Diabetes among Hispanics has reached epidemic proportions. (1) [Pre-diabetes] education is key in diabetes prevention and control yet education tools that translate into culturally engaging, yet simple and easy to understand information is a challenge for Hispanics. Limited health literacy, lack of English-language proficiency, trouble accessing healthcare and socio-cultural barriers represent great disparities for this under- served population (2). As of 2010, the Hispanic population in the United States reached 50 million, comprising over 16.7% of the U.S. population (3) and rural Hispanics comprise 6.3% of the nation's non-metro inhabitants (4). Almost 25% of the Hispanic population in the U.S. does not speak English (2) and accessing important health information about diabetes prevention and control and other chronic diseases eludes them. The challenge is compounded as health providers attempt to educate and inform the 3.2 million Hispanics living in rural areas of the country, as they are even more isolated than those Hispanics in metro areas (4). Fotonovelas, a popular Latin American storytelling medium are stories told with photos and dialogue bubbles. Because fotonovelas are entertaining, graphic and colorful, and have a minimum of text;they are intrinsically easy to read. Originally a pop culture entertainment medium in Latin America, fotonovelas are popular and well- received among U.S. Hispanics (5,6,7,8,9,10) and they have proven to be effective health education tools (6,7,10,11,12,13,14,15,16,17). This Phase I SBIR application is a collaboration among ACMA Social Marketing, the most experienced producer of health education fotonovelas in the U.S., New Mexico Department of Health Diabetes Prevention and Control Program, [Viridian Health], a national healthcare improvement company, and VisionQuest, a biomedical firm dedicated to preventing eye disease related to diabetes. The proposed innovation combines the potential of three popular, credible and well-accepted communication agents to address Hispanic health disparities in rural areas: health fotonovelas, bilingual and/or community-based tabloid newspapers and promotoras. [Our innovation involves combining the health fotonovela with the community newspaper to iterate it into a """"""""foto-tabloid,"""""""" effectively turning the community newspaper into a health information vehicle to reach out to underserved rural Hispanics. In this Phase I period, we will use rural New Mexico as a test-bed and assess if foto-tabloids are more effective as outreach and health communication tools than the standard patient education pamphlet.]
[In Phase I revised application, our innovation involves collaborating with the New Mexico Department of Health - Diabetes Prevention and Control Program, Viridian Health, a national health improvement organization and VisionQuest Biomedical, a biomedical firm dedicated to preventing eye disease related to diabetes to convert and re-purpose fotonovelas produced by Viridian Health based on the National DPP Lifestyle Curriculum content into Foto-tabloids to insert into community newspapers. The foto-tabloid is a patient-centered, low- cost, entertainment education storytelling educational approach that will effectively convert community newspapers into health information vehicles. The proposed project combines the effectiveness of three effective communication vehicles to address Hispanic health disparities in rural areas: health fotonovelas, bilingual and/or Spanish newspapers and promotoras. In Phase I, in select rural communities in New Mexico, we will assess the feasibility, acceptability and preliminary behavior-changing capacity of the foto-tabloid as compared to a standard pamphlet approach. In Phase II, the foto-tabloid will be produced, serialized and published in other rural areas of the U.S. to demonstrate its behavior changing and diabetes prevention capabilities in a more in-depth and robust manner. Although the foto-tabloid will be designed primarily as a tool that transforms the community newspaper into a health information vehicle, it will also be designed to stand alone and be used by promotoras as outreach, easy-to-read, motivational and educational tools, or to be mailed directly to people with pre-diabetes in rural areas.]
