Talking Fotonovelas to educate older African Americans about Diabetes and High Blood Pressure

Older adults with low socioeconomic levels and ethnic or racial minority status have the greatest risk of poor health outcomes. This CMS funded project examines innovative and culturally appropriate ways to improve knowledge, attitudes and practices (KAP) related to diabetes and high blood pressure control among predominantly older African Americans. A staggered pretest-posttest, non equivalent control group design was implemented in a community of 400 older African Americans residing in affordable housing. Mixed methods were used to evaluate process, impact and outcomes. This study evaluated Talking Fotonovelas, which consist of health behavior presentations that contain photographs and dialogue that draw on oral history and fotonovela traditions. The dialogues and images were tailored to the interests, age, language and preferences of the target audience. The Talking Fotonovelas addressed barriers and promoted adherence to dietary and physical activity guidelines for diabetes and high blood pressure control. Study instruments included Stanford Diabetes Self Efficacy scale, Nutrition and Physical Activity Self Efficacy Scales, and the Short TOFHLA. Preliminary results of the field test shows associations among KAP changes and Talking Fotonovelas interventions. Implications will be discussed: 1) for improving health behaviors and self-efficacy in at risk populations; 2) as an economical way to create nontraditional communications that address literacy and learning barriers by using culturally appropriate dialogue and images.