Stories for Change (S4C) Diabetes

Racial and ethnic minorities in the United States, including immigrants and refugees, have higher rates of diabetes, and worse outcomes than the general population. Stories told by people who live successfully with diabetes may improve the health of people who are having difficulty living with diabetes.

Stories for Change Diabetes is multi-phase project using a digital storytelling intervention aimed at improving diabetes management among Hispanic and Somali immigrants and refugees with type 2 diabetes.  Phase 1 included development and deployment of a culturally and linguistically appropriate interview-based survey, in order to understand diabetes-related attitudes, knowledge and health-seeking behaviors among Hispanic and Somali adults with diabetes. Results from the survey were used to develop a focus group facilitation guide which was used in Phase 2.  Focus group attendees included a subset of survey participants who were invited in order to learn more about their lived experiences with diabetes management. Transcripts from the focus groups were analyzed and emergent themes were used to inform the next phase. During Phase 3, a storytelling guide was developed.  Eight participants were invited to share stories that centered on themes related to successful culturally relevant strategies for medication management, glucose self-monitoring, physical activity, and nutrition for diabetes. The study team worked with the Center for Digital Storytelling to develop and record eight digital stories during a multiday workshop. Phase 4 was a pilot feasibility project to test screening and enrollment processes and examine the potential effectiveness of these digital stories among 25 participants in five different clinical sites (four in Minnesota and one in Arizona).  Participants found the stories to be interesting, attention-getting and useful. Implementation processes of this intervention in the clinical settings were streamlined. The intervention resulted in self-rated improvement in psychosocial constructs associated with healthy diabetes self-management behaviors, and some evidence of improvement in glycemic control. 

In the current phase, RHCP is evaluating the effectiveness of these digitally recorded stories in improving health outcomes among Hispanic adults with diabetes, through a multi-site randomized clinical trial with partners at Mountain Park Health Center in Phoenix, AZ and Hennepin Healthcare in Minneapolis, MN. The study has enrolled and completed measurements on 455 participants. Data analysis is currently ongoing.

In addition, RHCP is evaluating the effectiveness of these digitally recorded stories in improving health outcomes among Somali adults with diabetes, through a randomized clinical trial in Rochester, MN.

Funding

Mayo Clinic:  Values Council, Office of Health Disparities Research, and Center for Clinical and Translational Science
George Family Foundation: Catalyst Award

National Institutes of Health: National Institute of Diabetes and Digestive and Kidney Diseases (R01 DK 113999)

Materials

Stories for Change - Spanish

Stories for Change - Somali