Susan,

Thank you for all you have shared (and others as well). This discussion
about different facets of photonovellas has been extraordinarily informative
as well as exciting.

I would appreciate insights and recommendations on appropriate, validated,
reliable (etc.) evaluation instruments that have been used to assess and
confirm the effectiveness of interventions utilizing photonovellas.  Are you
aware of any evaluation instruments that have been developed specifically
for photonovellas? 

How would you recommend someone planning a public health intervention
determine what and how to measure the outcomes?

Are you are aware of any published reports documenting appropriate
evaluation tools and analyses to measure the outcomes and success of using
photonovellas? I have looked but not found anything specific to evaluation.

Thanks again to everyone.

Kind regards,

Marty



On 11/19/08 1:26 PM, "Susan Auger" <sauger at mindspring.com> wrote:


> I wanted to share some background info to help clarify how I came to develop

> and use photonovellas differently...

> In the early 1990's I Œdiscovered¹ photonovellas while conducting a national

> search for culturally appropriate bilingual educational materials for NC

> health departments.  As the State Training Coordinator for women's health at

> the time, I was responsible for conducting statewide training needs

> assessments, as well as developing and coordinating training for health

> professionals in maternity and family planning.

> Serving the growing Hispanic population posed many challenges, e.g., lack of

> bilingual, bicultural staff, interpreters, and bilingual materials. It was

> common for women to come into prenatal care late or just show up in the

> emergency room at the time of delivery. Issues voiced by providers included

> problems with no-shows, 'non-compliance,' and perceptions that Latinos were

> 'difficult to reach,' and 'didn't like groups.' The more I learned about

> literacy and cultural competency, I realized that this probably had more to do

> with our lack of cultural competency (individually and organizationally) and

> ineffective service delivery strategies, than simply a lack of appropriate

> written materials and problem patients.

> Similar to John and Laura, Paolo Friere, along with Malcom Knowles' work

> (adult learning theory), were also inspirational to me.  From a systems

> perspective, I saw the need to transform how we were teaching mandated

> prenatal education- from a teacher or clinician-centered model to a learner,

> patient or cultured-centered model.  To me, the photonovella was a perfect

> tool to assist providers and educators who wanted to adopt a participatory,

> empowerment-based approach.

> Using a collaborative development process, we wove together key content taught

> in traditional prenatal education curricula, actual experiences of Latino

> families and providers who serve them to create the De Madre A Madre

> photonovellas.  Embedded in the stories are discussion Œsparks¹ related to

> common issues and concerns (mental, emotional, social, spiritual) experienced

> by women during and after pregnancy.

> As Julie and Mary mentioned, the women read the novella out loud like a play

> (so those who can¹t read can still participate). While key health messages are

> automatically addressed while reading the story, the dialog focuses on the

> priorities, experiences, and questions of the group members.  So they in

> effect tailor the session to their unique needs and interests. This structure

> shifts the dynamics from a passive, lecture style to an active, participatory

> one where everyone truly is a teacher and a learner.

> The group process, what we now call the Teach-With-Stories(TWS) method,

> fosters critical thinking, behavior change, and social support- all key

> elements of health literacy.  Julie touched on its simplicity and flexibility.

> It takes no more time than a traditional class and you can weave in other

> activities or use it to supplement an exisiting curriculum. And as Julie also

> mentioned, the photonovellas can still be used for information dissemination

> and in one-on-one education.

> As Mark suggests, the dynamics in making change in one¹ life or one¹s family

> are complex and can be complicated to explain. We need to create Œspace Œ in

> our systems of care to address these types of needs and realities.  It is at

> the heart of true health literacy. I think using photonovellas with a

> participatory, group approach, like our TWS method, gives providers and

> educators a practical and easy way to do this.

> Susan

>  

> Auger Communications, Inc.

> PO Box 51392

> Durham, North Carolina 27717

> tel:  919.361.1857

> fax: 919.361.2284

> email: auger at augercommunications.com <mailto:auger at augercommunications.com>

>  

> 

> 

> From: healthliteracy-bounces at nifl.gov [mailto:healthliteracy-bounces at nifl.gov]

> On Behalf Of MarkH38514 at aol.com

> Sent: Wednesday, November 19, 2008 10:55 AM

> To: healthliteracy at nifl.gov

> Subject: [HealthLiteracy 2481] Re: Treatment refusal and verbal abilitiesand

> phot...

> 

> Susan: 

>  

> This sounds promising. From my own experiences as a Psychologist and a

> patient...

>  

> Because so much information about medical treatments and research is focused

> on the patient,  health care providers don't always realize that every disease

> is a family disease.

>  

> Physicians are often frustrated by "non-compliant" patients (a description I

> despise) who don't do what they're told--losing weight, for example. But

> losing weight means you have to change what you eat and that decision alone

> can create profound spousal, family, cultural and religious conflicts.

>  

> Plus, successful weight loss can be psychologically threatening to other

> family members who can't or don't want to lose weight, or feel that their

> spouse's weight loss will threaten the marriage because the spouse may now be

> more attractive to the opposite sex. Sometimes family members can sabotage

> one's best efforts to lose weight and keep it off. Obviously there's more to

> weight loss than telling patients to lose weight and giving them nutritional

> handouts. 

>  

> If you can find patients willing to talk honestly about these issues, you may

> be able to identify possible barriers to healthy behavior and provide some

> possible solutions in a format that's more meaningful than just another

> medical handout. 

>  

> Mark

>  

> Mark Hochhauser, Ph.D.

> Readability Consultant

> 3344 Scott Avenue North

> Golden Valley, MN  55422

> Phone: 763-521-4672

> Fax: 763-521-5069

> Cell: 612-281-1517

> email: MarkH38514 at aol.com

>  

>  

> 

> 

> 

> 

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> today!

> 

> 

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