Abstract
Poor health literacy in the Western Cape Province of South Africa is one of the main factors hampering methamphetamine (MA) use prevention efforts in the area, where the abuse of this drug is a major health and social problem affecting especially previously disadvantaged communities. In the first part of a two-part study, we compared a health-related fotonovela about MA to an existing brochure group and a control group. Main findings show that the vast majority of readers preferred the fotonovela over the existing brochure. This included participants from all three age groups and for both levels of health literacy (low/high) distinguished (n = 372). Furthermore, specifically for older people with low levels of health literacy, the fotonovela outperformed the existing brochure condition for knowledge level. In the second part of the study, we found that healthcare providers (n = 75) strongly prefer a fotonovela over an existing brochure, while this cohort viewed the potential use of fotonovelas in a health care setting as very positive. Our findings add to the promising results of an earlier fotonovela study about MA use in South Africa, providing further support for considering using narratives in health communication as a serious option to effectively communicate convincing health information about this drug to target audiences in the Western Cape Province.
Highlights
We wanted to find out how a MA fotonovela compared to an existing health brochure and how it would be evaluated when assessed by healthcare providers (RQ2)
A four-armed randomized controlled trial (RCT) was conducted, including four message conditions: a group who read a fotonovela with a Q&A section; a group who read a fotonovela without a Q&A section; a group who read an existing brochure used in the field, and a no message control group
For RQ2, we wanted to find out how a MA fotonovela compared to an existing health brochure and how it would be evaluated when assessed by healthcare providers
Summary
Such is the case in the Western Cape Province of South Africa, where the alarming rise in MA use from 2002 to 2006/7 has since become a major social problem [3] With more users in the Western Cape Province than in any other South African province, MA—. Locally referred to as ‘tik’—is linked with higher rates of domestic violence and crime in this province, as well as with gang culture and the spread and contracting of tuberculosis [2,6,7,8,9]. Exacerbating the problem, is that the majority of people in South Africa who use drugs such as MA are already part of marginalized and vulnerable populations [3] (p.36)
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