The study used a randomized controlled design, and a sample of 300 participants, and found that viewing patient's videoed stories led to
Blood Pressure reduction among the group of listeners. A personal, rather than authoritative, approach was employed, wherein the speakers
were real other patients, telling their own personal experience and struggles with Hypertension, rather than actors delivering pre-instructed words.
Of equal importance, the video intervention was deliberately culturally appropriate for the target audience, in this case an African American group.
The idea is to utilize the natural resonation of patients with members of their own constituent population, to capitalize on people's natural empathy and trust toward members of their own ethnic group.
There are a few limitations to the study:
Such reservations notwithstanding, the study contains several valuable lessons and ideas:
Blood Pressure reduction among the group of listeners. A personal, rather than authoritative, approach was employed, wherein the speakers
were real other patients, telling their own personal experience and struggles with Hypertension, rather than actors delivering pre-instructed words.
Of equal importance, the video intervention was deliberately culturally appropriate for the target audience, in this case an African American group.
The idea is to utilize the natural resonation of patients with members of their own constituent population, to capitalize on people's natural empathy and trust toward members of their own ethnic group.
There are a few limitations to the study:
- We have no information about the audition process, or the criteria used to select the speakers. The researchers stated that they were looking for "clarity and persuasiveness", but at what point do these qualities spill into "manipulative" ?
- We also know very little of editing process. The authors report of "Retaining the character of the storyteller", but editing by definition implies framing and arranging of the material, and there's no mention of allowing the speakers to comment on or approve of the final versions of their stories.
- Generalizability is also an issue, because 71% of the participants were female. Research shows that women are especially attuned to relationships,which raises the question of whether shared personal experiences would be more compelling, and thus more effective for women than men.
- In addition, all participants were African Americans, who as an ethnic group hold a long standing tradition of fostering community through storytelling, and thus might be particularly receptive to this medium of intervention. The question rises of whether different ethnic groups that value the individual over the community, or express their communal identities through other means than storytelling, might be less receptive to this method of care.
- Lastly, yet very importantly, the study does not provide much information of whether the patients (some or all) were treated with anti-hypertension medication as well as the videos. If patients were receiving active medical treatment (as they presumably were), at what point was the intervention DVD given? The study would have been more informative if the investigators had fully accounted for medication use, and other confounders - for example: by comparing medication plus storytelling with medication alone.
Such reservations notwithstanding, the study contains several valuable lessons and ideas:
- Building a sense of community among people with similar health struggles can reduce suffering, and the sense of isolation that often accompanies chronic illnesses.
- By distributing videotaped peer-to-peer stories, the physician implicitly sanctions advice from people within the patient's own community. Thereby acknowledging that despite their advantage of extensive education, physicians do not hold a monopoly on knowledge and wisdom. This notion may encourage patients to learn from each other about their conditions, empower them to take greater interest and responsibility toward the actions they can take to help in the treatment of their condition, and decrease the psychological distance between physician and patient,, thereby promoting a trusting relationship. This last one is particularly important considering the history of distrust of the medical profession within the African American community.
- Finally, the simple process of sharing experiences and information is helpful in educating patients about their condition, possible treatments, life-style and/or dietary changes, which may be helpful to both patient and physician in communicating and working together to improve patients' lives.