Sweet Temptations: How Does Reading a Fotonovela About Diabetes Affect Dutch Adults with Different Levels of Literacy?

Abstract

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.

Improving health literacy and medication compliance through comic books: a quasi-experimental study of Chinese community-dwelling older adults

“…Comic books have been used in various populations for promoting different health issues, including encouraging children and their parents to make healthier lifestyle choices (8), improving children’s knowledge and medication compliance (9), and removing barriers to cervical cancer screening (10). Another kind of comic book, the ‘photonovella’, in which photographs instead of drawings are used, is another popular strategy in health promotion and maintenance (11–15).…”

Stepped-wedge cluster randomised trial of a smoking cessation counselling training programme for midwives treating women with functional health illiteracy and low socioeconomic status (PROMISE): a study protocol

“…By using simple texts and illustrations, information can be made accessible and comprehensible to both people with either poor or good literacy skills [ 39 ]. Storyboard leaflets stimulate doctor-client communication and have proven useful in other health-related domains, such as diabetes and obesity [ 40 , 41 ]. They may be used for counselling for both people with poor literacy skills and for people with good literacy skills [ 40 ].…”

Mobile Fotonovelas Within a Text Message Outreach: An Innovative Tool to Build Health Literacy and Influence Behaviors in Response to the COVID-19 Pandemic

“…There is substantial evidence that text messaging can be used for health outreach and to influence health behaviors [ 8 ]. At the same time, fotonovelas, a traditional print medium originally developed for Latin American audiences, have been used with great success with participants from other (eg, Dutch) cultures, particularly among low-literacy or underserved populations [ 9 - 11 ]. Similar to a comic book in format, fotonovelas typically tell a story using a dramatic or soap opera–style plot with illustrations or photographs and dialogue bubbles to capture the user's attention and share an important lesson.…”