Most public health campaigns push their message to the masses using traditional media: TV, web, radio, print and billboards.
But these conventional tactics may not be best suited for every demographic in a country as diverse as the U.S. That’s why Nebraska researcher Arthur “Trey” Andrews is helping Hispanic victims of violence through a lesser-known medium: fotonovelas, which are dialogue-based, photographic comic books that are a common research tool in Latino populations. He’ll pursue this research with a Scholars Program Grant from the Great Plains IDeA-Clinical Translational Research Network at the University of Nebraska Medical Center.
“Fotonovelas have been used in Latino mental health contexts before,” said Andrews, assistant professor of psychology and ethnic studies. “But gearing them toward victims of violence — that hasn’t been done before.”
Though Latinos experience violence at a higher rate than whites, they access mental health services at much lower rates. Instead, they often seek help through informal channels like religious leaders, family and friends. This reflects a cultural premium on interpersonal relationships, Andrews said.
To capitalize on these tight-knit ties, he’ll use a social network-based approach to distribute mental health literacy-focused fotonovelas in Latino communities. The goal is to educate Hispanic people about professional mental health services, reduce the stigma of seeking treatment and enhance the peer support available to victims of violence.
Rather than handing out the materials widely, Andrews’ team will give the booklets to a small group of people who receive training on the publications’ content and purpose. The team will then assess “downstream impact” — essentially, how effectively the information ripples throughout the community through peer interactions.
The work marks one of the first times social network analysis — the investigation of social links through network and graph theory — has been used in the context of mental health. Hispanic communities are fertile ground for this approach, Andrews said, because of their inherent social interconnectedness. In addition, fotonovelas are designed to be physically passed through a network, making them conducive to peer-to-peer interventions.
“The project puts education in the hands of friends and family members, with the hope that the information will spread more easily in these populations,” Andrews said.
He thinks the approach could also benefit other close-knit communities.
“Nebraska thinks of itself as very tight knit, with close and supportive social networks,” he said. “The research will shed light on how we can support people within these types of communities to recover better from adverse events.”
The project is part of Nebraska’s Minority Health Disparities Initiative, which is aimed at conducting high-level research on minority health and health disparities. Andrews, an MHDI faculty affiliate, said the center’s resources and expertise are instrumental to his work.
The four-year award provides researchers with partial salary support and up to $50,000 in seed funding for preliminary research projects that lay the groundwork for researchers to successfully compete for a National Institutes of Health R01 grant, the agency’s standard grant for health-related research. With this support, Andrews is receiving extensive training in social network theory, sharpening his manuscript and grant writing skills and enhancing his knowledge of research ethics.
For Andrews, the project is another step toward a goal he’s pursued since adolescence, when he observed firsthand that communities could benefit from research-based mental health resources. By age 16, he knew he wanted to become a bilingual professional tackling mental health issues after meeting refugees from Nicaragua’s civil war during a service learning trip to Costa Rica. Their stories about the lingering trauma of violence inspired the work he does today.
“Back in the U.S., I saw the exact same situations,” he said. “There are people here facing difficulties trying to make it, trying to fit in. By graduate school, I knew that research would be a big part of the puzzle in expanding services and reducing disparities for Spanish-speaking and Latino populations.”
The Great Plains IDeA-CTR Network’s Scholars Program, funded through an NIH grant to UNMC, supports early career researchers to become independent scientists and to increase the infrastructure and resources needed for clinical and translational research in the region. Andrews was one of five recipients in 2018.
The network is a collaborative effort between nine institutions in Nebraska, South Dakota, North Dakota and Kansas to reach medically underserved populations and transform health delivery and outcomes in the Great Plains region.