Evaluation of a bilingual video-novella method to teach elderly Mexicn American non-readers how to decrease their risk of diabetic complications

Abstract

Complications of non-insulin dependent diabetes mellitus (NIDDM) are the primary cause of death of Mexican Americans over age 40 in Texas. In Texas, 51.2% of Hispanics have eight or fewer years of school. Many are functionally illiterate and do not read in Spanish or English. Bilingual (Spanish and English) videotapes produced in drama/novella format were field-tested in 2 South Texas sites to teach elderly Mexican American non-readers to decrease the risk of NIDDM complications. Culturally appropriate information for survival was presented within a format of popular drama/novella soap operas to facilitate significant behavior change. Hypotheses assumed significant change in weight (BMI), blood pressure, and blood glucose (A$sb{rm 1c}$) for the experimental group. The experimental study design lasted 6 months, with treatment extending over the first 2 months. ANOVA was used to analyze the data for significance. Although most men and women in both the control and experimental groups at both sites needed to lower their BMI, weight hypotheses were not supported. For women, the trend was for the experimental group to lose more than the control group. Both systolic and diastolic blood pressure were measured; on average, few at either site needed to lower either systolic or diastolic pressure. None of the hypotheses were confirmed in terms of the treatment producing more effect than the control condition. Glycosylated Hemoglobin (A$sb{rm 1c}$) was used as an indirect indicator of blood glucose level. At the beginning of the study, the majority of the subjects had an unacceptable A$sb{rm 1c}$. Little change was shown during the course of the study, thus the hypotheses were not supported. Even though the hypotheses were not supported, many long-term benefits have accrued nationally through use of the video-novellas for at-risk, low-literacy Hispanic populations. Suggestions are given for using the video-novella program within a Public Health framework where communities, not individuals, are the patients. Individuals educated become change agents for their children, grandchildren, and others, even if they do not change their own behavior. Community change, not just individual change, should become pervasive within communities.