Exploring Factors Impacting Hispanic/Latinx Individuals' Response to a Type 2 Diabetes Digital Storytelling Intervention
Hispanic/Latinx individuals have high prevalence of type 2 diabetes and its complications yet often face barriers in accessing diabetes prevention and self-managemenet interventions. One possible approach is to implement digital storytelling interventions, which involve narrative-driven videos made by individuals who have lived experience with particular conditions or illnesses. These stories can inspire viewers with similar life experiences to change behaviors or attitudes. Little is known about which characteristics influence how individuals respond to digital storytelling interventions with healthful behaviors and improved outcomes - information necessary to further tailor these interventions to improve type 2 diabetes outcomes. Previously, the Rochester Healthy Community Partnership used the digital storytelling process to develop Stories for Change Diabetes and tested intervention effectiveness.
PLOS One Jun 2025
RHCP developed a culturally tailored digital storytelling intervention called Stories for Change (S4C) to support Hispanic/Latinx adults with type 2 diabetes. The intervention featured short, Spanish-language videos created by individuals with lived experience managing diabetes. These stories aimed to inspire viewers to adopt healthier behaviors. In a randomized trial involving 227 participants, researchers found that those who had been diagnosed with diabetes for less than five years or who showed increased confidence in managing their condition were more likely to experience a meaningful drop in blood sugar levels after three months.
The analysis revealed that self-efficacy—confidence in one’s ability to manage diabetes—played a key role in how participants responded to the intervention. Surprisingly, factors like education level and emotional connection to the stories did not significantly influence outcomes. These findings suggest that S4C may be especially effective for newly diagnosed individuals and those with lower initial self-efficacy. Because the intervention is low-cost, portable, and easy to integrate into existing care, it holds promise for reducing health disparities in diabetes management among Hispanic/Latinx communities. Future efforts could focus on adapting the approach for those with longer disease duration and exploring ways to boost self-efficacy.
Digital Storytelling Intervention for Hemoglobin A1c Control Among Hispanic Adults With Type 2 Diabetes A Randomized Clinical Trial
Hispanic adults with type 2 diabetes (T2D) are more likely to develop complications and die from the disease than the US general population. Digital storytelling interventions are narrative-based videos elicited through a community-based participatory research approach to surface the authentic voices of participants overcoming obstacles to health-promoting behaviors that perpetuate health inequities; research on the effect of digital storytelling on T2D outcomes among Hispanic adults is lacking.
JAMA Network Aug 2024
A digital storytelling video created by RHCP was tested to help Hispanic adults with poorly controlled type 2 diabetes improve their health. The video featured four personal stories in Spanish that focused on key diabetes self-care behaviors: healthy eating, physical activity, medication use, and blood sugar monitoring. Participants who watched the video reported feeling more confident and motivated to manage their diabetes. Compared to those who received printed materials, the video group showed a modest improvement in blood sugar levels after three months, especially when adjusting for factors like age and income.
The intervention was well-received, with nearly all participants saying it captured their attention and inspired behavior change. While the video didn’t lead to significant changes in other health measures like blood pressure or cholesterol, its strong emotional impact and cultural relevance suggest it could be a useful tool in diabetes care. Because it’s short, easy to distribute, and highly engaging, the video could be integrated into clinics or community programs and paired with longer-term support strategies to help improve outcomes for Hispanic patients with diabetes.
Stories for Change Protocol: A Randomized Controlled Trial of a Digital Storytelling Workshop Intervention for Hispanic/Latino with Type 2 Diabetes
Hispanic/Latino adults are disproportionately impacted by type 2 diabetes mellitus (T2D).
Contemporary Clinical Trials Jan 2023
To address the high rates of type 2 diabetes (T2D) among Hispanic/Latino adults, RHCP and its partners developed a culturally tailored digital storytelling intervention called Stories for Change (S4C). This project used a randomized controlled trial to test whether personal stories shared through video could improve diabetes self-management. Participants were recruited from clinics in Minnesota and Arizona and randomly assigned to either view the 12-minute video or receive usual care. The video featured four storytellers discussing their experiences with diet, exercise, medication, and glucose monitoring. To reinforce the message, intervention participants received monthly text prompts and were encouraged to share the video with family and friends.
The trial enrolled 451 participants, most of whom were women with an average age of 53 and HbA1c levels above 9%. Both groups received diabetes education materials, but only the intervention group viewed the video and engaged in follow-up activities. Early findings showed that participants connected with the storytellers and felt motivated to improve their health behaviors. The study measured outcomes like HbA1c levels, self-efficacy, social support, and healthcare utilization. While the full results are pending, the protocol offers a promising model for using storytelling to promote health equity and improve chronic disease management in underserved communities.
Experiences of Hispanic Safety Net Clinic Patients With Diabetes During the COVID-19 Pandemic
The inequitable impact of the COVID-19 pandemic in the United States resulted in substantial loss of life in Hispanic communities. Life expectancy among US Hispanics declined 3 years, the most of any race/ethnicity subgroup, from 2019 to 2020. Although COVID-19 led to a majority of this decline (90%), diabetes was noted as the third leading cause of increased deaths, behind unintentional injuries.
The Science of Diabetes Self-Management and Care 2022
Hispanic adults with type 2 diabetes faced major challenges during the COVID-19 pandemic, including financial strain, reduced access to medical care, and increased stress. Many participants lost jobs or insurance, struggled to afford food and medications, and experienced anxiety about attending clinic visits. Despite these hardships, most maintained their diabetes self-care routines. While physical activity and healthy eating declined for some, overall diabetes management behaviors remained stable. Participants reported low levels of COVID-related anxiety, even though many had family members who were infected.
Measures of diabetes self-efficacy and quality of life improved during the pandemic. People felt more confident in managing their condition and reported better emotional and physical well-being. However, outpatient visits for diabetes care decreased, especially with primary care and behavioral health providers. The study highlights the resilience of Hispanic patients who continued to prioritize their health despite systemic barriers. It also underscores the need for culturally responsive support systems that address both medical and social needs during public health crises.
Facilitated Stories for Change: Digital Storytelling as a Tool for Engagement in Facilitated Discussion for Reduction of Diabetes-Related Health Disparities Among Rural Latino Patients With Diabetes
Latino populations, especially those living in rural areas, experience a disproportionately high prevalence of type 2 diabetes mellitus. They are also less likely to achieve optimal glycemic control and have 1.5 times higher age adjusted diabetes related mortality rate than non-Hispanic Whites.
Journal of Transcultural Nursing SAGE 2020
A group-based digital storytelling program was tested with Latino adults living in rural Minnesota to support better management of type 2 diabetes. Participants watched a 12-minute video featuring personal stories from others in their community who live with diabetes, followed by a guided discussion. The intervention was designed to be culturally relevant and grounded in narrative and social cognitive theory. Participants reported feeling more motivated and confident about managing their diabetes after the session. They connected deeply with the storytellers and each other, sharing similar challenges and learning from one another’s experiences.
The format encouraged reflection, emotional engagement, and peer support, which helped reinforce key messages about healthy behaviors like medication adherence, diet, and exercise. Participants appreciated the opportunity to talk openly and suggested involving family members in future sessions to strengthen support at home. The intervention was rated highly for usefulness and interest, and all participants said they would recommend it to others. These findings suggest that combining storytelling with group discussion can be a powerful, scalable way to promote culturally congruent care and improve diabetes self-management in underserved communities.
Pilot Feasibility Study of a Digital Storytelling Intervention for Immigrant and Refugee Adults With Diabetes
Immigrants and refugees often arrive in the United States healthier than most Americans, but with time, their health becomes similar to that of the general population, including with regard to unhealthy cardiovascular risk factors and incidence of type 2 diabetes mellitus (T2DM).
The Diabetes Educator 2017
RHCP developed and tested a culturally and linguistically tailored digital storytelling intervention to support diabetes self-management among Somali and Latino immigrants with type 2 diabetes. The intervention consisted of a 12–13 minute video featuring four personal stories, an introduction, and a closing educational message, all created through a participatory process. Delivered during routine clinic visits, the video was rated highly by participants for its usefulness, interest, and motivational impact. After viewing, 96% felt more confident managing their diabetes, and 92% reported intentions to change specific behaviors. A1C levels decreased significantly among Latino participants, particularly those with higher baseline values, suggesting potential clinical benefits.
The intervention’s success was rooted in its CBPR framework, which emphasized community ownership, cultural relevance, and authentic storytelling. Participants identified key messages aligned with diabetes self-management—healthy eating, physical activity, medication adherence, and glucose monitoring—and expressed willingness to share the video with others. While the pilot study was nonrandomized and limited in size, it demonstrated feasibility and acceptability across diverse clinical settings. These findings support further research into scalable, narrative-based interventions to address chronic disease disparities in immigrant and refugee populations.
Diabetes Knowledge, Attitudes and Behaviors Among Somali and Latino Immigrants
Persons from Somalia constitute the largest group of immigrants and refugees from Africa among whom diabetes-related health disparities are well documented.
Journal of Immigrant and Minority Health Dec 2015
A community-based participatory research effort led by RHCP assessed diabetes knowledge, attitudes, and behaviors among Somali and Latino immigrants with type 2 diabetes in Rochester, Minnesota. Through a culturally and linguistically adapted survey administered by trained community partners, 78 participants shared their experiences managing diabetes. Despite high engagement with healthcare providers and strong self-reported confidence in managing their condition, actual diabetes knowledge was low. Participants reported significant disease burden, negative emotional impacts, and barriers to physical activity and glucose monitoring. However, they also demonstrated high levels of self-efficacy and social support, particularly from family members.
Findings revealed striking similarities between Somali and Latino participants, suggesting that shared experiences of immigration, socioeconomic challenges, and limited English proficiency may play a more significant role in shaping diabetes management than cultural differences alone. These insights underscore the importance of tailoring interventions to address systemic barriers and leveraging community strengths. The data will inform future behavioral interventions aimed at improving diabetes outcomes and reducing health disparities among immigrant and refugee populations in the U.S.
Stories for Change: Development of a Diabetes Digital Storytelling Intervention for Refugees and Immigrants to Minnesota Using Qualitative Methods
Immigrants and refugees are affected by diabetes-related health disparities, with higher rates of incident diabetes and sub-optimal diabetes outcomes.
BMC Public Health 2015
RHCP partnered with Somali and Latino communities in Rochester, Minnesota to co-develop a culturally and linguistically tailored digital storytelling intervention aimed at improving type II diabetes management. Using a CBPR approach, they conducted focus groups to explore lived experiences across four domains: medication management, glucose monitoring, physical activity, and nutrition. Participants shared barriers such as cultural norms, family responsibilities, misinformation, and structural challenges like cost and transportation. Despite these obstacles, many found motivation through family support, faith, and fear of complications, and adopted strategies like adapting healthy behaviors to daily routines and seeking reliable health information.
Building on these insights, RHCP collaborated with the Center for Digital Storytelling to train eight community members—selected for their storytelling abilities—to create personal narratives reflecting their diabetes journeys. These stories were developed through a four-and-a-half-day workshop and compiled into two intervention packages (Somali and Spanish, both with English subtitles). The process fostered community ownership, empowerment, and capacity building, and the final products were described as powerful and motivational. While the intervention’s efficacy will be evaluated in future work, this participatory model offers a replicable framework for other communities seeking to address chronic disease disparities through culturally grounded storytelling.