Digital Storytelling as a tool for health messaging on an American Indian reservation: A development process

Introduction: Digital stories offer a collaborative approach to health messaging, and can raise awareness among viewers on issues presented in stories. This study used an iterative, participatory process to produce and vet digital stories for increasing community awareness about strategies to improve child and family health on an American Indian (AI) reservation. Methods: We used a collaborative approach to develop digital story topics and content. This included input from the study leadership team, with members representing a tribal college, a tribal health organization, and a university. Story attributes, such as likability and cultural embeddedness of characters, identification with the storyteller, and language were included to increase influence on viewers’ attitudes, beliefs, and behavior change. The advisory board and the tribal health and wellness committee were then engaged in a four-step, iterative process (view, evaluate, prioritize, and revise) to evaluate the story. The survey was adapted from a health promotion digital story evaluation study completed in rural Alaska. The twelve-item, closed ended, Likert-style survey explored community members’ perspective on digital storytelling likability, intent to communicate with family and friends about the topics presented, cultural acceptability, and intent to change family health behavior. Viewers were asked to complete a written evaluation, then to share feedback on how to make it more likeable, informative, and culturally relevant. Results/Discussion: A total of 22 community members viewed and evaluated the digital story. The viewers were mostly female (63%), mostly AI or Alaska Native (63%), and 50% were between the ages of 30-39. They reported liking the story (86%), feeling that it was a good way to learn about improving the health of their families (90%), and 90% felt digital stories are a culturally respectful way to receive health messages. Changes suggested by viewers included different music, including kids’ voices, and adding text to the screen to emphasize the message. Dissemination plans include social media outlets for the tribal college, tribal health organization, and a local hospital. Study findings suggest the four-step, iterative digital story development process may produce an effective health messaging tool for improving community awareness of child health, and that digital storytelling can be a likeable and culturally acceptable tool for health promotion