My wife had just finished meeting with her medical oncologist for her bi-annual check-up at MD Anderson’s Thoracic Clinic. We were sitting in an area called “the Park” rehashing what her doctor had said when a mother and her daughter sat down at our table. There were lots of empty seats in area but for some reason they decided to sit with us. Call it serendipity. It turned out that both my wife and Megan (the daughter) had just gotten “good news” from their respective oncologists.
We ended up talking with our new friends for one and a half hours – my wife and the daughter about the travails of cancer (hair loss, uncertainty, and so on) – the mother and I about care giver stuff (insurance authorization, navigating the health system, etc.). My wife and I always feel so energized after “talking story” with other dealing with the same issues. You see these “chance meeting” always happen to us….and a lot of other patients as well I suspect.
Talking Story Hawaiian Style
I have always supposed that there was some “therapeutic benefit” to these chance meetings with other cancer patients. Turns out I was right, according to a recent study of hypertensive patients in the Annals of Internal Medicine.
The study explored the use of culturally appropriate “storytelling” among a population of inner-city African-Americans (71% women) diagnosed with hypertension. In the study, an experimental group of patients received a DVD showing “people just like them” talking about their experiences living with high blood pressure. For example, lessons learned about how to best interact with their physicians, and strategies to increase medication adherence. A control group received a general introductory DVD on hypertension without the “storytelling.”
The study found that that patients diagnosed with uncontrolled hypertensionbenefited the most from receiving culturally sensitive “storytelling” messages promoting hypertension control. People in the experimental group (at 3 months post baseline) had an 11mm Hg greater reduction in systolic blood pressure than the control group. Smaller reductions (6mm) were also found for diastolic blood pressure among the experimental group. No change in systolic or diastolic blood pressure was found among patients in the experimental group diagnosed with controlled hypertension. Blood pressure reduction in these patients from baseline to 6 to 9 months also favored the intervention group for systolic and diastolic blood pressures.
Researchers theorized that narratives or “storytelling” can break down cognitive resistance people may have to behavior change by helping listeners:
- make meaning of their lives
- actively engage them in their care
- influence their health behavior
- get them to imagine picture themselves taking part in the same behavior/action
So What Does This Mean For You?
Storytelling may well turn out to be an effective, inexpensive, and highly appealing strategy for engaging patients with all kinds of conditions in behavior change. Primary Care Medical Groups, Accountable Care Organizations, Health Plans, Population Health Management and Disease Management Vendors should explore ways of “pairing up” culturally-like patients…say with uncontrolled hypertensive patients with culturally similar patients who have successfully gotten their condition under control. Same thing diabetes, asthma and other conditions. Social media, e-mail and the telephone are ways that patients can begin sharing their stories…and improving health outcomes.
If you would like more information on “storytelling” and how it might work for your organization, feel free to contact me by leaving a comment below.
Houston, T. et. al. Culturally Appropriate Storytelling to Improve Blood Pressure A Randomized Trial. Annals of Internal Medicine. 2011;154:77-84.