Digital Storytelling Intervention Research Articles

Effect of an integrated narrative program (INP) on quality of life among patients with non-small cell lung cancer (NSCLC): an experimental trial

ObjectiveTo investigate the effectiveness of an integrated narrative program (INP) in enhancing the resilience, self-efficacy and quality of life of postoperative NSCLC patients. Materials and MethodsAdditional 45 participants at baseline were recruited into the integrated narrative program group and received both the digital storytelling intervention and narrative therapy after a randomized controlled trial where the control group (n=45) received routine care and the intervention group (n=45) underwent the digital storytelling intervention (DST). Questionnaires were administered to assess resilience, self-efficacy and quality of life at baseline (T0) (within 3 days before surgery), immediately after intervention (T1), one month post-intervention (T2), and three months post-intervention (T3). A linear mixed effects model was conducted via the intention-to-treat analysis. ResultsDuring follow-up assessments, the INP group exhibited significantly greater increase in resilience, self-efficacy, and quality of life (all P < 0.001) compared to both DST group and control group, which were consistent with the sensitivity analysis results (all P < 0.001). ConclusionThe INP was more effective than DST in improving the resilience, self-efficacy, and quality of life of postoperative NSCLC patients, and these benefits could persist for at least three months post-intervention. Due to the fact that the INP process is relatively complicated, so we recommend the use of web-based platforms for INP interventions in future clinical work.

Digital Storytelling Intervention for Hemoglobin A1c Control Among Hispanic Adults With Type 2 Diabetes

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. To assess the impact of a digital storytelling intervention on glycemic control and its acceptability among Hispanic patients with poorly controlled T2D. This was a multicenter, randomized clinical trial conducted within 2 primary care networks in Minnesota and Arizona among Hispanic adults with poorly controlled T2D (hemoglobin A1c level ≥8%). Enrollment and follow-up were conducted between February 14, 2019, and November 1, 2023. The intervention group viewed a 12-minute digital storytelling video. The video included 4 Spanish-language stories that reinforced 4 diabetes self-management behavioral goals (healthful diet for diabetes, physical activity, medication adherence, and glucose self-monitoring). The control group received printed, culturally tailored T2D education materials. The primary outcome was the mean change from baseline to 3 months for hemoglobin A1c levels, adjusting for baseline hemoglobin A1c, age, gender, education, and income. Acceptability and narrative quality of the intervention were assessed through questionnaires. There were 451 study participants, with 227 (mean [SD] age, 54.3 [9.3] years; 158 [69.3%] women) randomized to the intervention group and 224 (mean [SD] age, 54.5 [9.1] years; 156 [69.3%] women) to the control group. Of these, 390 completed 3-month follow-up of the primary outcome (86% retention). There was a small improvement in the mean (SD) hemoglobin A1c level in the intervention group compared with the control group in the adjusted model (9.1% [1.7] to 8.4% [1.6] vs 9.4% [1.8] to 8.8% [2.0]; P = .04] but not in the unadjusted model. Acceptability and narrative quality of the intervention were high. In this randomized clinical trial, a digital storytelling intervention developed with and for Hispanic adults with T2D was highly acceptable and feasibly implemented within primary care settings and resulted in a modest improvement of glycemic control. This was a highly scalable intervention that may be integrated into clinical practice as part of a longitudinal diabetes self-management program for Hispanic adults. ClinicalTrials.gov Identifier: NCT03766438.

553-P: Digital Storytelling Intervention for Type 2 Diabetes Self-Management among Hispanic Adults—A Randomized Clinical Trial

553-P: Digital Storytelling Intervention for Type 2 Diabetes Self-Management among Hispanic Adults—A Randomized Clinical Trial

My Dog, My Hero: Assessing the Feasibility of a Cross-Generational Digital Storytelling Intervention for Veterans

During the COVID-19 pandemic, social isolation had a devastating effect on well-being. Veterans were among the most vulnerable given their high rates of military trauma-related conditions. Research supports that dogs can provide veterans with a sense of purpose, social support, and stress management. Digital storytelling provided a unique perspective with focus on a recognized hero, the veteran’s dog, and an opportunity for engagement with other veterans during COVID-19. The purpose of the study was to assess the feasibility of this digital storytelling intervention based on Story Theory framework and tailored to encompass components of cross-generational collaboration in combination with individual and group virtual sessions as a mechanism to promote social engagement. The research was conducted using a descriptive exploratory design. Veterans (N = 8) were paired with a trained student and grouped in sets of four. There were eight guided 1-hour weekly virtual sessions to create their digital story. Demographic and pre-post intervention survey data were also collected. Based on eight established criteria, this article systematically evaluates the feasibility of the digital storytelling intervention for veterans. The findings suggest practical considerations to ensure viability of digital storytelling as a therapeutic intervention for veterans and other populations at-risk for suboptimal well-being.

Protocol for a community-based digital storytelling pilot intervention to reduce Hispanic parents' vaccine hesitancy to immunize their children against COVID-19.

COVID-19 vaccines, currently available to children over six months old, are a powerful method of reducing the risk of COVID-19-related hospitalizations and death. However, vaccination rates among Hispanic children remain suboptimal, primarily due to parental vaccine hesitancy. Health communication researchers have suggested using culturally aligned storytelling to reduce vaccine hesitancy; however, few studies have evaluated this approach for Hispanic parents of unvaccinated children. Working with community health workers, we will engage Hispanic parents who were previously hesitant to vaccinate their child(ren) against COVID-19 but currently support vaccination. We will ask them to share their stories of conversion in COVID-19 vaccine perspectives to help other parents overcome their mistrust of COVID-19 vaccines. We will then assess the feasibility and acceptability of a web-based pilot digital storytelling intervention based on these conversion stories vs. an information-only control among 80 parents and/or legal guardians of children who are not up-to-date with COVID-19 vaccines. We will also examine pre- to post-intervention changes in vaccine perceptions, hesitancy, intentions, and uptake of children's COVID-19 vaccination at two months post-intervention. If our pilot study demonstrates feasibility and acceptability while reducing COVID-19 vaccine hesitancy and increasing vaccine uptake, we will conduct a full-scale randomized controlled trial to examine the effectiveness of the DST intervention to reduce vaccine hesitancy.

Effect of digital storytelling intervention on resilience, self-efficacy and quality of life among patients with non-small cell lung cancer (NSCLC): A randomized controlled trial

ObjectiveTo verify and compare whether the digital stories could effectively improve the resilience, self-efficacy and quality of life of postoperative NSCLC patients. Materials and methodsA total of 90 participants at baseline were randomly assigned to two groups, 45 patients per group. The intervention group received the digital storytelling intervention which includes 4 videos on different topics: positive psychological quality, cultivating healthy living habits, establishing good social support, and insisting on scientific exercise, whereas the control group received only routine care. The resilience, self-efficacy, and quality of life were assessed at baseline (T0) (within 3 days before surgery), immediately after intervention (T1), one month after intervention (T2), and three months after intervention (T3). A linear mixed effects model was used to test the effects of the digital storytelling interventions on resilience, self-efficacy, and quality of life. ResultsThe intervention group reported significantly greater improvements in resilience, self-efficacy, and quality of life (all P < 0.001) at follow-ups than the control group after controlling for age, gender, and education level as covariates. Moreover, the sensitivity analysis results are consistent with the per-protocol, that overall time × group interactions effects were significantly different in resilience, self-efficacy, and quality of life (all P < 0.001). ConclusionThe digital storytelling intervention based on lung cancer survivors’ experience can effectively improve resilience, self-efficacy and quality of life in postoperative lung cancer patients. More comprehensive researches are needed to evaluate the longer-term impacts of the DST and its feasibility for those with more advanced cancer.

Digital Storytelling Intervention for Enhancing the Social Participation of People With Mild Cognitive Impairment: Co-Design and Usability Study.

Community-based social participation has shown promise in delaying cognitive decline in older adults with mild cognitive impairment (MCI) who are at risk of developing dementia. Although group storytelling interventions have proven effective, the need for a skilled workforce to support people with MCI can limit broader community implementation. Technology-based interventions may offer a solution to this limitation by replicating the abilities of therapists. This study aims to co-design a digital storytelling intervention and evaluate its usability. This co-design process involved 3 stages, engaging people with MCI (n=12), their caregivers (n=4), and therapists (n=5) in Beijing, China. In the first stage, we used card sorting and voting methods to identify potential incentives for social participation and target the specific abilities that people with MCI wanted to enhance. In the second stage, we conducted brainstorming sessions with people with MCI and their caregivers to identify the potential features of a digital storytelling application named Huiyou ("meeting new friends" in Chinese). Finally, we assessed Huiyou's usability with people with MCI and therapists, leading to iterative improvements based on the usability findings. We uncovered a crucial link between boosting the self-confidence of people with MCI and their ability to address social participation challenges. Notably, we identified memory improvement and enhanced language expression as key factors for effective communication with grandchildren. Subsequently, participants suggested features and interfaces to address these challenges, leading to the development of Huiyou, a group-based digital storytelling application featuring functions such as generating story materials, conducting memory retrieval activities, and sharing stories. It received an "excellent" rating in the User Experience Questionnaire benchmark, displaying high levels of attractiveness, dependability, stimulation, and novelty. People with MCI achieved an average task completion rate of 87% (n=19; SD 0.13) of the 22 tasks. However, feedback from people with MCI and therapists highlighted usability issues in navigation, activity management, user interface, and feature optimization, indicating a need for improved accessibility and efficiency. The co-design approach contributed to developing the Huiyou prototype, supporting community-based social participation. User feedback highlighted the potential of Huiyou to enhance well-being and facilitate meaningful social interactions while maintaining crucial existing relationships.

The promise of digital storytelling for kindergarteners: language and technology skills

ABSTRACT This study aims to investigate the impact of digital storytelling activities on children's language skills, specifically focusing on expressive, receptive, and narrative abilities, as well as their utilization of technological elements in their stories. The study involved 18 children who were enrolled in a public kindergarten classroom, and it employed a mixed-methods design. Over six weeks, the children participated in digital storytelling activities twice a week. Pre- and post-intervention assessments measured children's language skills, and digital stories were evaluated for technical elements. Semi-structured interviews were also conducted to gain insights into the children's experiences. The findings revealed significant improvements in the participants’ receptive, expressive, and narrative skill scores following the six-week digital storytelling intervention. The children expressed high levels of enjoyment and interest in the digital storytelling activities. These results were discussed in relation to existing literature, and the implications of the findings were explored.

Development of a Digital Storytelling Intervention to Increase Breast, Cervical, and Colorectal Cancer Screening in the Hispanic/Latino Community: a Qualitative Evaluation.

Digital storytelling (DST) interventions may be one way to address disparities in cancer screening experienced by the Hispanic/Latino population. Digital stories are short, first-person narratives that include voice-over narration and images. With storytellers' permission, researchers can screen digital stories as a health intervention. Digital stories can inspire viewers to adopt or change their behavior, such as completing cancer screening. Rochester Healthy Community Partnership (a 20-year community-based participatory research partnership) together with eight Hispanic/Latino, Spanish speaking cancer survivors, co-survivors, or recently screened individuals, developed digital stories about breast, cervical, and colorectal cancer screening. Here, we describe our qualitative evaluation of the DST workshop. To understand what the storytellers thought viewers would find relatable in their digital stories, we applied Narrative Theory. We also assessed workshop successes and opportunities for improvement. We used the constant comparative method for data analysis. We learned that the storytellers anticipated their stories would be engaging and that viewers would connect with Hispanic/Latino cultural values. During the workshop, the storytellers felt like they were making an important contribution. The storytellers highlighted specific opportunities for improvement including sharing the stories more quickly after the workshop. Future research is needed to test whether this intervention follows the Narrative Theory causal pathway by persuading viewers to complete recommended cancer screenings.

A Digital Diabetes Storytelling Intervention for the Hmong Community: A Pilot Study

Hmong-Americans experience higher rates of diabetes and poorer diabetes-related health outcomes than their White peers. Traditional methods of diabetes education do not reach Hmong patients effectively due to known socioeconomic and literacy barriers. The purpose of this study is to examine the acceptability of a culturally informed diabetes self-management education video tool, using digital storytelling that was created using a community-engaged approach, administered in a single academic clinic that sees a large percentage of Hmong patients. The video tool was successful in the areas of acceptability, story transformation, and story identification; 96% of participants stated that the video felt like something from their community, 88% stated that they could identify with the story, 79% stated that they wanted to know what happened next, and 70% of participants reported that they were motivated to do something different after watching. New methods to improve diabetes education and improve health outcomes in Hmong communities are needed. Culturally informed digital storytelling is one tool, which may be used to improve diabetes health outcomes in this population.

Crafting L2 Multimodal Composing Identities

Identity currently features as a prominent theme in digital multimodal composition (DMC), given the significant impact of DMC on identity expression. However, L2 learners’ writer identity development and fluctuation in this type of textual composition needs further exploration in light of the absence of clearly established DMC-specific identity categories and a detailed account of writer identity expansion and restriction processes therein. This study attempts to fill this void by scrutinizing how three 11th graders learning English as a foreign language in Spain crafted their writer identities in English in a 16-week genre-based digital storytelling (DST) intervention that followed the genre-based systemic functional linguistics tradition of L2 writing, and included instruction on attitude (Martin &amp; White, 2005). Qualitative data analysis of multi-source data followed Ivanic’s (1998) writer identity framework, attitude categories, and key notions in multimodality, as well as the DST and identity literature. Results indicate students’ awareness raising of such categories throughout digital story writing, and general preference for appreciation and judgment in writer identity construction, which was contingent upon certain factors. Students’ writer identities and their fluctuation revealed types of specific DMC identity categories, and expansion and restriction processes, which illustrated their multimodal composing identity formation and transformation in digital story creation.

Digital storytelling intervention to enhance social connections and participation for people with mild cognitive impairment: a research protocol.

Interventions utilizing the principles of digital storytelling can improve cognitive ability by cultivating positive emotions and framing a new way to enhance social participation among people with mild cognitive impairment. However, existing research has understudied group-based storytelling, focusing instead on building individual stories and connections with family and friends. In response to this research gap, this paper proposes co-designing a digital storytelling intervention for people with Mild Cognitive Impairment (MCI) to enhance their social participation and build meaningful connections. We will conduct two co-design workshops with people with MCI (n = 12), their caregivers (n = 4-12), and therapists (n = 5) in Beijing, China, to facilitate the co-development of the digital storytelling application. During the first workshop, we will utilize card sorting and voting to define potential facilitators of social participation, identifying the abilities people with MCI want to improve through storytelling. During the second workshop, we will build on these findings to facilitate people with MCI and their caregivers to visualize the interfaces. After reflexive thematic analysis of the co-design workshops, we will develop a digital storytelling application and test its usability and efficacy among people with MCI and therapists, respectively. A single-blinded field test will be conducted with 20 community-dwelling adults with MCI (Age: 65+). The testing will consist of an intervention group of 10 participants who use the co-designed digital storytelling intervention and a control group of 10 participants who will not use the co-designed intervention on the waiting list. The intervention period will extend over 7 weeks, with individual intervention sessions lasting 30 min. We will evaluate its efficacy in terms of social participation, social connectedness, self-efficacy, subjective sense of happiness, and user experience of people with MCI. This study will examine an innovative digital storytelling intervention to enhance social participation among people with MCI. This study is expected to advance the concept of community-centric social groups in social health service contexts by integrating technological solutions with the self-identified needs and lived experiences of people with MCI, increasing the motivation of people with MCI to cultivate social participation. Swinburne University of Technology's Human Research Ethics Committee gave ethics approval for this research (Approval Number: 20226525-11105; Date: 26/09/2022). Our findings shall be reported in peer-reviewed journal articles and at relevant conferences.

Digital storytelling intervention to promote HPV vaccination among at-risk Asian immigrant populations: Pilot intervention study.

The high morbidity, mortality, and economic burden attributed to cancer-causing HPV call for researchers to address this public health concern through human papillomavirus (HPV) vaccination. Despite disparities in HPV-associated cancers in Korean and Vietnamese Americans (KAs, VAs) their vaccination rates remain low. Evidence points to the importance of developing culturally and linguistically congruent interventions to improve HPV vaccination rates. Digital storytelling (DST; a specific form of cultural narrative) shows promise as an effective culture-centric health promotion strategy. Study aims were to assess the preliminary effects of an innovative remotely delivered culturally and linguistically congruent DST intervention consisting of stories of personal lived experiences on KA and VA mothers' attitudes and intention in vaccinating their children against HPV. We also examined if the association between attitudes and intention differed by child's sex (boy vs. girl) and by ethnicity (KA vs. KA). Participants were recruited from via multiple outlets (e.g., ethnic minority community organizations, social media, flyers posted in local Asian supermarkets and nail salons). Valid and reliable measures were administered online to collect data pre- and post-intervention. Statistical analysis including descriptive statistics, paired and independent sample t-tests, chi-square, and McNemar's test were used to describe the distributions of variables and to examine differences between subgroups and changes in key variables over time. We estimated logistic regression models to examine associations between mother's HPV- and vaccine-related attitudes and vaccination intention, and to explore if the association between attitudes and vaccination intention differed by the target child's sex or ethnicity. In our sample of 50 KA mothers (mean age = 42.8 years; SD = 4.8) and 114 VA mothers (mean age = 41.5 years; SD = 5.4), 36% of KA and 51% of VA mothers reported children receiving free or reduced-price lunch at school. Mother's attitudes toward HPV and the vaccine (t [163] = 2.49, P = .014) and intention to vaccinate their children improved significantly (2 1 = 18.38, P < .001). The measure of mother's positive attitudes toward HPV and the vaccine was significantly associated with the higher vaccination intention (OR = 0.246, p < .001), adjusting for background variables (sociodemographic characteristics) and other HPV-related variables (family cancer history, prior HPV education, HPV communication with healthcare providers). Findings did not suggest that child's sex or ethnicity moderated association between attitudes and vaccination intention. This brief intervention using digital stories was feasible and showed preliminary effects on promoting KA and VA mothers' intention to vaccinate their children against HPV.

Undergraduate student reflections of the Out of Darkness storytelling project on bipolar disorder stigma: A qualitative study

Mental illness is prevalent amongst university-aged individuals; however, stigma makes it difficult for these individuals to reach out for support. Arts-based approaches, specifically, digital storytelling interventions, have shown promise in addressing mental health difficulties and stigma. This study involved university students viewing a set of digital storytelling films (the Out of Darkness project – which were originally created for medical residents in psychiatry) and then participating in a focus group discussion to explore students’ experience of watching the films. We transcribed focus group discussions and used thematic analysis to uncover student perspectives of the digital storytelling intervention. The major themes identified include a change in attitude, empathy, and compassion, encouraging conversation, recognizing the importance of support, increased understanding that mental illness is not a choice, and acknowledging the stigma that still exists. The findings of this study suggest that the Out of Darkness digital storytelling intervention has merit beyond the training of medical professionals and can act as a valuable tool for addressing the stigma associated with severe mental illness on university campuses.

Digital Storytelling as a Tool to Increase Colorectal Cancer Screening Intention in a Latinx Church Community.

Although colorectal cancer screening (CRCS) rates have improved for all racial groups due to wider availability of screening, Latinx continue to have lower screening rates and are more likely to be diagnosed with later stages of colorectal cancer compared to non-Latinx whites. More culturally tailored educational interventions are needed to reach this population. This study introduced a digital storytelling (DST) intervention in a church community setting and explored its potential to influence CRCS intention and perception among Latinx and the acceptability of the DST intervention. Participants (n=20) between the ages of 50 and 75 who were not up-to-date with CRCS were recruited to view digital stories developed by fellow church members with previous CRCS experience. They completed surveys assessing their intention to complete CRCS before and after the viewing and were asked to participate in focus groups to understand, qualitatively, how the digital stories influenced their perceptions and intentions related to CRCS. Analysis of participant narratives revealed three overarching themes related to their perceptions and intentions of CRCS after the DST intervention: (1) the duality of the faith-health connection and fatalism, (2) willingness to consider other screening methods, and (3) the push-pull of individual barriers and interpersonal facilitators. Participants felt the DST intervention humanized the CRCS process and that it would be acceptable and well received in other church settings. The introduction of a community-based DST intervention within a church setting is a novel strategy with the potential to influence members of the Latinx church population to complete CRCS.

Developing a Culturally and Linguistically Congruent Digital Storytelling Intervention in Vietnamese and Korean American Mothers of Human Papillomavirus-Vaccinated Children: Feasibility and Acceptability Study.

The high morbidity, mortality, and economic burden attributed to cancer-causing human papillomavirus (HPV) call for researchers to address this public health concern through HPV vaccination. Disparities of HPV-associated cancers in Vietnamese and Korean Americans exist, yet their vaccination rates remain low. Evidence points to the importance of developing culturally and linguistically congruent interventions to improve their HPV vaccination rates. We adopted digital storytelling (DST) that combines oral storytelling with computer-based technology (digital images, audio recording, and music) as a promising approach for facilitating the communication of culturally relevant health messages. This study aimed to (1) assess the feasibility and acceptability of intervention development through DST workshops, (2) conduct an in-depth analysis of the cultural experience that shapes HPV attitudes, and (3) explore aspects of the DST workshop experience that could inform future formative and intervention work. Through community partners, social media, and snowball sampling, we recruited 2 Vietnamese American and 6 Korean American mothers (mean age 41.4, SD 5.8 years) who had children vaccinated against HPV. Three virtual DST workshops were conducted between July 2021 and January 2022. Our team supported mothers to develop their own stories. Mothers completed web-based surveys before and after the workshop and provided feedback on each other's story ideas and the workshop experience. We used descriptive statistics to summarize quantitative data and constant comparative analysis to analyze qualitative data collected in the workshop and field notes. Eight digital stories were developed in the DST workshops. They were well accepted, and the mothers showed overall satisfaction and relevant indicators (eg, would recommend it to others, would attend a similar workshop, it was worth their time; mean 4.2-5, range 1-5). Mothers found the process rewarding and appreciated the opportunity to share their stories in group settings and learn from each other. The 6 major themes that emerged from the data reflect the mothers' rich personal experiences, attitudes, and perceptions about their child's HPV vaccination, which included (1) showing parents' love and responsibility; (2) HPV and related knowledge, awareness, and attitudes; (3) factors influencing vaccine decision-making; (4) source of information and information sharing; (5) response to children's being vaccinated; and (6) cultural perspectives on health care and HPV vaccination. Our findings suggest that a virtual DST workshop is a highly feasible and acceptable approach to engaging Vietnamese American and Korean American immigrant mothers in developing culturally and linguistically congruent DST interventions. Further research is needed to test the efficacy and effectiveness of digital stories as an intervention for Vietnamese American and Korean American mothers of unvaccinated children. This process of developing an easy-to-deliver, culturally and linguistically aligned, and holistic web-based DST intervention can be implemented with other populations in other languages.

Hematopoietic Cell Transplantation Patient-Caregiver Dyad Perspectives on Participation in a Digital Storytelling Intervention: A Qualitative Approach

Storytelling has long been considered an effective means of communication, allowing the teller to process their emotions in light of particular life challenges. Effects on the listener also have been demonstrated to be beneficial, especially if the listener is faced with a similar life challenge. Less is known regarding the potential effects of storytelling on listening dyads and opportunities for joint processing following exposure to relevant stories. We sought to study these phenomena in the context of hematopoietic cell transplantation (HCT), a demanding medical procedure requiring intensive informal caregiving and thus great patient-caregiver entwinement. The purpose of this qualitative descriptive study was to explore participants' perceptions of a 4-week web-based digital storytelling (DST) intervention using both quantitative ratings of acceptability and qualitative coding of interviews conducted after intervention completion. A total of 202 participants (101 HCT patient-caregiver dyads) were recruited from the Mayo Clinic Arizona and randomized into either a DST arm or an Information Control (IC) arm. Participants in the DST arm rated the acceptability of the intervention and were asked to participate in a 30-minute phone interview to discuss their experience with the DST intervention. All interviews were recorded and transcribed verbatim and imported into NVivo 12 for coding and analysis, using a combination of deductive and inductive approaches to organize the data, create categories, and develop themes and subthemes. A total of 38 participants (19 HCT patient-caregiver dyads) completed the post-intervention interviews. Patients were 63% male and 82% White, 68% received allogeneic HCT, and their mean age was 55 years. The median time from HCT was 25 days (range, 6 to 56 days). Caregivers were mostly patients' spouses (73%) and female (69%), with a mean age of 56 years. In general, the 4-week web-based DST intervention was well accepted and liked by both patients and caregivers regarding the duration, dyadic participation, and convenience of participating in the intervention at home. Patients and caregivers who completed the DST intervention indicated that they were satisfied with the intervention (mean score, 4.5 of 5), were likely to recommend it to others (mean score, 4.4), would watch more stories (mean score, 4.1), and that the experience was worth their time (mean score, 4.6). Major themes that emerged from the qualitative analysis included (1) building communal connection through engaging with the stories; (2) positive emotional growth after HCT; (3) value of gaining the other's perspective; and (4) impact of open communication on the patient-caregiver relationship. A web-based DST intervention provides an attractive format through which to deliver a nonpharmacologic psychosocial intervention to HCT patient-caregiver dyads. Watching the emotional content in digital stories may help patients and caregivers cope with psychoemotional challenges together and provide an opportunity for emotional disclosure. Further work on determining optimal paths to disclosure is warranted.

Stories for change protocol: A randomized controlled trial of a digital storytelling intervention for Hispanic/Latino individuals with type 2 diabetes

BackgroundHispanic/Latino adults are disproportionately impacted by type 2 diabetes mellitus (T2D). The Stories for Change (S4C) Diabetes digital storytelling intervention promotes T2D self-management among Hispanic/Latino people. We describe the S4C protocol and participant baseline characteristics. MethodsStudy eligibility criteria: Hispanic or Latino, age 18–70 years, ≥1 office visit within a year at a participating clinic, T2D diagnosis for ≥6 months, HbA1c ≥ 8%, and intention to continue care at the recruitment clinic. We used a two-group, parallel randomized controlled trial design and an intervention derived through a community-based participatory research approach. All participants received usual diabetes care and two cards describing how to engage healthcare teams and access diabetes-related resources. At baseline, the intervention group additionally viewed the 12-min, intervention video (four stories about diabetes self-management). To encourage subsequent video viewing, participants received five monthly text messages. The messages prompted them to self-rate their motivation and self-efficacy for T2D management. The control group received no additional intervention. Bilingual (English/Spanish) staff collected data at baseline, six weeks, three months, and six months including biometric measurements and a survey on diabetes self-management outcomes, theory-based measures, and the number of video views. We reviewed the number of diabetes-related appointments attended using electronic medical record data. ResultsParticipants (n = 451; 70% women, mean age = 53 years) had an average HbA1C ≥9%. Intervention participants reported identifying with the storytellers and engaging with the stories. ConclusionWe present a digital storytelling intervention protocol that provides a template for future health promotion interventions prioritizing health disparity populations.ClinicalTrial.gov#NCT03766438

Women-Reported Barriers and Facilitators of Continued Engagement with Medications for Opioid Use Disorder.

Opioid-related fatalities increased exponentially during the COVID-19 pandemic and show little sign of abating. Despite decades of scientific evidence that sustained engagement with medications for opioid use disorders (MOUD) yields positive psychosocial outcomes, less than 30% of people with OUD engage in MOUD. Treatment rates are lowest for women. The aim of this project was to identify women-specific barriers and facilitators to treatment engagement, drawing from the lived experience of women in treatment. Data are provided from a parent study that used a community-partnered participatory research approach to adapt an evidence-based digital storytelling intervention for supporting continued MOUD treatment engagement. The parent study collected qualitative data between August and December 2018 from 20 women in Western Massachusetts who had received MOUD for at least 90 days. Using constructivist grounded theory, we identified major themes and selected illustrative quotations. Key barriers identified in this project include: (1) MOUD-specific discrimination encountered via social media, and in workplace and treatment/recovery settings; and (2) fear, perceptions, and experiences with MOUD, including mental health medication synergies, internalization of MOUD-related stigma, expectations of treatment duration, and opioid-specific mistrust of providers. Women identified two key facilitators to MOUD engagement: (1) feeling “safe” within treatment settings and (2) online communities as a source of positive reinforcement. We conclude with women-specific recommendations for research and interventions to improve MOUD engagement and provide human-centered care for this historically marginalized population.

A Digital Storytelling Intervention for Vietnamese American Mothers to Promote Their Children's HPV Vaccination.

HPV vaccination has effectively prevented its related cancers. A culturally and linguistically congruent DST intervention targeting HPV vaccination can increase mothers' intention to vaccinate their children. See related Spotlight, p. 419.