPHS.DHHS.GOV 3/7/2005 3:31:26 PM >>> Bill, Bill, Would you mind posting some specific references to evaluation studies of fotonovelas? The original inquiry related to efficacy. The listserv responses have focused on formative research and production processes. The Healthy People 2010 objective 11-3 encourages both formative research, which is what most people have discussed, and evaluation research. Cynthia Baur HHS -----Original Message----- From: nifl-health@nifl.gov [mailto:nifl-health@nifl.gov] On Behalf Of William Smith Sent: Monday, March 07, 2005 3:20 PM To: Multiple recipients of list Subject: [NIFL-HEALTH:4680] RE: Research on the use of Photonovellas? I spent a good deal of my early life developing photonovels in Latin America. I'd be glad to offer that experience if people want specific guidence. I'm pretty fluent in Spanish if that helps. Wm. Smith Executive Vice President Academy for Educational Development 1825 Connecticut Ave., NW Washington, D.C. 20009 A little change hurts a lot. A lot of change doesn't hurt that much more. Phone: 202-884-8750 Fax: 202-884-8752 e-mail: bsmith@aed.org Wm. Smith Executive Vice President Academy for Educational Development 1825 Connecticut Ave., NW Washington, D.C. 20009 A little change hurts a lot. A lot of change doesn't hurt that much more. Phone: 202-884-8750 Fax: 202-884-8752 e-mail: bsmith@aed.org >>> rrudd@hsph.harvard.edu 3/7/2005 12:30:23 PM >>> Hello, It is good to see discussions about this topic. I'd like to make a brief note about photonovels. As you all now, this form of wrting material is very popular in Central and South America. The format is set like a comic book. However, photos are used instead of comics. The story line is carried by dialogue bubbles and aided by a brief note on top of a new page [e.g. the next day...]. The dialogue bubbles must be very brief and this helps with literacy related issues. However, as you examine a wide variety of photonovels developed to address an array of health issues..... do look into the development process. In some cases the photonovel was developed by experts. It will be important for you to consider the rigor with which it was developed, piloted, and revised by members of the intended audience. In some cases the photonovel was developed by members of the intended audience through a process facilitated by an outside or inside expert. Here too, be sure to consider the rigor of the process. Debra Roter, John Comings and I [Rudd] wrote about this participatory approach and indicated the importance of authentic voice. Also -- for those of you thinking about developing such material, you will find a how-to approach on the following website: www.hsph.harvard.edu/healthliteracy. We've found this to be a rich experience, a lot fun, and a worthwhile endeavor. Participatory materials development enables members of the intended audience to share a story of their own about critical topics. The power of this story, told visually and in words that are the participants', captures the attention of readers and most often speaks to them in 'plain' everyday terms. Rima Rudd >===== Original Message From nifl-health@nifl.gov ===== >Hi- >I just started working on an article related to our use of the photonovels >we developed for prenatal care. (We've discussed the De Madre A Madre/From >Mother to Mother bilingual photonovels on this listserv previously.) >Although the article is not published yet, you might be interested in our >work. > >After developing the photonovels (a hybrid design- combining a traditional >photonovel format with a literacy component) we received several small >grants to develop a method to teach prenatal education classes using the >photonovels. We've developed a simple 6 step process. Over a period of >about 4 years, we have tested the 'Teach-With-Stories' (TWS) method in >several sites across North Carolina with pregnant Latino women with low >literacy skills in English and/or Spanish. The facilitators also had >different skill and literacy levels. Each class they would read and discuss >a story together. Group members took the photonovels home. They reported >keeping them, rereading and sharing them with friends and other family >members. > >The TWS method addresses health literacy, health empowerment, and health >education needs. While our focus was on refining the method and learning how >to train facilitators in the process, we did some informal qualitative >evaluation. The results and stories were fairly consistent across sites. >Many of our findings are similar to the published findings in studies on the >efficacy of patient-centered care. Both clients and clinic staff benefit. >Note: A great summary of these studies is in the Institute of Medicine's >Health Professions Education: A Bridge to Quality report (2003). > >At the core of the TWS method is a 'power-sharing' way of relating and >educating (i.e., educator as facilitator rather than expert). In addition, >we have tried to build on your work, Dr. Rudd's work and the work of Rick >Arnold (who developed the 'Spiral Model'- an educational empowerment >process). > >Just recently, the TWS method was selected as a national demonstration >project and will be more formally evaluated. We are looking at how to >evaluate its impact on the group members' health literacy (and also the >impact on the group itself). We are especially interested in how to >evaluate change in levels/types of social support and how it relates to >health literacy of individuals and the group.) If anyone has any >suggestions about this, please let me know! > >If you would like additional information, feel free to contact me directly. > >Hope this helpful- > >Susan Auger >Executive Director >Auger Communications/Aprendo Press >sauger@mindspring.com >tel: 919-361-1857 > >-----Original Message----- >From: nifl-health@nifl.gov [mailto:nifl-health@nifl.gov] On Behalf Of >Lendoak@aol.com >Sent: Monday, February 21, 2005 12:05 PM >To: Multiple recipients of list >Subject: [NIFL-HEALTH:4657] Research on the use of Photonovellas? > >Several of us are preparing a paper on the efficacy of visuals in patient >education. Our question is: What research or practice has been published >on the >use of Photonovellas? > >We would appreciate any information. > >Len and Ceci Doak >Patient Learning Assoc. >4 Chilham Ct. >Potomac, Md. 20854 Rima E. Rudd, MSPH, Sc.D. Department of Society, Human Development,and Health Harvard School of Public Health 677 Huntington Avenue Boston, MA 02115 Phone: 617-432-1135 fax: 617-432-3123 Note new listings on our Health Literacy Web Site: www.hsph.harvard.edu/healthliteracy
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