Rima,

Thanks so much for adding to this discussion! Your work shows that this
method has been around for a long time, and as John said, the advances
in technology have made parts of this process so much easier and more
flexible. I am glad to see that there is so much interest in
phonotovellas out there.

And you do have some data that speaks to the effectiveness of
phonovellas. Are any of those reports available online? Also, could you
give us the jist of what you found about the "efficacy, intent to act,
and reported activities/behavior change"? 

Again, any way to verify that there is evidence to support their use
will help bring this tool to more people!

Thanks again,
Julie

Julie McKinney
Health Literacy List Moderator
World Education
jmckinney at worlded.org

>>> "Rima Rudd" <RRUDD at hsph.harvard.edu> 11/22/08 10:54 AM >>>

Hello again,
After scanning the questions posed by Julie, I thought I'd share a bit
more about the work done by Rudd, Comings, and Roter [together and
independently]. Keep in mind that much of this work was done in the
previous century! However, Debra Roter continues to work with her
graduate students at Hopkins to develop photonovels with community based
organizations. She has been doing this every year for 2 decades. Some of
her students have gone on to develop and study the use of photnovels
elsewhere [e.g. Korea]. 
Past work: 
1. We developed and applied a participatory process that engaged a wide
range of participants [all of whom were members of the intended
audience]. Various participants served as writers, actors, set
designers, evaluators, photographers, and lay out designers.... . We
also worked with local production groups and looked into production
capabilities in local schools. 
2. We did conduct several studies and engaged in formative, process, and
outcome evaluations. Our formative evaluations focused on readability
and attractiveness as well as on distribution plans. Our process
evaluations examined the extent and scope of participation and decision
making [amongst those who actively participated] and expressed
preferences for and use of various materials [amongst members of the
various audiences who received the materials]. We also looked at value
of including faces and places familiar to the readers. We asked readers
to compare the photonovel materials [content and format] with other
materials addressing the same issues. We counted materials taken from
distribution sites that carried the photonovels as well as other
materials addressing the same issue/topic. We queried whether or not
people shared the materials with others in their family and community.
Our proximal outcomes included measures of efficacy, intent to act, and
reported activities/
 behavior change  [linked to a more distal outcome via theory] . 

Sadly, I did not write up all of our work although I had presented at
several APHA meetings in the late 1970s and at an International Health
Promotion Meeting in 1980 [in London, with Debra Roter].  But we did
publish some. Here are the old references:
1. Roter DL, Rudd RE, Keoge J, Robinson B. Worker Produced Health
Education Material for the Construction Trades.  International Quarterly
of Community Health Education 7; 7(2): 109-121. 1986-7.
2. Roter DL, Rudd RE,  Frantz S, Comings JP. Participatory Materials
Development in Health Education. Public Health Reports, 96(2):169-172.
1987.
3. Rudd RE, Comfort L, Mongillo J, Zani L.    Student Produced Health
Education Materials, chapter in Matiella (ed), Comprehensive Health
Education in the Multiethnic Classroom, Santa Cruz, CA: ETR Associates,
1994.
4. Rudd RE, Comings JP.  Learner Developed Materials: An Empowering
Product, Health Education Quarterly 21(3):33-47. 1994.

You might also want to look into the very exciting participatory work
called photovoice [you can link to it via my web site] developed by
Caroline Wang.
Hope this is helpful...
Rima Rudd 



Rima E. Rudd, ScD, MSPH
Department of Society, Human Development & Health
Harvard School of Public Health
677 Huntington Avenue
Boston MA 02115
Phone: 617 432 1135
fax:     617 432 3123
web:    www.hsph.harvard.edu/healthliteracy
www.hsph.harvard.edu/sisterstogether
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