Evaluation of a Diabetes Education Video Among the Tz'utujil Maya in Guatemala

Abstract

The prevalence of diabetes is rising throughout Latin America, particularly in the Tz’utujil Maya town of Santiago Atitlan, Guatemala. Major gaps in biomedical knowledge about the causes, chronicity, and long-term complications of diabetes have been reported in rural Guatemala among diabetes patients. In one rural Guatemalan study, respondents believed that ‘‘strong emotions’’ caused diabetes. Diabetes education services are limited in Santiago Atitlan, as the primary language for 94% of the population is Tz’utujil Maya, one of 21 distinct Mayan dialects spoken in Guatemala, and few biomedical clinicians are conversant in this non-written language. To address this need, a health education video was developed for a target audience of Tz’utujil-speaking community residents living with type 2 diabetes mellitus for use by the local hospital and other healthcare posts. Health education videos are an increasingly utilized medium of communication, with over 500 American hospitals currently having produced publicly available health education videos. The purpose of this letter is to provide an evaluation for this Tz’utujil-language diabetes education video. Mixed qualitative and quantitative methods for this study included semistructured interviews and preand post-testing of the video’s content immediately before and after the video screening as a rough metric of understanding and retention. The stratified random sample included 20 community residents (stratified as 17 urban and three rural) who were selected via randomly generated Global Positioning System points on a satellite map of the town. A Tz’utujil–Spanish translator was present to assist with each semistructured interview. Responses from the interviews were captured on digital audio recordings and paper-based field notes. Interviews were conducted between 09:00 and 15:00 h Monday– Friday in March 2010 and typically lasted 30–60 min. SPSS version 12.0 for Windows (SPSS Inc., Chicago, IL) was used to analyze preand post-video responses using v tests and t tests for comparisons of means. The study was approved by the Committee on Human Research at the University of California, San Francisco and the Mayor and Ministry of Health of Santiago Atitlan, Guatemala.