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Can narratives and Cochrane reviews work together?
 

Can narratives and Cochrane reviews work together?

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  • Thank you for having me speak today – wonderful opportunity to meet you all in person. Also wonderful to have a chance to talk to you about access to information and libraries – an area that is becoming increasingly important to consumers.

Can narratives and Cochrane reviews work together? Can narratives and Cochrane reviews work together? Presentation Transcript

  • Cochrane reviews and storytelling: Can they work together? Tamara Rader Cochrane Musculoskeletal Group March 7, 2008
  • Welcome!
    • Introductions
  • What Are Narratives?
    • Stories which follow a certain format
    • Have a beginning a middle and an end and make a point
    • There is mounting evidence to suggest that making stories, listening to stories and responding to stories is an essential and transformational human process, that helps make meaning of life’s often deeply contradictory experiences.
    • It can promote acceptance and recovery, inspire hope and trigger insights that can lead to significant personal growth.
  • Why Narratives?
    • Narratives or story telling is a natural part of the grieving process in many cultures
    • It is a form of communication which is suitable for many populations
    • Can be written, auditory or visual
    • Can be in real time or asynchronous
  • Literature review
    • Narratives can be a therapeutic, knowledge translation or evaluation tool
    • Using narratives as a contextual tool to develop a program which meets the specific needs of a community or individual
  • Best Practices from Literature Review
    • Adequate planning
    • Defined criteria for participants
    • Prolonged engagement
    • Process of checking and confirming
    • Participant checks
    • Dissemination
    • Adapted from Kirkpatrick 2005
  • Adequate planning
    • Comprehensive review of narrative methods
    • Develop a clear goal of the storytelling intervention
  • Define Criteria
    • Choose a consistent story type which is appropriate to your purpose and audience
    • Ensure that participants are properly trained and supported
  • Prolonged engagement
    • Careful data collection [interviews?, journals? Participant observation?]
    • Ideally involves a follow up of a year or more
  • Process of checking and confirming
    • Validation, reflecting and checking
    • ongoing contact with story teller
  • Participant checks
    • Share the narrative summary with participants to ensure it reflects their story.
    • Somewhat dependent on the kind of narratives and how they are being used (ie participants telling their story vs storytellers telling constructed stories)
  • Dissemination
    • Use stories to promote understanding of the lives and stories of people’s experiences
    • Stories create relationships
    • Told and retold
  • Examples of narratives in action!
    • Adherence to antiretroviral therapy
    • Bereavement project
    • AfriAfya
    • DIPEx
  • Adherence to antiretrovirals
    • Using lay health workers to enhance adherence to antiretroviral therapy among homeless people
    • Homeless people communicate through stories
    • Authenticity is critical
  • Current practice
    • Highly Active Antiretroviral Treatment (HAART) is prescribed at community health centres in Ottawa
    • Adequate adherence to HAART is less than 55% (Mills 2006)
    • Lack of follow-up and monitoring due to:
      • lack of family physician,
      • personal beliefs,
      • lack of social support,
      • daily schedule barriers (Mills 2006)
  • Bereavement project
    • Ottawa End of Life network initiated working group on Bereavement
    • Desire to improve availability and effectiveness of bereavement care recognizing limits of funding and resources
  • Current Practice
    • Little funding for bereavement services and no reasonable expectation of future funding from government sources
    • National standards include expectation of bereavement care
    • Pediatric standards are specific, adults not but, there is an obligation to provide services for all populations
    • Traditional approach to bereavement services tends to concentrate on therapy/counseling, self help groups or volunteer contact
    • Recognition that certain populations (mental illness, dementia, oral cultures, literacy issues) are not being adequately served by current practice.
    • Interest in looking at sustainable initiatives which could be applied to many populations and setting
  • AfriAfya
    • Kenya-Ottawa partnership
    • Uses puppet shows and theatre, comic books to convey messages to the community about best evidence on HIV/AIDS treatment and prevention.
  • AfriAfya in Support of Narrative:
    • African culture is an oral culture . “ We prefer to talk, rather than read . It therefore makes sense to harness the narrative aspects of our culture in information sharing and exchange”.
    • Low levels of literacy can be a barrier to information sharing and exchange
    • Limited communication infrastructure in most rural parts of the country, narrative becomes a cost effective and easily adaptable way of information sharing and exchange
    • - AnneRose Kaiya
  • DIPEx
    • Database of Individual Patient experiences
    • Stories of patients experiences with diseases or treatments
    • Compelling but may risk emphasizing negative aspects of treatment
  •  
  • 8 Narrative Patterns
    • A Springboard story
    • Communicating who you are
    • Communicating who the company is (Branding)
    • Transmitting values
    • Fostering collaboration
    • Taming the grapevine
    • Sharing knowledge
    • Leading people into the future
  • A springboard story
    • Story of one person carrying out some recent change that improved the organization.
    • explains what would have happened without the change.
    • has a happy ending,
    • Inspires action in the audience.
  • Communicating who you are
    • colourful, well-told story, usually based on an incident in your life
    • reveals some strength or vulnerability and helps others to understand you better.
    • it shows others what you value.
  • Communicating who the company is
    • These are the stories told about the company (organization) and its products, to develop trust and establish a brand.
  • Leading people into the future
    • Evocative story of the future,
    • Example: Martin Luther King's "I Have A Dream" speech.
    • Requires a high degree of verbal skill
  • Transmitting values
    • parables
    • describe an incident that exemplifies the values you want listeners to follow
    • not explicit, but instead lets people reflect on what the story means.
  • Fostering collaboration
    • Groups sharing stories to build bonds
    • It’s the act of sharing the story
    • One story sparks another among participants
  • Taming the grapevine
    • Using a story to diffuse negative rumours.
    • Using gentle humour
    • Make sure the bad news is true
  • Sharing knowledge
    • Explains a problem and how it was solved.
    • Detailed
    • We learn from our mistakes, and we can learn from other people’s mistakes through this type of story.