I second this.  It is more about the participatory process, not the product.  
Again, this is reiterated in the findings of James et al. (2005) who found that photonovels proved to be an effective strategy to prepare South African youth for adequate preventive behaviours. The study, however,  identified the need to combine photonovels with other planned theory-based interventions to initiate preventive behaviour with respect to sexually transmitted infections.
Laura

--
Laura Nimmon 
Ph.D Student
Social Sciences & Humanities Research Council of Canada Doctoral Fellow
Michael Smith Foundation for Health Research Senior Graduate Trainee 
www.photonovel.ca

Language and Literacy Education
University of British Columbia
2125 Main Mall
Vancouver, BC
Canada V6T 1Z4


-----Original Message-----


> Date: Wed Nov 26 06:13:04 PST 2008

> From: "Rima Rudd" <rrudd at hsph.harvard.edu>

> Subject: [HealthLiteracy 2516]   Re: Evidence-based? ... Literacy	benefits?

> To: "The Health and Literacy Discussion List" <healthliteracy at nifl.gov>

>

> Hello [and Happy Thanksgiving]

> I write, as a fan of Cris Zarcadoolas who always manages to cut to the chase. There are indeed two dangers hidden in our enthusiasm. The first is the easy temptation to reach into our pocket for our favorite tool with the intent to use it for all situations. The second is to forget that materials [even exciting materials such as the photonovels] serve only as a support for a well designed program -- they do not and should not constitute the program as a whole.

> The participatory processes underlying the focus on photonovels in  public health/education efforts should be at the center. The photonovel serves as an example. We need to look at other participatory processes [e.g. photovoice] and be sure that our attention is on the process and not the product.  

> Rima

> 

> 

> Rima E. Rudd, ScD, MSPH

> Department of Society, Human Development & Health

> Harvard School of Public Health

> 677 Huntington Avenue

> Boston MA 02115

> Phone: 617 432 1135

> fax:     617 432 3123

> web:    www.hsph.harvard.edu/healthliteracy

> www.hsph.harvard.edu/sisterstogether

> 

> >>> christina <zarcac01 at imail.mssm.edu> 11/25/2008 9:37 AM >>>

> Julie, Susan, ...

> 

> I think of photonovellas the way I do about any 

> text.  And as Susan so rightly put it - is is one 

> of many texts - verbal, visual, print,   that 

> contribute to advancing a person's engagement and 

> understanding.

> Therefore "evidence based" is so medical and 

> narrow a standard - in some ways setting the bar 

> too low.

> If a text has meaning for someone it will give 

> voice, empower, and democratize what is too often 

> the rarified, closed codes of science ( or other 

> technology). Not all of these powerful things can 

> be accomodated in our "evidence based" tool kit.

> 

> What tempers my enthusiasim for novellas ( or any 

> one kind of text) is that I see too often that 

> "it" becomes the default.  Therefore instead of 

> struggling with the messiness of true 

> collaboration to see what the text is/might need 

> to be, we decide it will be a novella for X 

> community, for y subset of the population. We can 

> become wooed into thinking that is the one true 

> answer.

> 

> Another concern with text formats that "work" is 

> that we have to learn more about what they work 

> at.  Can they convey more than the information 

> given.  The gold standard for me is, can the text 

> convey the information in a way that is 

> productive - allows the user to use something of 

> the information in a new way, in a new context.

> 

> What prompted me to post today is there is some 

> breaking news on the all the morning

> Study: Do breast tumors go away on their own?

> http://www.usatoday.com/news/health/2008-11-24-breast-cancer_N.htm?csp=34 

> 

> Perhaps not totally on the topic of novellas - 

> but a text  question in its own rightŠ.

> 

> What do the texts we create ( alone or with our 

> collaborates) do to promote an active engagement 

> with concepts as much as the literal facts or 

> information?

> 

> Thanks for a stimulating discussion this past week.

> 

> Happy Thanksgiving to you all,

> Chris

> 

> Christina Zarcadoolas, PhD.

> Health and Environmental Literacy Initiative

> Dept. of Community and Preventive Medicine

> Mount Sinai School of Medicine

> One Gustave L. Levy Place

> Box 1057

> New York, NY 10029

> 212-824-7061

> 

> Visit my blog     www.zarcbark.blogspot.com 

> 

> 

> 

> >Hi Julie-

> >It's nice to finally be back on-line!

> >

> >The question are photonovellas an 

> >"evidence-based" strategy made me pause. 

> >Empirical studies could help us arrive at a 

> >'yes' or 'no' answer. However, given the level 

> >of variability in design, development, 

> >populations, objectives, and usage, the 

> >generalizability of the findings would be quite 

> >limited (which I think is what you were getting 

> >at when you suggested it's not an easy yes or 

> >no). This makes me wonder if it would be more 

> >helpful to ask how empirical research and 

> >different cultures of inquiry can help inform 

> >our development and use of photonovellas to 

> >achieve our stated objectives. An 

> >interdisciplinary approach seems ideal, drawing 

> >from fields such as medicine, public health, 

> >education, communications, and social psychology 

> >(I'm sure there are others).

> >

> >As I reflected on the question, 'evidence of 

> >what?' my thinking came full circle, back to Dr. 

> >Chris Zarcadoolas's comments last year about the 

> >problems that can stem from defining health 

> >literacy in terms too narrow, or from not 

> >incorporating our powerful creative abilities as 

> >human beings to use language to make meaning and 

> >change in our worlds. Evaluating the 

> >photonovella challenges us in this regard 

> >because, as many of the shared experiences 

> >reflect, we must consider not only the results 

> >of the creative process but also the mystery of 

> >creation, the intuitive, spontaneous elements. 

> >As Laura Nimmon's mentioned in her most recent 

> >post, that she trusts the creative potential of 

> >the participants and that in and of itself is a 

> >means to restore human agency. The experiences 

> >of John Comings, Rima Rudd and others suggest 

> >that it is possible to help a community in this 

> >way also.

> >

> >Thanks to the pioneering efforts of many members 

> >on this discussion list, the health literacy 

> >movement is growing and evolving. Evaluation of 

> >programs and approaches to improve the health 

> >literacy of individuals and communities is a 

> >critical part of that proces. I appreciate and 

> >am encouraged by the interest expressed in 

> >developing, using, and evaluating photonovellas. 

> >I look forward to continuing the dialog as we 

> >move forward!

> >

> >To clarify the difference between using a 

> >photonovella and using the Teach-With-Stories 

> >(TWS) Method:

> >

> >You can use a photonovella in different ways:

> >    --develop a photonovella as the intervention 

> >(like Laura and John discussed) and then, for 

> >example, the group can use it to teach others in 

> >their community

> >    --use it for information dissemination 

> >(distribute at health fairs, clinics, home 

> >visits, etc.),

> >    --use it to reinforce health information 

> >provided in a different format (e.g., we 

> >provided radio health program then had same info 

> >in a novela available in local businesses)

> >    --use to spark group dialog and provide 

> >education. The photonovella provides the 

> >'curriculum' structure for both health and 

> >participatory literacy instruction.

> >

> >The Teach-With-Stories Method is a 6 step 

> >participatory group facilitation process. This 

> >method of facilitation can be used with 

> >any 'spark' (e.g. photonovella, video, plays, 

> >article, current event)

> >

> >We developed the method to assist educators in 

> >making the shift from a traditional, didactic 

> >approach (that typically relies heavily on 

> >written communication) to a culturally 

> >appropriate, participatory approach that builds 

> >on oral traditions (like creating a play and 

> >keeping the focus on dialog).

> >

> >Our website is currently being renovated but 

> >should be up in the next couple of weeks. We 

> >will have additional details about the TWS 

> >facilitation training and training materials for 

> >the De Madre A Madre prenatal program. Also, we 

> >will be posting the findings from our TWS study 

> >re: Lay Educator Prenatal Outreach Program for 

> >Latinas. I will let you know when it's up and 

> >running.

> >

> >Susan

> >

> >-----Original Message-----

> >From: healthliteracy-bounces at nifl.gov 

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

> >On Behalf Of Julie McKinney

> >Sent: Thursday, November 20, 2008 2:30 PM

> >To: healthliteracy at nifl.gov 

> >Subject: [HealthLiteracy 2494] Evidence-based? ... Literacy benefits?

> >

> >I'm glad that Marty brought up evaluation! 

> >So...John, Susan and others, can we call 

> >phonovellas an "evidence-based" strategy? For 

> >public health?

> >How about for literacy teaching?  (My guess is it's not an easy yes or

> >no!)

> >

> >We have not heard from many adult literacy 

> >teachers: for you all, what benefits do you see 

> >in literacy gains using photonovellas vs. other 

> >authentic materials?

> >

> >And one question for Susan: what is the 

> >difference between using a phonotovella and 

> >using the TWS (teach with stories)method?

> >

> >Thanks to all for great questions and answers!

> >

> >Julie

> >

> >Julie McKinney

> >Health Literacy List Moderator

> >World Education

> >jmckinney at worlded.org 

> >----------------------------------------------------

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> >

> >

> >----------------------------------------------------

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> >Email delivered to christina.zarcadoolas at mssm.edu 

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> 

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--
Laura Nimmon 
Ph.D Student
Social Sciences & Humanities Research Council of Canada Doctoral Fellow
Michael Smith Foundation for Health Research Senior Graduate Trainee 
www.photonovel.ca

Language and Literacy Education
University of British Columbia
2125 Main Mall
Vancouver, BC
Canada V6T 1Z4