Evaluation of a Fotonovela to Increase Depression Knowledge and Reduce Stigma Among Hispanic Adults

Fotonovelas—small booklets that portray a dramatic story using photographs and captions—represent a powerful health education
tool for low-literacy and ethnic minority audiences. This study evaluated the effectiveness of a depression fotonovela in
increasing depression knowledge, decreasing stigma, increasing self-efficacy to recognize depression, and increasing intentions
to seek treatment, relative to a text pamphlet. Hispanic adults attending a community adult school (N = 157, 47.5 % female, mean age = 35.8 years, 84 % immigrants, 63 % with less than high school education) were randomly assigned
to read the fotonovela or a low-literacy text pamphlet about depression. They completed surveys before reading the material,
immediately after reading the material, and 1 month later. The fotonovela and text pamphlet both produced significant improvements
in depression knowledge and self-efficacy to identify depression, but the fotonovela produced significantly larger reductions
in antidepressant stigma and mental health care stigma. The fotonovela also was more likely to be passed on to family or friends
after the study, potentially increasing its reach throughout the community. Results indicate that fotonovelas can be useful
for improving health literacy among underserved populations, which could reduce health disparities.