104 - Storytelling as an Evaluation Tool to Support Health Equity Among Latine Communities

Abstract Information: Storytelling is an important tool that reveals the stories of communities, connects communities to resources, and elevates the voices of marginalized groups. The Latine community has a long history of experiencing inequitable access to health care resulting from sociocultural discrimination, language access, economic opportunities, and structural racism. Evaluation can utilize storytelling to show impact, identify health issues, support quantitative data, analyze the experiences of community members, and use innovative models to deliver services to community members. Personal stories can often elicit information on how culture, language, and other barriers influence access to programs and how this information can be used to adapt culturally appropriate programs. Through a poster, we describe how storytelling impacts how evaluation is conducted in Latine communities. Specifically, we draw upon narratives of health literacy, health behavior, HPV vaccine hesitancy and uptake, and mental illness within Latine communities. In particular, this poster will contribute to the discourse on the intersections among Latine communities and health inequities. Uplifting the stories of Latine community members in evaluations plays an integral part in achieving health equity.

Relevance Statement: Latine communities experience disproportional health inequities resulting from poor access to health care due to cultural, language, and structural discrimination in the health care system. Storytelling is a tool used in evaluations to understand how to address inequities and racial biases in Latine communities. Storytelling helps explain the social and political histories of Latine communities and disrupt the mainstream narratives to empower these communities. The narrative theory approach is a form of storytelling that can be used to collect narratives of people’s experiences. In one community in Chicago, Ilinois, narrative theory was introduced in a workshop with 25 Latinas to develop advocacy materials for low-cost/free breast cancer services (Olagoke et al., 2022). Narrative theory helped researchers understand how Latinas engaged policy-makers on addressing their needs and understanding cultural norms. Fotonovelas are graphic novels that are often associated with Latine culture and are used to develop culturally relevant and linguistically appropriate health literacy tools. The Centro De La Comunidad/United Community Center (UCC) and the Medical College of Wisconsin in collaboration held focus groups to support healthy eating among Latine communities (Hinojosa, 2011). The researchers learned that the nutrition materials were poorly developed due to poor translations and inadequate literacy levels. Community members were asked to participate in the development of the fotonovela to ensure its relevance to the culture, ethnicity, gender, social class, and appropriateness according to the needs of the community. Another intervention used fotonovelas to improve HPV vaccination rates among Latines in a clinic located in Southern California. The evaluation results indicated that there was an improvement in HPV vaccine knowledge, attitudes, and intention to vaccinate and greater influence on others to vaccinate within their network (Chan et al., 2015). Cuentos are also effective tools in treating mental health illness among Latine youth through answering questions in narrative form (SAMHSA, 2022). Fotonovelas can be used by healthcare providers as a health education tool to reduce stigma associated with accessing mental health treatment. One clinical tool that supports storytelling is the Cultural Formulation Interview (CFI) which measures the relations with culture and behavioral health. We propose a poster to discuss how incorporating storytelling in evaluation can be influential in reducing health disparities among Latine communities and pose the following questions: 1. How does storytelling inform the kinds of evaluation tools used in evaluating programs that improve Latine health? 2. In what ways can storytelling be used in evaluations to promote health equity among Latine communities? 3. What is the role of Latine evaluators in ensuring that storytelling elevates the voices of Latine communities? Dominant public health narratives reinforce existing relations of power that silence the voices of social groups with limited power. Through this poster, we hope to elevate the stories of Latine communities by acknowledging the importance of personal experiences in reducing health inequities and promoting well-being.