auger communications, inc.
Photonovel FAQs

 De Madre A Madre Prenatal Care Photonovels FAQs

Q.1 How were the De Madre a Madre photonovels developed?

Q.2  How did you select the words for the glossaries?

Q.3 What lessons did you learn from field-testing the glossaries?

Q.4  What does the bilingual bubble layout look like?

Q.5  How can you use the De Madre a Madre photonovels?

Q.6 How do you make a photonovel?

Q.7  How do you use photonovels with people who cannot read?

Q.8 What are some of the major differences between 'photovoice' and photonovels?


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Q.1  How were the photonovels developed?

 A.1 The seven universal stories are woven together from the voices and real-life experiences of Latinos from diverse backgrounds. To ensure the cultural and linguistic appropriateness of the photonovels, Latino families participated in all aspects of the development and field-testing process: from concept and content development to design and production.

Health professionals from a wide range of disciplines helped ensure that the information is accurate and, when appropriate, complies with state and federal program guidelines.

This multi-faceted, community-based participatory approach required repeated testing and retesting of the materials, including content, photos, layout, and other design elements. The development process took three years to complete. Responding to the needs and issues identified during the field-testing process inspired many of the unique features of these photonovels.

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Q.2  How did you select the words for the glossaries?

 A.2  Our initial English for Speakers of Other Languages (ESOL) literacy component began with a few simple words for vocabulary exercises. However, during our field-testing process when we were checking for comprehension, we learned that many terms and health concepts that are commonly used and understood in the United States are not familiar to many Hispanic clients who are new to this country.

While we simplified the story, we also tracked the words that are commonly used in prenatal education and care and are often not explained. We added these words to our glossaries and put them in bold in the stories. The words in bold may be new words for the women but they are also cues to educators to check comprehension. The simple definitions help ensure that the clients understand basic terms used in clinics that may not be explained fully or at all.

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Q.3  What lessons did you learn field-testing the glossaries?

 A.3  Initially, we asked health professionals who work in systems that serve low-income clients to help us write the definitions for some of these basic health terms. However, when we tested them with Latinas, we found that the explanations were still too complicated. Many women did not understand the words or explanations in English or Spanish.

Our field-tested glossaries help give staff and interpreters a reference and starting point for dialog. They can add information as needed and appropriate. These features make the De Madre A Madre photonovel series a valuable resource for promotores or lay health educators.

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 Q.4  What does the bilingual bubble layout look like?

To view a sample page, click here.

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Q.5  How can you use the photonovels?

 A.5  Our stories are designed to assist you in teaching in a way that truly reaches those you serve. 

Use them to share prenatal care information. 

  • Distribute the stories at health fairs, churches, stores where your clients may shop…just a few ideas!
  • Give them to clients after a clinic or home visit to reinforce the important health messages you have shared. 
Use them in groups. 
  • Use with the TWS Method to trigger meaningful discussion among participants about the issues in the stories.
  • Effectively introduce and/or reinforce health messages presented in other prenatal education programs, such as March of Dimes' Comensando Bien.
Use them as a reference and training tool.  
  • Help train staff about the educational needs when working with Hispanic clients with low literacy skills. 
Use the photonovels as a language tool. 
  • Unlike many brochures and pamphlets, the prenatal care photonovels are in a dialog format so the information is written the way a person speaks. This can help bridge language differences.  While this is far from the ideal, the bilingual bubble layout and content give clients and staff some way to communicate when an interpreter or bilingual staff person is not available.
Use for literacy instruction.
  • The photonovels set the stage for many other types of related learning activities that can improve comprehension and participants’ literacy skills.

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Q6. How do you make a photonovel?

 A.6  There are different ways to develop a photonovel. As Rudd and Comings (1994) explain, how you define ‘community’ and the level of involvement of the community can and will vary depending on your timeframe and objectives (which are often driven by funding stipulations).

At one end of the continuum, a photonovel is planned, written, designed, photographed, produced, and printed by community members. ‘Outsiders,’ including health professionals, act in a technical advisory capacity only. One of the primary goals is to capture and preserve the integrity of the voices, faces, and ‘codes’ of a particular community. Participation in the conception and creation of the photonovel is as important in the empowerment process as the actual product.

Community capacity building to identify respected formal and informal leaders and stakeholders is important to the photonovel development process. For example, community leaders may possibly give their approval/blessing, help guide the project, adapt the process for the community, and select participants.

Depending on how to you plan to use the photonovel when it is done, involving and getting buy-in of community and system leaders (e.g., healthcare, school system, local and state governments) up front can be critical for advocacy and community change efforts. The process of photonovel development by itself can be a powerful intervention with a group or specific community.

In our development process, we define ‘community’ in a broader, more inclusive way. Our goal is to create health education photonovels that can be used across communities with the Teach-with-Stories Method, i.e., they are designed so you can use them in facilitated group settings, not just as a stand alone written educational piece. These universal stories are then critically discussed at the group level so the dialog and issues naturally reflect the needs, concerns, and feelings unique to each group.

We gather extensive information from diverse perspectives and sources. Everyone’s voice is valued, community members and health professionals alike. Our process involves focus groups, reviews of the literature, existing materials and programs, key informant interviews, and advisory board feedback with members from local, state, and national levels.

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Q.7  How do you use photonovels with people who cannot read?

 A.7   Using photonovels with the Teach-with-Stories Method makes this possible. Everyone is a teacher and a learner. In a typical session, group members volunteer to be the characters in the photonovel and together read their parts like in a play. Teaching points and health issues are embedded in the stories. These give the facilitator natural openings and ‘chispas,’ or sparks, to stop and discuss. The characters’ and the participants’ life experiences, feelings, and beliefs are a vital part of the group dialog. Those who cannot read can listen and participate in the discussion.

As a health educator, you may not have the time or opportunity to teach someone to read or write, but you can help them improve their health literacy skills, which includes critical thinking and problem-solving. Improving a person’s and/or community’s health literacy is helping them understand how to access, interpret, and use health information and systems in daily life. This participatory, learner-centered approach helps you meet many needs simultaneously, in a culturally appropriate way.

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Q.8 What are some of the major differences between 'photovoice' and photonovels?

 A.8 The ‘photovoice’ process is typically a series of independent photographs that captures a story and voices the need/perspective/feelings of the ‘storyteller’ photographer. Th photography may be accompanied by a written or oral narration to illuminate the idea or feelings behind the photographs.

A photonovel is a structured story with dialog bubbles, like a comic strip. Photographs are usually used instead of cartoons. ‘Storytelling’ is at the core of the use and development process for both photovoice and the photonovel.

Findings from a health literacy study (Hohn, 1998) call for innovative ways of teaching and reaching people.  “Even if health materials are written at appropriate literacy levels, they were insufficient by themselves in promoting active engagement with a health issue likely to result in behavior change.” When describing lessons learned from their research, Hohn (1998) observed, “Storytelling was a vitally important part of the process (for fostering empowerment in health education).  It brought the information back into the psychological-emotional realm so that meaning and connection could emerge.”

For more info, see:  Hohn, M.D. (1998). Empowerment health education in adult literacy: A guide for public health and literacy practitioners, policy makers and funders. NIFL Literacy Leadership Fellowship Project (Vol. 3, No. 4, Part A). Washington, DC: National Institute for Literacy.

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