AL CASTRO, ANGELES SORIA, MARIA BARKER

JUNE, 2015

Reaching Out to the Latino Community with Health

Literate Messaging

Introductions

FacilitatorsAudience

Agenda

Learn how two Milwaukee agencies reach Latinos with health literate messages.

Hear one health promoters experience delivering these efforts

Discuss how your agency can replicate these efforts

Who is Your Audience and Community?

Hispanics/Latinos are the second largest and fastest growing minority racial and ethnic population in Wisconsin.

Wisconsin has 336,056 Latinos (US Census, 2010)-(74% increase from 2000).

Represents about 6% of State’s population.

Milwaukee County is home to 126,000 Latinos, comprising 33% of Wisconsin's Latino population.

33% of Hispanics are foreign born

40% are not comfortable speaking in English

Wisconsin’s Latino Population

Surveys / Data Review:

• Bruce Guadalupe Community School (n=1,100):• 50% of students (K3-8th) – overweight/obese

• Elder Programs (n=156):• 40% diabetes Type II

• Survey of Parents (n = 413)• Perceived risk of diabetes not showing correlation

to odds of screenings

UCC Internal Scan

Community members identified a need for accessible information

• Medical jargon

• Spanish/ cultural translation

• Literacy levels vary

• Interesting•Telenovela•Fotonovela

• Pisando Fuerte

Focus Groups/ Community Advisory Board:

Television in many ways has always been a social phenomenon. It has been the fixture that anchors family life; a cultural phenomenon whose impact is felt across generations and across geographies.

According to Nielsen Media Research…

•Latinos watch more television than the general US population.9

•Latinos are more likely to report acting on information they learned on television than their white counterparts.10

•55% to 62% of Latinos in all age groups watch an average of 2.5 telenovela episodes per week.11

- The New Power of TV, Initiative 2013

Theoretical Framework

Bandura’s Social Cognitive Theory12

• We learn vicariously from the successes and failures of other people through a process called social modeling

• Modeling is more likely to occur when you identify closely and empathize with the other person

Our Hypothesis

Viewers who identify with the characters in our telenovela will demonstrate1. Increased comprehension of “oral”

diabetes-related health messages.

2. Positive changes in knowledge, information retention, information-seeking behaviors and self-reported changes in eating and exercise habits.

3. Expressed satisfaction with the “telenovela” as an educational tool to use to communicate information to family members and friends

Methods

Viewers who identify with the characters in our telenovela will demonstrate• First, our study team conducted interviews with diabetic Latinos in

Milwaukee to help us identify key diabetes-related health messages.

• Second, we developed the storyline and script and met with our Community Advisory Board numerous times to discuss key cultural and linguistic elements.

• We cast volunteers from the community to portray the characters and worked over several months to produce the telenovela.

• Developed a diabetes knowledge, attitudes and behaviors assessment tool in Spanish and English to administer pre- and post- exposure to the telenovela.

• Pilot tested the telenovela with 125 Latino adults

Knowledge items

20 items

• 11 items show significant positive change in knowledge

• 8 items on health attitudes.

• 2 items on behavioral intentions.

Conclusions

•Telenovela promises to be an effective educational medium with Latinos for diabetes (maybe other diseases?)

•Majority of participants exhibited significant increased knowledge of the disease

•Significant change in behavior intent to follow up with screening

•Actors are becoming “messengers” to others after their experience

Dulce Tentacion Trailer

Telenovela: Dulce Tentacion

Assessment of Your Community

Community Based Participatory Research

SurveysInterviews with experts in the field

Focus groups

Commonalities Challenges

Values!Latino Values are often guided by 5 principals

FamilyRespect

Male roleFemale role

Religion

Income and health equity challenges to using health care

Language and cultural literacy of health resources

Severe barriers for immigrants to health information, screening and care.

The Findings

The Development of Informed, Culturally Relevant Material

The Messanger The Venue

The Messenger and the Venue

Meet a PPWI Messenger

Ángeles SoriaPPWI Health Promoter

Questions?

How can we be of service for your agency to reach Latinos

with health literate messages?

Reference1. Cowie CC, Rust KF, Byrd-Holt DD, Eberhardt MS, Flegal KM, Engelgau MM, Saydah SH, Williams DE, Geiss LS, Gregg EW. (2006) Prevalence of

diabetes and impaired fasting glucose in adults in the US population: NHANES 1999–2002. Diabetes Care. 29(6):1263–1268.

2. Harris MI, Klein R, Cowie CC, Rowland M, Byrd-Holt DD. (1998) Is the risk of diabetic retinopathy greater in non-Latino blacks and Mexican Americans than in non-Latino whites with type 2 diabetes? A US population study. Diabetes Care. 21(8):1230-1235.

3. Engelgau MM, Geiss LS, Saaddine JB, Boyle JP, Benjamin SM, Gregg EW, et al. (2004) The evolving diabetes burden in the United States. Ann Intern Med. 140(11):945-950.

4. Eberhardt, M.S., Ingram, D.D., & Makus, D.M., et al. (2001) Urban and rural health chartbook. Health, United States, 2001. Hyattsville, MD: National Center for Health Statistics.

5. Council on Scientific Affairs (1991) Hispanic health in the United States. Journal of the American Medical Association. 265:248-252.

6. Harris MI, Eastman RC, Cowie CC, Flegal KM, & Eberhardt MS (1999) Racial and ethnic differences in glycemic control of adults with type 2 diabetes. Diabetes Care, 22, 403-408.

7. The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus (2002) Diabetes Care 25, S5–S20.

8. Institute of Medicine (IOM). 2004. Health Literacy: A Prescription to End Confusion. Washington, DC: The National Academies Press.

9. Nielsen Media Research. (2000). National Hispanic people meter sample, September 1999–May 2000. Retrieved, from Nielsenmediaresearch.com.

10. Beck, V., Huang, G. C., Pollard, W. E., & Johnson, T. J. (2003). TV drama viewers and health information. Paper presented at the American Public Health Association 131st Annual Meeting and Exposition, San Francisco, CA.

11. Carrasquillo, M., Pearson, M., Valente, T., Wilkin, H., Slan, L., Beck, V., & Huang, G. (2003, November). Spanish language TV viewers and health information: Partnering with public health to educate about breast cancer. Presentation at the 131st American Public Health Association Annual Meeting and Exposition, San Francisco, CA.

12. Bandura, A. (2004). Social cognitive theory for personal and social change by enabling media. In A. Singhal, M. J. Cody, E. M. Rogers, & M. Sabido (Eds.), Entertainment-education and social change: History, research, and practice (pp. 75–97). Mahwah, NJ: Lawrence Erlbaum Associates.

13. Spader J, Ratcliffe J, Montoya J, & Skillern P. (2009) The Bold and the Bankable: How Nuestro Barrio Telenovela Reaches Latino Immigrants with Financial Education. The Journal of Consumer Affairs 43(1):56-79.

14. Wilkin HA, Valente TW, Murphy S, Cody MJ, Huang G, & Beck V. (2007) Does Entertainment-Education Work With Latinos in the United States? Identification and the Effects of a Telenovela Breast Cancer Storyline. Journal of Health Communication, 12:455-469.

15. Jibaja ML, Kingery P, Neff NE et al. (2000) Tailored, interactive soap operas for breast cancer education of high risk Hispanic women. Journal of Cancer Education, 15:237-242.