A story of change: The influence of narrative on African-Americans with diabetes.

Abstract

OBJECTIVE: To understand if narratives can be effective tools for diabetes empowerment, from the perspective of African-American participants in a program that improved diabetes self-efficacy and self-management. METHODS: In-depth interviews and focus groups were conducted with program graduates. Participants were asked to comment on the program's film, storytelling, and role-play, and whether those narratives had contributed to their diabetes behavior change. An iterative process of coding, analyzing, and summarizing transcripts was completed using the framework approach. RESULTS: African-American adults (n=36) with diabetes reported that narratives positively influenced the diabetes behavior change they had experienced by improving their attitudes/beliefs while increasing their knowledge/skills. The social proliferation of narrative - discussing stories, rehearsing their messages with role-play, and building social support through storytelling - was reported as especially influential. CONCLUSION: Utilizing narratives in group settings may facilitate health behavior change, particularly in minority communities with traditions of storytelling. Theoretical models explaining narrative's effect on behavior change should consider the social context of narratives. PRACTICE IMPLICATIONS: Narratives may be promising tools to promote diabetes empowerment. Interventions using narratives may be more effective if they include group time to discuss and rehearse the stories presented, and if they foster an environment conducive to social support among participants.