Photonovela to be introduced to Appalachia

Part of toolkit, new teaching opportunity provided

A photonovela is part of the diabetes tool kit Sharon A. Denham, RN, DSN, professor of nursing at Ohio University School of Nursing in Athens and director of the Appalachian Rural Health Institute, is creating for use in the Appalachian region. It will address family support for patients with diabetes.

Although it has not been used in the Appalachian region, the storyline of a photonovela creates drama and interest that has been shown to be appealing to other groups. Therefore, Denham decided to try it.

The toolkit will have two photonovelas. One will have a positive storyline and one a negative, but both will be used to generate discussion about family support for patients with diabetes. On the positive side will be a discussion on managing diabetes with family support, and on the negative will be a discussion about problems that occur when there is no family support.

Denham envisions educators using the photonovela in groups, with people playing characters and reading different parts or reading them silently before discussing the storyline. There will most likely be a guidebook on their use with a few discussion questions.

The whole idea of the toolkit is to provide ways for people to look at how diabetes is managed in their home and what the entire family can do to cooperate.

"Diabetes should be considered a family disease — not an individual disease — so the materials I am creating will be used with that in mind," says Denham.

The process for creating the photonovelas for the toolkit included the following steps:

Step One — Determine the storyline and write the script.

Denham says developing the story took time as she worked through her ideas and simplified the language. She also had to get the storyline in the proper order.

Step Two — Create a storyboard for the photo shoot.

Once the storyline was completed, Denham created a storyboard, sketching each page with stick figures to determine how to take each photo.

Step Three — Create a shot book to determine the order to take the photos.

The photographer is involved in the creation of a shot book, says Denham. The story in the photonovelas happens over five days. Therefore, clothing changes had to be brought to the photo shoots.

Denham says she noticed that the photos in Hispanic photonovelas were taken at close range, showing facial expressions, but she wanted to show background, because place is important in Appalachia.

She solicited the help of a graduate student from Appalachia and her family members for the photo shoot. It was important to use a family so people in the photonovela looked like relatives.

The one mistake made with the photos is that all were taken horizontally, says Denham. She said it would be wise to create more of a map of how the photos will appear in the book in that one horizontal photo could cover one entire page.

Step Four — Work with a printer to format the photonovela with the script in bubbles on each appropriate page.

There was lots of discussion during the formatting process, says Denham. During this time, she simplified language further. "The script has a different visual quality that you don't necessarily notice in a document, so it is a continual simplification process. You don't want the picture to be overwhelmed, and then it is a conversation taking place in the picture, so you must make sure the right person and the right dialogue are connected," explains Denham.

The design work and printing was the most expensive part of the process, costing several thousands of dollars. Denham had 300 copies of each version of the photonovelas printed for the initial pilot project. They are in full color, because that is more appealing than black and white, she says.

It's important that they are attractive, so people will pick them up and read them, says Denham.