from fotonovela to beyond webnovela:

Sponsors:

Center for Public Health Practice & Leadership,

Berkeley School of Public Health

Welcome to the Health Communication Matters! Webinar

Webinar will begin at 10am PT / 1pm ET

Health Communication Working GroupCommunity Health Planning & Policy Development

From Fotonovela to Beyond Webnovela:The Power of Storytelling for Health Promotion

**To avoid audio issues, please select “Dial In” option via conference phone line (vs. connecting through computer speakers)

Conference Line: 949-229-4400PIN: 9267663#

Mission: Health Communication Matters! Webinar Series

The Health Communication Matters Series will help participants in all walks of public health to apply techniques to communicate effectively with consumers,

health professionals, disenfranchised communities and your public health peers.

Other Events in HCM Series• What’s Your Peer Crowd?: Identifying Your Audience and Messages that

Resonate

• Shifting the Narrative: The Role of Social Media in Public Health Communication

• The Challenge of Numeracy: Why Simply Providing Data is Not Enough

• Design Matters! Integrating Design into Public Health Communications: Two Case Studies

• Storytelling as Health Communication: Fighting Obesity and Diabetes

• Making Web Design Work for People with Limited Vision

• PowerPoint Tips & Tricks

• Putting Culture Into Practice: Communicating with Diverse Latino Communities

• Applying Health Literacy to Health Insurance: How We Can Help Consumers

• Communicating the Affordable Care Act

http://sph.berkeley.edu/health-communication-matters-webinar-series

Today you’ll hear from . . .

Mel Baron, PharmD, MPAProfessor of Clinical Pharmacy

School of PharmacyUniversity of Southern California

mbaron@usc.edu

Hua (Helen) Wang, PhDAssociate Professor of Communication

University at Buffalo, State University of New York

hwang23@buffalo.edu

And your moderator. . .

Erin Brigham, MPHModerator

Erin.Brigham@caresource.com

How to Participate!

• Phone line is automatically on mute

•Use chat function to send questions or comments

• We’ll consolidate questions and pose them to speakers throughout and during Q & A

• Links to archived recording, slides and resources will be shared with everyone who registered following the webinar

Who is in our audience: Geography

38%

4%

6%5%3%

8%

36%

Participant Location

California Illinois New York

Texas Colorado DMV (DC, MD, VA)

28 Other States

Who is in our audience: Organization

• Top organizations represented: city, county, tribal and state health departments; CDC; and academic institutions

• Others organizations: independent research organizations, health insurance plans; health systems/hospitals; nonprofits

Who is in our audience: Role/Position

Agenda

1. Review of session objectives

2. Feature Presentation: Health Literacy and Its Impact on Patient Outcomes (Mel Baron)

3. Feature Presentation: Transmedia Edutainment for Health Promotion and Behavior Change (Helen Wang)

4. Q&A

5. Conclusion

Objectives

• Describe at least 2 steps to help produce a successful fotonovela

• Describe the key factors that contributed to the success of a digital TV series

• List at least 2 measures for assessing a digital series as a public health communication intervention

PRESENTATION

Mel Baron, PharmD, MPAProfessor of Clinical Pharmacy

School of PharmacyUniversity of Southern California

mbaron@usc.edu

Health Literacy and Its Impact on Patient Outcomes

Dr. Mel Baron

USC School of Pharmacy

LEARNING OBJECTIVES

• At the conclusion of the presentation the participants will be able to understand the challenges of producing a fotonovela

• Participants will be able to assess the needs of a targeted population

What is Health Literacy?

• The ability of individuals to obtain, interpret and understand basic health information and services in ways to enhance health

It affects people’s ability to:

• Navigate the healthcare system

• Share personal information with providers

• Understand and act on disease state management materials and information

• Read and act on prescription labels or directions given by a doctor or pharmacist

Prevalence of Poor Health Literacy

• Only 12% of US adults have proficient health literacy

• 14% of adults have below basic health literacy– More often they report health as poor and have

no health insurance

• Older adults, some racial and ethnic minorities, low education, and low income levels correlate with low health literacy

Impact on Adherence

• Lower use of preventative services

– Mammograms, Pap Smears, flu shots, etc

• Less knowledge and control of chronic disease states

– Improper use of metered dose inhaler for asthma

• Increase in preventable hospital visits and emergency admissions

Health Literacy Developing Strategy: Plain Language

• Organize information so that most important points come out first

• Breaking complex information into understandable chunks

• Simple language and define technical terms

• Avoid medical terms when possible

– i.e. say “high blood pressure”, instead of “hypertension”

• Use Focus Groups and Field Testing

Tips for Healthcare Professionals

• Avoid giving too much information

• Use multiple methods to explain

– i.e. pictures, verbal, print, and demonstration

• Invite questions to confirm comprehension

• Use the “teach-back” method

– i.e. ask the patient to show you how to use their metered dose inhaler for asthma

Depression

Fotonovella

CommunicationProcess Variables

• Audienceinvolvement

• Audienceidentification

• Interpersonalcommunication

Psychological Outcomes

• Increasesknowledge

• Reduces stigma• Increases self-

efficacy

Behavioral Outcomes

• Increases intentionsto seek help

• Increase treatmentengagement

• Increase treatmentretention

Conceptual Model

FormulatingObjectives

StorylineDevelopment

ScriptDevelopment

Production

Translation

Graphic Design& Printing

Production Process

Multi-Stakeholder Input:Clinicians, researchers, actors,

funding agencies, community members

Fotonovela Project Phases

Research

• Research• Script Development• Production• Layout Design• Printing• Distribution• Research Evaluation

Script Development

Production

Layout / Design

Printing

Distribution

Evaluation

In Contrast

In Contrast

Q&A’s

Action Plans

Fotonovela Titles Available

1) Forgotten Memories (Recuerdos Olvidados): a fotonovela on the recognition and treatment options for dementia 2) Sweet Temptations (Tentaciones Dulces): a fotonovela on diabetes management and the risks and myths associated with the disease among Hispanic families. This was translated into Dutch for use in a research study at the University of Groningen 3) Secret Feelings (Sentimientos Secretos): a fotonovela on depression to educate patients about the condition and improve drug compliance to achieve positive health outcomes. 4) Rosa Out of Control (Rosa Fuera de Control): a fotonovela on childhood obesity focusing on prevention and treatment 5) Oscar and the Giant (Oscar y el Gigante): a

fotonovela on improving management and drug

compliance for pediatric asthma

Fotonovela Titles Available

6) Fiesta Fiasco (Fiesta de Fiasco): a fotonovela

on medication adherence

7) What My Girlfriend Didn’t Know (Lo Que No

Sabia Mi Novia): a fotonovela on folic acid and

its importance in reducing the risk of birth

defects

8) Gloria Takes the Leap (Gloria da el Gran

Salto): a fotonovela on breast cancer and the

importance of mammograms

9) Marta On A Mission (El Reto De Marta): a

fotonovela on 2nd and 3rd hand smoke

10) Infectious Rumors! (tbd): a fotonovela on

immunization and the importance of vaccines

Audio-Visual Novela’s Available

1) “Rosa Out of Control” (“Rosa Fuera de Control”), the first audio-visual novella, was produced for computer and TV viewing in clinics, hospitals, buses, and adult education schools in underserved Latino communities. The obesity audiovisual novela was broadcast March 30, 2014 on KLCS-TV, a PBS station in Los Angeles. 2) “Forgotten Memories”(“Recuerdos Olvidados”), based on the dementia fotonovela, was also produced for computer and TV viewing in clinics, hospitals, buses, and adult education schools in underserved Latino communities. The dementia audio-visual novella was broadcast on May 17, 2015 and May 31, 2015 on KLCS-TV, a PBS station in Los Angeles.

RESOURCESCabassa LJ, Oh H, Humensky J, Unger JB, Molina GB , Baron M. Comparing the Impact on Latinos of a DepressionBrochure and an Entertainment-Education Depression Fotonovela, Psychiatric Services. Psychiatric Services March 2015 DOI Unger JB, Cabassa LJ, Molina GB, Contreras S, Baron M. Evaluation of a fotonovela to increase depression knowledge and reduce stigma among Hispanic adults. J Immigrant Minority Health. April 8, 2012. DOI: 10.1007/s10903-012-9623-5. Cabassa, LJ, Contreras S, Aragon R, Molina GB, Baron M. Focus Group Evaluation of “Secret Feelings”: A Depression Fotonovela for Latinos With Limited English Proficiency. Health Promot Pract. August 1, 2011. DOI: 10.1177/1524839911399430. Cabassa LJ, Molina GB, Baron M. Depression fotonovela: Development of a Depression Literacy Tool for Latinos With Limited English Proficiency. Health Promot Pract. November 4, 2010. [Epub ahead of print]. Unger JB, Molina G, Baron M. Evaluation of Sweet Temptations, a Fotonovela for Diabetes Education. Hispanic Health Care International. 2009; 7(3):145-152.

CONTACT INFORMATION

Mel Baron, Pharm.D.,MPA,FACA, FCPhA, FAPhA

Professor of Clinical Pharmacy

University of Southern California

School of Pharmacy

323 442-2686

mbaron@usc.edu

PRESENTATION

Hua (Helen) Wang, PhDAssociate Professor of Communication

University at Buffalo, State University of New York

hwang23@buffalo.edu

Transmedia Edutainment for Health Promotion and Behavior Change

American Public Health Association “Health Communication Matters” Webinar, September 14, 2016

Hua (Helen) Wang, Ph.D.

Associate Professor of Communication State University of New York at Buffalo

Learning Objec-ves

1.  Tounderstandwhatistransmediaedutainmentandhowthisstrategycanbeusedforhealthpromo9onandbehaviorchange

2.  Toillustratethepoten9aloftransmediaedutainmentforeffec9ve

healthcommunica9onusingtheexampleofEastLosHigh

The shortest distance between two people is …

From Telenovela to Beyond Webnovela

Edutainment for Health Promo-on and Behavior Change

Edutainment(orentertainment-educa9on)isacommunica9onstrategythataimsat

seamlesslyembeddingeduca9onalandsocialissuesintheentertainmentprogramming

withclearobjec9vestoraiseaudiencemembers’awareness,increasetheirknowledge,

createfavorableaFtudes,shiGsocialnorms,andchangeovertbehavior.

How do you watch TV these days?

A New Way to Experience TV

Extended Scenes

The Siren Newspaper

ASK Paulie

Ceci’s Vlogs

StayTeen PSAs

La Voz with Xavi

Comic Strips

The Bomb Squad Dance Tutorials

Tia Pepe (Maya’s recipes)

Transmedia Edutainment

La-no Authen-city

Mul-lateral Partnership

Narra-ve Engagement & Persuasion

Interven'onExposure

InterpersonalDiscussions

IntendedOutcomes

REACH ENGAGEMENT IMPACT

Research Design of Program Evalua-on

• GoogleAnaly9csandNGOpartnerwidgettracking

• Aviewersurveyonaudienceengagementandintendedoutcomes

• Anexperimentontheeffec9venessoftransmediastorytelling

•  Socialmediacontentandnetworkanalyses

• Par9cipantobserva9onandin-depthinterviews

Audience Reach: Analy-cs Tracking

•  In9months,

215,964visitsfrom

123,728uniquevisitors

•  Mostlocatedinstates

withhighLa9no

popula9ons

•  InCA,47%visitorscame

fromci9eswithbothhigh

La9nopopula9onand

povertyrates

•  Reachedvisitorsfrom

another163countries

100% 97%

61%

9%

30%

72% 71% 70% 69%64% 64%

59%

44%48%

98%

55%

8%

33%

75% 74%71%

68% 67% 65%61%

51%47%

0%

20%

40%

60%

80%

100%

120%

<20episodes

all24episodes

en9reshowonce+

en9reshowtwice+

en9reshow>twice

Ceci'sVlogs Maya'srecipes

Extendedscenes

AskPaulie TheSirenar9cles

Dancetutorials

StayTeenPSAs

LaVozwithXavi

Comicstrips

All(N=202) Target(n=110)

Audience Reach: Viewer Survey

Audience Engagement: Viewer Survey

81%

91%

73%79%

96%

76%

93%

74%78%

97%

0%

20%

40%

60%

80%

100%

120%

Storylinesappeal Webnovelaenjoyment Transmediaenjoyment Produc9onquality Wan9ngmore

All(N=202) Target(n=110)

Audience Engagement: Viewer Survey

Audience Engagement: Viewer Survey

Audience Engagement: Viewer Survey (Target)

84%

66%

31%26%

20%16%

6%

81%

66%

38%

29%

18% 20%

6%

0%

20%

40%

60%

80%

100%

Friends Siblings Parents Otheryoungrela9ves Auntsanduncles Niecesandnephews Grandparents

SocialMediaDiscussants Non-SocialMediaDiscussants

•  80%Face-to-face•  69%SMS•  46%Phone

Audience Engagement: Viewer Survey (Target)

0%0% 4%

19%

25%

53%

Hermits:notusinganyofthe4ELHsocialmediasites

Slackers:currentusersbutnoengagementwithELH

Lurkers:onlybrowsing/followingnothingelse

Endorsers:liking,markingELHasfavorites

Disseminators:sharing,retwee9ng,reblogging

Advocates:commen9ng,pos9ng,men9ons,replies

SocialMediaPar9cipa9on

Audience Engagement: Facebook Insights

• Mostpopularpostsarephotospostedwithacallforac9on

Audience Impact: Viewer Survey (Target)

91%

69%

96%99%

90%

72%

96%99%100%

70%

95%100%

0%

20%

40%

60%

80%

100%

Awarenessofservice Neverbeentested Willingnesstotest Willingnesstorecommend

STD HIV Pregnancy

84%

40%

93%91%

41%

89%86%

36%

75%

0%

20%

40%

60%

80%

100%

Awarenessofservice Noknowledgeofresources Likehoodtorecommend

Keepthebaby Adop9on Abor9on

Audience Impact: Viewer Survey (Target)

Audience Impact: Viewer Survey (Target)

EastLosHighchangedmylifealotbecauseitwassorealis8c….Ilearnedalotof

thingsthatmysex-edclassdidn'ttalktousaboutsuchasabor8onandother

op8ons.IttaughtmethatIhavechoicesandresponsibili8es.

--a14yearsoldLa9napar9cipant

•  48%ofthetargetsamplevisitedELHresourcespage.

•  Whentheydidvisitthepage,theybrowsedthrough13topics,theyallfoundtheinforma9onhelpful

•  81%sharedandrecommendedtheresourcestheylearned.

•  Teensonlinestorysubmissiontellingushowtheygathertheirfriendstowatchtheshowandtalkaboutsexopenlyandpassaroundcondoms

Audience Impact: Viewer Survey

Audience Impact: Lab Experiment

Whenassessingknowledgeofcorrectcondomuse,mixedANOVAindicatedasignificantmaineffectof9me,asignificantmaineffectofcondi9on,andasignificantinterac9oneffect.PairwisecomparisonsshowedasignificantknowledgegainfromT1toT2andfromT1toT3,indica9ngover9meknowledgegain;butnotfromT2toT3,indica9ngreten9onoftheknowledgegain.C5wassignificantlyhigherthanallotherformats,demonstra9ngtheposi9veeffectoftransmediastorytellingoverandaboveallotherformatstested.

Moving Forward

EastLosHighdemonstratedthepoten9alofusingtransmediaedutainmentforpromo9ngsexualandreproduc9vehealthamongyoungLa9nos.Afewdirec9onsforfutureresearch:

•  Linkinganaly9cstrackingtoindividualhealthbehaviors•  Conduc9nglarge-scalerandomizedfieldstudiestocomparetheexperienceandeffectbetweenviewersandnon-viewers,La9nosandotherracial/ethnicgroups,youngerandoldergenera9onsoveralongerperiodof9me

•  Inves9gatetheroleofmalesandparentsinthecommunica9on,decision-making,andprac9ceofsexualandreproduc9vehealth

Acknowledgement

IamthankfulforthesupportfromourresearchteamatUniversityatBuffalo,SUNY(Dr.GregoryD.Saxton,

Weiai(Wayne)Xu,GeorgesKhalil,Kris9nMaki,DanaHimoff,SusanKum,MikeRein9)andTheUniversityof

TaxesatElPaso(Dr.ArvindSinghal,CarlieneQuist,AnuSachdev,GabeLira,ClaudiaBoyd),theELH

produc9onteam,ourNGOpartners,andthegenerousresearchfundfromthePopula9onMediaCenter.

Resources

•  WangH,SinghalA.EastLosHigh:TransmediaEdutainmenttoPromotetheSexualandReproduc9veHealthofYoungLa9na/oAmericans.AmericanJournalofPublicHealth:June2016,Vol.106,No.6,pp.1002-1010.doi:10.2105/AJPH.2016.303072

•  SinghalA,WangH,RogersEM.Theentertainment–educa9oncommunica9onstrategyincommunica9on

campaigns.In:RiceRE,AtkinsC,eds.PublicCommunica8onCampaigns.4thed.BeverleyHills,CA:Sage;2013:321–334.

•  Website:www.eastloshigh.com

Season1trailer:htps://www.youtube.com/watch?v=cQnXknnCdocTransmediatrailer:htps://www.youtube.com/watch?v=2a9O2BJaW1E

Thank you!

Contactinforma'on:Dr.Hua(Helen)WangAssociateProfessorofCommunica9onStateUniversityofNewYorkatBuffaloBuffalo,NY14260Email:hwang23@buffalo.eduPhone:(716)645-1501

Q1:Howcantransmediaedutainmenthelpaddressyourpublichealthconcerns?Q2:Whatwouldyousuggesttoimprovethedesignandevalua9onofthiskindofhealthpromo9onprograms?

Q & A

Additional Content

Following today’s webinar, you’ll receive an email

with links to:

• Recording of today’s webinar, which will be archived

for future access

• Presenters’ slides

• List of resources related to today’s topic

Evaluation & Questions

• An evaluation will pop up following today’s webinar ─ please share your feedback that will

help us improve future webinars

• Let us know if you’d like to follow-up on anything

we touched on today

• Additional questions? Contact our presenters or moderator

Thank you to our planning committee

• Tammy Pilisuk, MPH, APHA-CHPPD

• Erin Brigham, MPH, CareSource, APHA-CHPPD

• Angela Falisi, MPH, National Cancer Institute, APHA-HCWG

• Nancy Murphy, MSHC, CSR Communications

• Meghan Bridgid Moran, PhD, Bloomberg School of Public Health, Johns Hopkins University

• Lisa Peterson, MPH, Center for Public Health Practice & Leadership

Thank you to our Sponsors!

American Public Health Association & National Public Health Week

Community Health Planning and Policy Development Section, APHA

Health Communication Working Group, APHA

Center for Public Health Practice & Leadership, University of California-Berkeley School of Public Health