Storytelling: The use of fotonovelas to raise awareness of eating disorders

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By: Yormeri Silva, B.A.

Date: 09/15/2015

There is a call to enhance early detection of eating disorders in the Latino population. However, Latinos/as who suffer from an eating disorder are less likely to use mental health services1 and due to clinician bias, are usually not referred for further evaluation by physicians, 2, 3 compared to non-Latino whites. This is very concerning because the lifetime prevalence for Latinos/as of anorexia nervosa, bulimia nervosa, and binge eating disorder are comparable to those found in Caucasians in the U.S.1, 4 The lack of knowledge and information on eating disorders, language limitations, shame, and lack of knowledge on available resources are some of the challenges faced by Latinos who struggle with eating disorders.5 With the support of the UNC- IBM Junior Faculty Development Award, Dr. Reyes-Rodriguez’ research team embarked on the task to develop culturally sensitive educative materials on eating disorders for the Latino population.

Dr. Reyes-Rodriguez applied the use of fotonovelas to raise awareness about eating disorders, as they have been widely used to address physical and mental conditions with Latinos/as.6-9 A fotonovela is a type of graphic novel that has been popular within the Latin community since the 1940’s and has been shown to be successful for health education and promotion with Latin populations. Fotonovela is a creative approach with the potential of reducing mental health care disparities and enhancing early detection of eating disorders in the Latino population in a very compelling way. The research team developed four different scripts tailored by gender (female and male) and by age (adolescent and adult). Those scripts were refined based on feedback from focus groups/in-depth interviews conducted with Latinos/as in the community. The potential contribution of fotonovelas to raise awareness of eating disorders in the Latino population is promising. Participants found fotonovelas more eye catching than traditional brochures and the story and characters easily relatable to, in a less stigmatizing way. Our future research direction is to test the fotonovelas and compare them with traditional brochures. All scripts are available through the UNC’s Center of Excellence for Eating Disorders website: http://www.med.unc.edu/psych/eatingdisorders/informacion-en-espanol/fotonovelas.

References

  1. Marques, L., Alegria, M., Becker, A.E., Chen, C.N., Fang, A., Chosak, A. et al. Comparative prevalence, correlates of impairment, and service utilization for eating disorders across US ethnic groups: Implications for reducing ethnic disparities in health care access for eating disorders. Int J Eat Disord. 2011 Jul;44:412-20.
  2. Becker, A.E., Franko, D.L., Speck, A., Herzog, D.B. Ethnicity and differential access to care for eating disorder symptoms. Int J Eat Disord. 2003 Mar;33:205-12.
  3. Franko, D.L., Becker, A.E., Thomas, J.J., Herzog, D.B. Cross-ethnic differences in eating disorder symptoms and related distress. Int J Eat Disord. 2007 Mar;40:156-64.
  4. Alegria, M., Woo, M., Cao, Z., Torres, M., Meng, X.L., Striegel-Moore, R. Prevalence and correlates of eating disorders in Latinos in the United States. Int J Eat Disord. 2007 Nov;40 Suppl:S15-21.
  5. Reyes-Rodríguez, M., Ramírez,J., Patrice, K., Rose, K., Bulik, C.M. Exploring barriers and facilitators in the eating disorders treatment in Latinas in the United States. Journal of Latina/o Pychology. 2013;1:112-31.
  6. Cabassa, L.J., Molina, G.B., Baron, M. Depression fotonovela: development of a depression literacy tool for Latinos with limited English proficiency. Health Promot Pract. 2012 Nov;13:747-54.
  7. Cabassa, L.J., Zayas, L.H., Hansen, M.C. Latino adults’ access to mental health care: A review of epidemiological studies. Adm Policy Ment Health. 2006;33:316-30.
  8. Hernandez, M.Y., Organista, K.C. Entertainment-education? A fotonovela? A new strategy to improve depression literacy and help-seeking behaviors in at-risk immigrant Latinas. Am J Community Psychol. 2013;52:224-35.
  9. Valle, R., Yamada, A. M., & Matiella, A. C. Fotonovelas:a health literacy tool for educating Latino older adults about dementia. Clinical Gerontologist. 2006;30:71-8.