From Colored to Black: a narrative medicine approach to theatre and community reconciliation.

OBJECTIVE: The purpose of this article is to analyze the research concepts underlying the construction of a theatrical health intervention on Black well-being, narrative medicine and what we reference as intentional locative healing. STUDY DESIGN: Descriptive postintervention evaluation. METHODS: This short communication article provides specific examples on how to practically implement elements of narrative medicine into an artistic health intervention and in postproduction assessments. RESULTS: Creative interventions that are designed to engage wellness on both an individual and communal level yield more nuanced findings. We recommend embedding reflexive exercises in the intervention for creators, the intended audiences, and jointly within both groups. This approach is in alignment with how narrative medicine is practiced in a clinical setting. It also emphasizes multiple opportunities to integrate close readings and deepen empathetic attentiveness. In addition, in an applied theatrical context, location can be meaningfully used to: 1) address historical tensions in spatial and social communities; 2) provoke curative dialogue to ease said tensions; and 3) ascribe a more restorative meaning to that spatial or social site. CONCLUSIONS: To innovate the discourse and further inform the practice of narrative, arts-based public health interventions, it is important to audit the theoretical thinking that helped guide the creative process. Those intending to engage narrative medicine should take care to remain keenly aware of narrative humility at every step.

Exploring the Perceived Effectiveness of Applied Theater as a Maternal Health Promotion Tool in Rural Zambia.

In the current study, we aimed (a) to extend the previous research conducted in Kalomo District on the psychosocial factors that influence women's intention to utilize maternal health care services (MHS) and (b) to explore community members' perceptions of the use of a theater-based health promotion program to positively influence these factors among pregnant women. Semistructured, in-depth interviews were conducted with 44 respondents, and confirmed the importance of knowledge, perceived behavioral control, attitudes, social norms, and risk perception as influences on women's health care utilization. The majority of respondents were positive about the use of theater interventions in improving maternal health care-seeking behavior. The behavior change methods proposed to incorporate in theater plays were seen as appropriate and useful to convey health-related information in theater plays, in particular if the main character was an identifiable role model. Discussion focuses on the unique contributions and possibilities of utilizing theater in (maternal) health promotion.

Enhancing social connections through an acting and improvisation course for older Americans in low-income housing.

BACKGROUND: Older adults living in subsidized housing may be at increased risk of social isolation. Applied theater, a participatory art program, can facilitate social connections among older adults. METHODS: A professionally-facilitated 12-week acting and improvisation course was held in two federally subsidized buildings in an urban setting. The mixed-method design included thematic analysis of interviews, participant observation, field notes, and statistical analysis of change over time in social isolation, community belonging, and social exclusion. RESULTS: Participants were motivated to meet other building residents, and the course included aspects that encouraged social bonding. CONCLUSIONS: Although recruitment of socially-isolated older adults presented challenges, this study presents lessons on what motivates residents of low-income senior housing to enroll in an acting program and how to design a theater course in this setting that promotes group bonding.

Using Culturally Adapted Theater Outreach to Promote Cancer Screening Among Medically Underserved Minority Communities.

Black, Hispanic, and Asian individuals, the three largest US racial/ethnic minorities, continue to suffer disproportionately from breast, cervical, and colon cancers largely because cancer screening continues to be underutilized even after decades of availability. This study examined the utility of theoretically grounded and culturally adapted in-person theater monologues aimed at promoting early detection screening among the three highest population racial/ethnic groups in Harris County, Houston, TX. Nine monologues were created to promote cancer screening and early detection for breast, cervical, and colorectal cancers in three different languages (English, Spanish, Vietnamese) and targeting underserved Black, Hispanic, and Vietnamese adult Harris County residents. From January 2014 to March 2020, 265 live monologue outreach events were held with 110 focused on prevention and screening for breast cancer, 75 for colorectal cancer, and 80 for cervical cancer. A total of 5989 individuals attended these outreach events and 86.3% completed the post-performance evaluation survey. Overall for all monologues, 6.6% of participants reported a positive change in their intent to screen from 75.7 to 82.3% after intervention (p < 0.001) and audience member scores on knowledge questions for all three cancers were mostly positive. Importantly, early detection questions for all three cancers were over 90% correct for all respondents, and well over 70% for the various groups. The findings revealed opportunities for improving monologue content to cultivate cancer early detection and screening knowledge. Results suggest that a theater-based approach may be an effective strategy to disseminate cancer screening education, improve knowledge, and increase intent to obtain screening among medically underserved communities.

Peerformance: Bystanders Enacting and Challenging Gender Norms in Community-Based Theater to Prevent Domestic Violence.

This study examined the gender beliefs and norms expressed by South Asian community members when intervening as bystanders in Peerformance, a publicly performed scene depicting a husband's controlling behavior toward his wife enacted by a peer-led theater group. Using a grounded theory approach, inductive coding and reiterative visual analysis of videotaped bystander interactions revealed that, while most community members confronted the husband, beliefs about gender roles and relations impacted how these confrontations occurred. The complexity of gender norms in bystanders' interventions calls for sociocultural tailoring; bystander programs must attend to the rich, within-group variations in community members' attitudes and beliefs.

After the Storm: Inter-disciplinary Dialogic Discourses With a Post-Fishing Community.

This paper is a critical evaluation of a unique approach to working with disadvantaged communities, which involves inter-disciplinary collaboration between an Applied Theater (AT) director and a sociologist. The application of the approach, in a community disadvantaged by the loss of industry, provides the case study basis for the evaluation. Between 2014 and 2017 community participants from Eyemouth, southeast Scotland, worked with an artistic team led by director Fiona MacPherson, and a sociologist, Carol Stephenson, to develop a creative performance of the town's fishing disaster of 1881. This inter-disciplinary project was facilitated through dialogic discourses between community participants, AT director and sociologist in which the equalization of relationships, meaning-making and active listening were established as shared values and processes. The paper makes four claims. Firstly, sociological observation of the negotiation of the creative process revealed previously hidden and nuanced social interactions, which could later be examined in greater detail with the AT director and in focus group discussions with community participants. Second, the use of dialogic discourses in the critical appraisal of AT practice by the sociologist ultimately enabled the inter-disciplinary sharing of practice, ideas and theories that were mutually beneficial. Third, the creative process revealed insights into the lived experience of post-industrial communities and enabled public sociology discourse, which ultimately prompted social activism within the case study community. Last, while the inter-disciplinary approach is labor intensive and demands high levels of commitment to the shared values associated with dialogic discourses, it provides a new and innovative way of working with, and for, disadvantaged communities.

Using Theater as an Educational Tool for Understanding Medication Experiences from the Patient Perspective.

Objective. To develop a play depicting patients' medication experiences and evaluate its usefulness as an educational tool for improving health care professionals' understanding of medication experiences from the patient perspective. Methods. An award-winning playwright was recruited to write the script, which was based on 2,178 written comments submitted by respondents to a national consumer survey on patients' medication experience and pharmacist roles. The resulting play, Go Ask Alice, was presented during November 2016 in two Minnesota cities. Attendees were asked to complete a survey before and after the performance and to provide their email address if interested in completing a three-month follow-up survey. The research team conducted descriptive and inductive thematic analyses on the quantitative and qualitative data, respectively. Results. A total of 225 people viewed the performances, with 161 completing both the pre- and post-intervention surveys and 58 providing feedback three months later. Two themes emerged in the follow-up survey: the play illuminated barriers that patients face when seeking health care services, as well as the major hindrances and other contributors to patients' medication experiences. Conclusion. Theatrical performance can be an effective educational tool for understanding medication experiences from the patient perspective.

Reactions to Diversity: Using Theater to Teach Medical Students about Cultural Diversity.

Training medical students to understand the effects of culture and marginalization on health outcomes is important to the future health of increasingly diverse populations. We devised and evaluated a short training module on working with diversity to challenge students' thinking about the role of both patient and practitioner culture in health outcomes. The workshop combined didactic teaching about culture as a social determinant of health using the cultural humility model, interactive exercises, and applied theater techniques. We evaluated changes in the students' perceptions and attitudes over time using the Reaction to Diversity Inventory. There was initial significant improvement. Women and students with no past diversity training responded best. However, scores largely reverted to baseline over 12 months.