Pattern - Digital storytelling or process that counts?

Is it the digital storytelling or the process that counts?

Name

Is it the digital storytelling or the process that counts?

Authors

Paul Hindle reviewing DiFulvio et al. (2016).

Summary

The process of telling one’s own story and listening to others tell theirs was more beneficial than the creation of digital stories in a digital storytelling workshop to improve sexual health attitudes of young Puerto Rican women in an American city.

Illustration (optional)

Problem

DiFulvio et al. (2016) identify that research on digital storytelling (DST) has focussed on the effectiveness of stories in achieving positive health behaviour change, it has been more limited in terms of assessing the process behind individuals telling their own stories and identifying their own struggles. Some research (Bosticco & Thompson, 2008; Rich, Lamola & Woods, 2006; Sharf & Vanderford, 2003) has shown improved self-efficacy and social support, thereby improving physical and mental health amongst those creating narratives, but more research is needed to confirm these small scale study results.

To try and evaluate the DST process DiFulvio et al. (2016) created a DST project in a 40,000+ population city in the state of New England, USA. Self-identified Puerto Rican Latinas were studied as they are suffering some of the highest sexual health disparities in the state and this city has the highest percentage population of Puerto Ricans in mainland USA (45%).

Synopsis

A poor city in the USA with a high Puerto Rican Latina population and the highest teen birth rate in the state, along with other sexual health disparities amongst it’s young person population.

Forces (optional)

Objectives are to measure the effectiveness of the DST process in creating positive change of participants sexual health attitudes and values. Pre and post workshop surveys were used to measure demographics, self-esteem, social support, empowerment, sexual attitudes and workshop evaluation, with a final follow up after 3 months (26 out of 30 completed this).

Constraints were the level of poverty in the city and distrust of authority making recruitment of subjects difficult. Some participants were under 18 so parental consent was required. The university funding the project had an ethics board that may limit some aspects including the funding for a long term project (they went with three, four-day workshops). 30 participants enrolled with 29 completing an individual digital story.

Context

Poor, immigrant neighbourhoods in the USA suffer higher rates of poor health, some of this is related to social inequality in American society, this leads to ethnic minority groups finding it harder to get out of these situations partly due to their own lack of self-esteem/worth from being in disparate groups.

Origins

Material

A medium sized city in the US state of Massachusetts using the youth service agencies of the city to recruit participants.

Social

15 – 21 year old self-identified Puerto Rican Latinas who are living or receiving services in the city. They were either pregnant, parenting or nulliparous. They were recruited from all around the city so it is not clear how many of them knew each other before the workshops.

Intentional

City has highest teen birth rate in the state, 3.5 times the average rate of Chlamydia for the state and double the HIV state diagnosis rate.

Solution

DST workshops focussing on engaging individuals in developing their own DSTs to improve their self-esteem and attitudes around sexual behaviour.

Pedagogical aspects

Heavy focus on Cognitivism as participants explore their own attitudes, beliefs and stories and then reflect on them to identify their own “truth” and frame it in a more positive way. A learner-centred approach.

Technical aspects

Digital literacy and access to computer devices capable of creating a digital story, although based on the findings it may not be important to record the stories, the telling and listening of them is the key, so technology requirements may be limited.

Diagram

Related patterns

Use of more knowledgeable other and scaffolding to help participants create a digital story may bring in constructivism but still has much cross over with cognitivism.

Examples

Other studies (Esterling, LAbate & Murray, 1999; Gortner, Rude & Pennebaker, 2006; Pennebaker, 2000) have shown positive benefits for DST to increased self-efficacy and decreased depression. This is one of the first studies to show a benefit to the process rather than just showing improved outcomes from a DST workshop. In fact DiFulvio et al. (2016) suggest that their study showed the benefits came from the reflective process of the workshop and not from the actual DST. Mastery (Bandura, 1997) is something that has been shown to be important in building self-confidence, therefore repeated positive experiences of these workshops may be required for long term gains.

Notes

The process seems to be more important than the end result of a digital story. It appears to be important to do work as a group as one of the main pieces of positive feedback from participants was hearing other people’s stories and being able to tell their stories to other people and feel listened to. This means that potentially the digital part of the process may not even be necessary at all, just getting a group of people together and sharing their stories (as has probably happened round campfires for thousands of years) is the beneficial process. Having said that the recording of the process through digital means may offer longer term benefits to the participants as they have something to watch multiple times and remember the positives from, it also allows for the dispersion of the stories to a much larger audience and may be enough to carry some benefits to that wider audience, although they would be missing out on being able to tell their story to others if they were just a digital consumer of the story at a later date.

The sense of control and confidence that participants gained from the workshop was generally not maintained at 3 month follow up. This means further research is needed to see what methods may help participants retain their new found gains, perhaps a weekly or monthly session of group discussions? Is this part of the benefit of groups like alcoholics anonymous? Maybe participants could be encouraged and supported in setting up their own workshops to spread the benefits to a new audience whilst reinforcing the benefits for themselves. Almost like a Ponzi scheme, but one that does not try to exploit the new recruits for the benefits of the originator!

Data and References

Bandura A. (1997) Self-efficacy: the exercise of control. New York, NY: Freeman.

Bosticco C and Thompson TL. (2008) Let me tell you a story: narratives and narration in health communication research. In: Zoller HM and Dutta M (eds) Emerging perspectives in health communication: meaning, culture, and power. New York, NY: Routledge, 2008, pp.39–62.

DiFulvio GT, Gubirum AC, Fiddian-Green A, Lowe SE, Del Toro-Mejias LM, (2016) Digital Storytelling as a narrative health promotion process: Evaluation of a pilot study. International Quarterly Community Health Education 2016 Apr; 36(3): 157-64.

Esterling BA, L’Abate L, Murray EJ, (1999) Empirical foundations for writing in prevention and psychotherapy: mental and physical health outcomes. Clin Psychol Rev 1999; 19: 79–96. 17.

Gortner E, Rude SS and Pennebaker JW. (2006) Benefits of expressive writing in lowering rumination and depressive symptoms. Behav Ther 2006; 37: 292–303.

Pennebaker J. (2000) Telling stories: the health benefits of narrative. Lit Med 2000; 19: 3–18.

Rich M, Lamola S and Woods ER. (2006) Effects of creating visual illness narratives on quality of life with asthma: a pilot intervention study. J Adolesc Health 2006; 38: 748–752.

Sharf BF and Vanderford ML. (2003) Illness narratives and the social construction of health. In: Thompson TL, Dorsey AM, Miller KI and Parrott R (eds) Handbook of health communication. Mahwah, NJ: Erlbaum, 2003, pp.9–34.

Photo attribution:
Image from Arlene Gottfried in Simon Y, (2016) These Photos capture the richness of Loisaida’s Nuyorican life in the 70s and 80s, Available at: https://slate.com/culture/2016/03/new-yorks-puerto-rican-community-in-the-1970s-and-80s-photographed-by-arlene-gottfried.html (Accessed 12/6/2021)