I just wanted to reinforce Peter's comment on the need to study further the
use of photonovels and their ability to impact behavior change. We are
slowly but surely making progress. 

On a positive note, below is a link to the report just released by Center
for Health Care Strategies, entitled: Reducing Racial and Ethnic
Disparities: Quality Improvement in Medicaid Managed Care ToolKit. It
includes the Teach With Stories Method for prenatal education using
photonovels.

Shortcut to:

http://www.chcs.org/publications3960/publications_show.htm?doc_id=440684

The results from the national CHCS demonstration project at Neighborhood
Health Plan of Rhode Island showed that the women were very receptive to the
information provided in the photonovel format and appreciated the personal
approach. The members that received the Teach-with-Stories intervention
using photonovels (n=42) had higher rates of optimal prenatal care
(receiving more than 81% of expected care) as compared to the NHPRI's
overall prenatal population (n=411) (90.48% vs 64.72%). The women also had a
slightly higher rate of kept postpartum appointments (66.67% vs 62.29%) 

Note: The study did not impact timeliness of care since the women were
identified when already pregnant. 

The positive changes reflected in the women's behavior and the self-reported
changes in the feelings and attitudes of the women and facilitators and
staff involved in the study are encouraging. And we are continuing to build
on this work using photonovels and a participatory, client (or learner-)
centered group educational approach.

Susan Auger 

  
-----Original Message-----
From: healthliteracy-bounces at nifl.gov
[mailto:healthliteracy-bounces at nifl.gov] On Behalf Of Peter S. Houts
Sent: Thursday, January 11, 2007 9:35 PM
To: The Health and Literacy Discussion List
Subject: [HealthLiteracy 569] Re: using pictures in health communications

Both Megan and Susan have commented on the importance of including one to 
one contact and personalized explanations of pictures and written 
materials.  I think this is a very important point.  Interestingly, I have 
not read this idea before - but that probably is a reflection of my limited 
exposure to the field - which is mainly the research side.  It is an 
important idea that should be researched.  I think that it is very likely 
that personal explanation will have a marked effect on some patients' 
comprehension and behaviors.  It would be a simple study to design:  text 
plus pictures versus text plus pictures plus personalized explanations.  I 
suspect that the results will be complex - greater effects on certain 
populations and certain topics.

I also appreciated the enthusiastic comments from several people on photo 
novels.  I share their expectation that photo novels can be very effective 
in changing behavior - but, as a researcher, this is a hypothesis rather 
than an established fact.  As I mentioned in an earlier message, we could 
not find rigorously controlled studies to prove it.  I very much hope that 
the people who use these techniques will carry out the research that is
needed.

I am leaving on at trip tomorrow morning - returning on January 22.  I look 
forward to reading more messages on this topic when I return and will add 
my thoughts as well.  Thank you for allowing me to participate - this has 
been a very stimulating and enjoyable project.

All the best,
Peter

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