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The storytelling intervention showed a small improvement in blood sugar at 3 months. Blood sugar dropped from 9.1% to 8.4% for those who watched the video, compared to 9.4% to 8.8% for the comparison group. The difference was small and only appeared when accounting for starting differences. Effectiveness is rated as Limited Evidence because the improvement was modest, only appeared in adjusted analyses, and didn't come with improvements in other health measures or behaviors.

Digital storytelling intervention for diabetes self-management

Previous research shows storytelling videos can help with chronic conditions. One study found a culturally tailored video about high blood pressure worked as well as medication for African American adults. An Australian study found storytelling videos helped diabetes patients feel more confident, though blood sugar wasn't measured. This appears to be the first study testing digital storytelling for diabetes blood sugar control.

The results align with other research on culturally tailored programs for Hispanic people with diabetes. A program called Dulce Digital using interactive text messages saw larger improvements. This suggests storytelling may work better when combined with ongoing support. Reviews show more interactive, longer programs tend to produce larger effects.

Blood pressure, weight, and cholesterol didn't improve in this study, unlike some other diabetes programs. However, participants already had normal levels for these measures at the start. Only blood sugar was high. The short 3-month timeframe makes comparisons difficult. The focus on creating an easy-to-use intervention may make it more practical for community health centers than resource-intensive programs.

Confidence is moderate because the study was well-designed with good follow-up. However, the blood sugar improvement was small. The benefit only appeared when accounting for starting differences between groups.

The video was highly acceptable and easy to use. But the study only lasted 3 months. We don't know if benefits continue longer. Other health measures didn't improve, suggesting the video mainly affected motivation rather than actual behaviors.

A brief digital storytelling intervention may produce small improvements in blood sugar among Hispanic adults with poorly controlled type 2 diabetes, though effects are modest.

The intervention increased confidence and motivation to manage diabetes, with very high acceptance and emotional engagement, though these feelings didn't translate into measured behavior changes within 3 months.

Digital storytelling appears to be a culturally appropriate way to activate patients at the start of diabetes programs, but likely works best when combined with more intensive ongoing support.

Culturally tailored storytelling videos may help improve blood sugar in Hispanic adults with poorly controlled diabetes, though improvements are modest when used as a brief intervention.

The evidence is strongest for boosting motivation—nearly all participants felt more confident and engaged, showing the video connected emotionally with viewers.

The evidence is weaker for lasting health impact, as blood sugar improvement was small and didn't come with changes in other health measures or behaviors during the 3-month period.

The video's ease of use and low cost make it valuable, but it appears to work best as a starting point within a larger diabetes program rather than on its own.

The video may have more real-world impact when paired with ongoing text message support, regular doctor visits, or other diabetes programs, since a brief video alone may not provide enough support for lasting behavior change.

The intervention was a 12-minute video featuring four Hispanic people sharing their experiences managing type 2 diabetes. The storytellers included 2 women and 2 men from Mexican, Central American, and South American backgrounds. Each person talked about one key diabetes behavior: healthy eating, physical activity, taking medications, or checking blood sugar.

Study staff showed the video to each participant during their enrollment visit. Staff asked three questions after viewing to check understanding and motivation. Participants received access to the video through a mobile app, DVD, flash drive, and web link. The app included additional diabetes education materials.

Participants received monthly text messages asking them to rate their motivation and confidence on a 0-10 scale. If they scored below 7, the text suggested rewatching the video and provided a link. This ongoing support maintained engagement while keeping implementation simple.

Digital storytelling behavioral intervention, diabetes self-management education, culturally tailored health education, narrative-based intervention, community-based participatory research intervention, mobile health text messaging, diabetes diet education, physical activity promotion, medication adherence support, glucose self-monitoring education

Wieland ML, Vickery KD, Hernandez V, et al. Digital Storytelling Intervention for Hemoglobin A1c Control Among Hispanic Adults With Type 2 Diabetes: A Randomized Clinical Trial. JAMA Netw Open. 2024;7(8):e2424781. doi:10.1001/jamanetworkopen.2024.24781

After 3 months, blood sugar dropped in both groups. The video group went from 9.1% to 8.4%. The comparison group went from 9.4% to 8.8%. The difference was small and only appeared when accounting for starting differences.

Nearly all participants who watched the video found it helpful. About 98% felt more confident managing diabetes and motivated to make changes. Most wanted to eat healthier and be more active. People connected emotionally with the storytellers.

Blood pressure, weight, and cholesterol didn't improve differently between groups. Actual behavior changes in diet and exercise also didn't differ. The video increased motivation but didn't lead to measured behavior changes within 3 months.

No measured behavior changes despite increased motivation

A culturally tailored storytelling video may modestly improve blood sugar in Hispanic adults with diabetes.

The study happened during COVID-19. Extra stress may have affected how people managed their diabetes. The 3-month follow-up is short for a chronic condition. Longer-term effects are unknown.

The Hispanic community is diverse. This video may not work equally well for all Hispanic groups. One group started with slightly higher blood sugar, which may have affected results. Study staff conversations may have unintentionally helped the comparison group improve too.

Results varied depending on how missing data was handled. This creates some uncertainty. The video improved confidence but didn't change actual diet or exercise behaviors. More support may be needed to turn motivation into action.

Motivation and confidence → ↑ (strong increase)

Actual behaviors → → (no measured change)

Digital Storytelling Intervention for Hemoglobin A1c Control.

Effectiveness of Digital Health Interventions for Glycemic Control

Culturally Appropriate Storytelling to Improve Blood Pressure

Impact of a Community Health Workers Intervention Among Latinos

Diabetes Self-Management Education and Support (DSMES)

Narrative Communication in Cancer Prevention and Control

This study tested a digital storytelling video at two primary care networks in Minnesota and Arizona. 451 Hispanic adults with type 2 diabetes and poor blood sugar control were randomly assigned to watch the video or receive printed materials. Participants were ages 18-70 and had been diagnosed with diabetes for at least 6 months.

The video group watched a 12-minute video with four stories about managing diabetes. They received the video through a mobile app, DVD, flash drive, and web link. They got monthly text messages prompting them to rewatch the video if their motivation was low. The comparison group received printed diabetes education materials and usual care.

Blood sugar was measured at the start and after 3 months. Other measures included blood pressure, cholesterol, weight, and diabetes self-care behaviors. During COVID-19, some participants used home testing. 86% of participants completed the 3-month follow-up.

Digital storytelling may improve blood sugar in Hispanic adults with type 2 diabetes

This study tested a 12-minute video featuring four Hispanic people sharing their diabetes management stories. 451 Hispanic adults with poorly controlled type 2 diabetes watched the video or received printed materials.

After 3 months, blood sugar dropped slightly more in the video group. The effect was small but noticeable when accounting for starting differences. Nearly all participants felt more motivated and confident about managing their diabetes.

The video didn't change other health measures like blood pressure or weight. While motivation increased, this didn't lead to measured behavior changes in the short 3-month period. The video may work best as part of a larger diabetes program.

The study was done during COVID-19, which may have created extra stress for participants. Results might be different under normal conditions.

The study only lasted 3 months, which is too short to know if improvements last longer or if people might see more benefits over time.

The blood sugar improvement only appeared after accounting for starting differences between groups, and results varied depending on how data was analyzed, creating some uncertainty about how meaningful the benefit really is.

A trial of 451 Hispanic adults testing a 12-minute storytelling video for 3 months

Hispanic or Latino adults with poorly controlled type 2 diabetes, particularly those who are Spanish-speaking, foreign-born, have limited English proficiency, and receive care in community health centers. May be especially relevant for patients with lower levels of formal education and limited income.

Hispanic or Latino adults with type 2 diabetes who have poor blood sugar control, particularly those who are foreign-born, Spanish-speaking, and receiving care in community health centers.

Standards of Care in Diabetes—2024

This study tested a 12-minute video featuring four Hispanic people sharing their diabetes management stories. 451 Hispanic adults with poorly controlled type 2 diabetes watched the video or received printed materials.
After 3 months, blood sugar dropped slightly more in the video group. The effect was small but noticeable when accounting for starting differences. Nearly all participants felt more motivated and confident about managing their diabetes.
The video didn't change other health measures like blood pressure or weight. While motivation increased, this didn't lead to measured behavior changes in the short 3-month period. The video may work best as part of a larger diabetes program.

Digital storytelling may improve blood sugar in Hispanic adults with type 2 diabetes

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