Entre  Nos:    La-nas  Collaborate  for  HIV/AIDS  Preven-on      by  The  Health  Collabora-ve,  Sage  Words  Health  Communica-ons  and  Bexar  County  Ryan  White  Program  

The   Fotonovela   is   regarded   as   a   familiar   and   historically  accepted  form  of  delivering  health  care  informa6on  in  La6no  communi6es.  The  health  literate  strategies  embodied  in  the  form  of  the  fotonovela,  namely  the  reliance  on  graphics,  the  appeal  of  narra6ve,  and   the   limited  use  of   text,  provided  a  health  literate  basis  for  the  project  

Background  

Objec-ves  

•   Produce  three  bilingual  (English/Spanish)  varia6ons  of  age-­‐appropriate   and   relevant   fotonovelas   focusing   on   HIV/AIDS  preven6on    •    Increase   the   comprehension   and   effec6veness   of   the  materials  by  engaging  end-­‐users  at  mul6ple  points  during  the  crea6on   process:   specifically,   composing   dialogue   and   field  tes6ng  draM  versions  

•    Create  models   of   dialogue   for   actual   conversa6ons   about  preven6on  messages  

   

Funding  for  the  project  provided  by  Bexar  County  Ryan  White  Program  

Process/Methodology  

Next  Steps  FiMeen  clients  tested  the  materials  in  one-­‐on-­‐one  sessions.      They  read  the  materials,  “thought  aloud”  and  responded  to  a  scenario:    You  are  in  a  rela+onship  and  you  want  your  partner  to  use    condoms  or  to  get  tested:    what  would  you  say?      Measurement:  par6cipants’  incorpora6on  of  dialogue  or  text  from  the  fotonovelas  into  the  discussion  and  responses  to  these  ques6ons:  •  What  do  you  think  the  main  message  is?    •  Where  is  one  place  you  can  go  to  get  tested  for  HIV?  We  also  asked  clients  to  talk  about  specific  content:  6tles,  word  choice  in  both  Spanish  and  English,  and  dialogue.    Preliminary  Results:  •   All  three  fotonovelas  elicited  detailed  responses  •   The  damas  fotonovela  elicited  the  most  specific  responses  • Sample  responses:    “It’s  like  me.”  “I  related  to  it.”  “Similar  to  my  situa6on.”    •   14  out  of  15  par6cipants  tested  said  that  they  would  be  interested/very  interested  in  picking  it  up  if  they  saw  it  in  a  doctor’s  office  •   All  par6cipants  stated  the  main  message  accurately  •   Few  of  the  par6cipants  iden6fied  the  Resources  page  un6l  prompted  

Feedback  will  be  used  to  revise  the  final  version,  including  making  the  doñas  fotonovela  larger  in  order  to  increase  font  size,  text  altera6ons,  and  changing  the  Resources  page  to  make  it  more  obvious.  

•   Use  collabora6ve  composing,  the  process  of  involving  more  than   one   person   in   the   wri6ng   of   a   document.   All   writers  were  also  members  of  the  target  audience.        •    Engage   providers   in   the   development   process.   They   have  knowledge  of  their  clients’  experience  and  knowledge  of  the  systemic   opportuni6es   and   barriers   towards   using   pa6ent  educa6on  materials.  

•   Create  consistent  and  ongoing  partnerships  between  health  care   systems   and   community-­‐based   organiza6ons.   On-­‐going  rela6onships  provide  easier  access  to  pools  of    clients  who  are  ready  to  contribute  the  essen6al  perspec6ve  of  the  end  user.    

Product/Three  Bi-­‐lingual  Fotonovelas  

“jovencitas”  (age  18-­‐30)    

The  panel  suggested  a  pocket  size  for  discre6on  and  for  easy  conversion  to  an  animated  phone  app  or  web-­‐based  video.  

“damas”  (age  30-­‐45)    

This  group  thought  they  would  be  most  likely  to  pick  up  and  read  a  “Revista”  or  magazine    format  

“doñas”  (age  45  and  older)    

The  doñas  opted  for  a  tradi6onal  fotonovela    

Recommenda-ons  Expert  Panel  HC  convened  a  group  of  experts  from  BC  

HIV/Aids  service  agencies  with  SW  to  shape  project  

     

Health  Collabora-ve  (HC)    Sage  Words  (SW)  

Bexar  County  Ryan  White  Program  (BC)      

   

Collabora-ve  Composing  Spanish/  English-­‐speaking  clients  from  BC  service  agencies  met  with  SW  to  write  text    

Usability  Tes-ng  Clients  from  BC  service  agencies  tested  draMs  with  SW