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.

Sweet Temptations: A study into the effects of a fotonovela about diabetes on low-literatesIn this experiment the effectiveness of a fotonovela for Dutch low-literates was assessed and underlying mechanisms that could account for possible persuasive effects were studied. The Entertainment Overcoming Resistance Model (EORM; Moyer-Gusé, 2008) served as a theoretical framework. The fotonovela that was used was a Dutch translation of the diabetes fotonovela ‘Sweet Temptations’ developed and tested in the US. Participants were 92 low-literates, randomly assigned to one of three groups: a group that read the fotonovela, a group that read a traditional diabetes brochure, and a control group that only answered questions about diabetes knowledge and behavioral intentions. Both the fotonovela and the traditional brochure produced more diabetes knowledge and stronger behavioral intentions than were measured in the control group. The fotonovela outperformed the traditional brochure in effects on diabetes knowledge. No support was found for propositions in the EORM concerning the role of mediators in the persuasive effects of processing a narrative message.