Impact of a Community-Developed Nutrition Fotonovela Versus a Brochure on Dietary Practice in the Dominican Republic




Jean, Alice

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BACKGROUND: Cardiovascular disease is the number one cause of mortality in the Dominican Republic, and diet is one of the main factors contributing to its development (World Health Organization, 2016; Mokdad et al., 2018). A fotonovela is similar to a comic book but uses photographs to tell a story about a health topic and has been shown to increase awareness and promote healthier practices. OBJECTIVE: After two weeks and one month, participants experiencing the community-developed nutrition fotonovela will display more changes in dietary behavior than the participants experiencing the nutrition brochure. METHODS: Zumbón was randomly selected from five communities surrounding Santo Domingo to develop a fotonovela about eating a balanced diet through focus groups. Haina and El Batey were the intervention groups in which the pastors presented the fotonovela to the communities while San Joaquín and Tres Brazos were control groups in which the pastors presented an existing nutrition brochure to the communities. Before the presentation, the participants completed a survey containing demographic and dietary behavior questions. To evaluate whether the fotonovela or brochure intervention significantly changed their diet, participants completed an identical survey two weeks and one month after the presentation. RESULTS: Besides differences in gender, cooking ability, employment, and household composition, there were no other demographic differences within the brochure and fotonovela presentation communities. With a p-value of less than 0.05 being significant, people in Haina were eating starches more often two weeks after the fotonovela presentation. In San Joaquín, significantly more people ate grains daily at one month than before the brochure presentation. In the brochure presentation communities of San Joaquín and Tres Brazos, significantly more people ate no added fat at the one month survey compared to the two week survey. No other significant dietary changes were found within the brochure and fotonovela presentation communities when comparing pre- to post-presentation surveys. CONCLUSION: Although differences in dietary changes between those receiving the brochure versus fotonovela were limited, the brochure presentation communities made more preferable changes in their diet than the fotonovela presentation communities within a one-month period. Nutrition brochures are effective in promoting a healthy diet while fotonovelas can potentially have long-term beneficial effects on diet. Future studies are recommended to distribute color copies of the fotonovela to a larger sample size and to follow participants' eating habits beyond one month.

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