Independent studies by the Institute for Health Promotion and Disease Prevention Research at USC and the Healthcare Management Corp. found that Sweet Temptations, a fotonovela produced by the USC School of Pharmacy, successfully increases diabetes awareness and knowledge in the Latino community.
“This is very good news. It gives us a validation that our materials are having a positive impact on the target population,” said Mel Baron, associate professor of clinical pharmacy at the School of Pharmacy and the producer of the fotonovela.
Comparable to a comic book, a fotonovela is a story told through photos and limited text. The medium, well known among Latinos, often covers social issues with soap opera-like storylines.
Prior to producing the project, Baron and his associates researched the myths and misinformation common in the Latino community that prevent people from seeking medical attention or sticking to therapeutic regimens in the treatment of diabetes. They also sought a format that was culturally sensitive and familiar.
According to the independent research conducted by Jennifer Unger, associate dean for research at the Claremont Graduate University, the findings provide compelling evidence that fotonovelas such as Sweet Temptations can be a useful medium for health education among Latinos. At the time of the study, Unger was with the USC Institute for Health Promotion and Disease Prevention Research.
Unger’s study used a test group of adult students at the Roosevelt Community Adult School in the Los Angeles Unified School District. The group was given a pre-test about diabetes and then asked to read the fotonovela, followed by retaking the same test.
“We developed a survey of people’s knowledge, attitudes and beliefs,” Unger said. “We found that the fotonovela did increase the participants’ knowledge of diabetes and that may ultimately lead to better behavior.”
The study reported that 100 percent of the 311 participants found the fotonovela to be informative. Diabetes knowledge increased from 66 to 86 percent after reading the fotonovela. In addition, the youngest respondents, in the 18 to 24 age bracket, benefited most from the fotonovela, with significant changes in their behavioral intentions and knowledge of the disease.
After reading the fotonovela, most of the study participants intended to exercise more, eat more fruits and vegetables, and talk to doctors and family members about diabetes.
The effectiveness of the fotonovela was validated when another independent research study conducted by the Healthcare Management Corp., a subsidiary of Wellpoint Inc., held focus groups on methods to educate minorities about diabetes. Once again, the fotonovela proved to be a signififcant educational tool.
“There is a knowledge disconnect about diabetes in our Latino focus groups, and the cultural relevance of the story in the fotonovela really helped participants connect more with the issue,” said Grace Ting, health services director at Wellpoint Inc. “They could relate to the family experiences of Sweet Temptations. The storyline was comfortable and familiar to them.”
According to Ting, the study group considered various forms of media and found the fotonovela to be the most helpful tool in terms of diabetes awareness.
These results have led Wellpoint to include Baron’s fotonovela in a pilot study that strives to recruit minorities into a disease management program. The success of the Sweet Temptations fotonovela also prompted Wellpoint to support a fotonovela on medication adherence that the School of Pharmacy will produce next year.
According to the Center for Disease Control, in 2008, the number of people with diabetes in the United States increased to 24 million, or around 8 percent of the population. The prevalence of diabetes among Latino Americans is 10.4 percent, resulting in 4.5 million Latinos nationwide having the disease.
Baron also has created fotonovelas on folic acid and depression. He is currently in production on fotonovelas dealing with pediatric asthma and dementia.
The fotonovela projects have been supported by USC Neighborhood Outreach grants, L.A. Care, AmerisourceBergen, the Institute for Community Pharmacy, the Botica del Sol Pharmacy, Eli Lilly, the NACDS Foundation, QueensCare Foundation and Takeda Pharmaceuticals of North America.