Stories for Change: Digital Storytelling for Diabetes Self-Management Among Hispanic Adults
Condition: Type2 Diabetes
MeSH terms: Diabetes Mellitus
Study type: Interventional

Summary: 
      Hispanic adults are twice as likely to have type 2 diabetes mellitus (T2D) and 1.5 times more
      likely to die from the disease than non-Hispanic whites. These disparities are mediated, in
      part, by less healthful levels of physical activity, dietary quality, medication adherence,
      and self-monitoring of blood glucose than non-Hispanic whites. Innovative approaches that
      arise from affected communities are needed to address these health disparities.

      Community-based participatory research (CBPR) has been successful in targeting health issues
      among Hispanic and immigrant populations; CBPR is an effective approach for addressing health
      behaviors in a sociocultural context. In 2004, the research team developed a CBPR partnership
      between immigrant communities and academic institutions called Rochester Healthy Community
      Partnership (RHCP)

      Storytelling or narrative-based interventions are designed to incorporate culture-centric
      health messaging to promote behavior change among vulnerable populations. Digital
      storytelling interventions are narrative-based videos elicited through a CBPR approach to
      surface the authentic voices of individuals overcoming obstacles toward engaging in health
      promoting behaviors to shape positive health behaviors of viewers through influences on
      attitudes and beliefs.

      RHCP partners from Hispanic communities identified T2D as a priority area for intervention,
      and have co-created each of the formative phases leading up to this proposal. Narrative
      theory and social cognitive theory formed the conceptual basis for intervention development.
      The study team conducted surveys and focus groups to derive the approach and personnel for
      building an authentic intervention that was created in a digital storytelling workshop where
      stories about diabetes self-management were captured, recorded, and edited to derive the
      final intervention products in video forma. The respective digital storytelling videos were
      pilot tested with 25 patients across healthcare institutions in Minnesota and Arizona. The
      intervention was rated as highly acceptable, culturally relevant, and perceived as
      efficacious for motivating behavioral change.

      The overall objective of this project is therefore to assess the efficacy of a digital
      storytelling intervention derived through a CBPR approach on self-management of T2D among
      Hispanic adults.
    

Detailed description: 
      The study team will conduct a two-group randomized controlled trial in primary care clinical
      settings at two healthcare institutions among 450 Hispanic adults with poorly controlled T2D
      (hemoglobin A1c≥8%). The intervention group will view the 12-minute digital storytelling
      video. Both the intervention and comparison groups will receive diabetes education and
      resource cards, as well as usual clinical care. The primary outcome will be glycemic control
      as measured by hemoglobin A1c 3 months after intervention delivery. Secondary outcomes will
      include diabetes self-management behaviors, blood pressure, LDL-cholesterol, and body mass
      index. The impact of concomitant covariates, including sex, age, and socio-economic status,
      on the sensitivity of the intervention effect will also be explored.
    

Intervention name(s): Digital Storytelling Intervention
Intervention type(s): Behavioral
Intervention description(s): 12-minute digital storytelling intervention in Spanish, with four individuals explaining their personal Type 2 Diabetes stories.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Supportive Care