Background: Storytelling is an intervention for health communication that has many forms, addresses varied health issues, and is suitable for low health-literate populations. Storytelling can impact knowledge, behaviors, attitudes, and health outcomes. Population Focus: Fictional storytelling has not been researched as an educational adaption in diabetes self-management for Hispanics with low health literacy. Forty-one percent of Hispanics in the United States have low health literacy, a contributing factor to poor health outcomes in chronic disease management. The Hispanic population has disproportional rates of diabetes complications. Research Question: How can short, fictional, orally presented stories be developed as culturally-adapted educational tools to improve diabetes knowledge and influence health behaviors for Hispanics with diabetes and low health literacy? Method: Using the qualitative research tradition of focused ethnography, five members of the Hispanic community with diabetes and low health literacy were exposed to five stories based upon recommended diabetes education, which was followed by their participation in qualitative interviews. The interview transcripts were analyzed for the concepts from the Learner Verification Interview and the Storytelling/Narrative Communication Theory. Following story revision based upon the data, the stories were shared with two participants to confirm data saturation. Findings: The research process produced five culturally adapted stories. The data indicated that storytelling resulted in diabetes knowledge and theoretically influenced health behaviors. An additional concept of reciprocity was identified. Recommendations: Research is needed to verify the impact of the stories on diabetes knowledge and health behavior, and to apply the model of story development to other topics and populations.

Date of publication

Summer 8-17-2021

Document Type




Persistent identifier


Committee members

Dr Beth Mastel-Smith, Dr. Janet Gehring, Dr. Baqiyyah Conway


PhD in Nursing