Stories of Us – Chuyện Kể Nhau Nghe: Building Community for Health through Stories

Abstract

Background: Research found that positive social connections are protective of health. For refugees and immigrants, whose established social ties are disrupted, strengthening existing social networks may promote population health. Purpose: This dissertation presents in three manuscripts the results of Stories of Us – Chuyện Kể Nhau Nghe, a community participatory action research that examined the relationships between cultural displacement, community cohesion, and self-rated health (SRH), evaluated the effects of an intergenerational life review intervention on the above variables, and assessed the feasibility and acceptability of Stories of Us – Chuyện Kể Nhau Nghe among Vietnamese-Americans. Methods: First, an integrative review of reminiscence literature on the effects of life review (LR) on social connections and health was conducted. Second, lessons learned from experiences of researchers in the literature and from Stories of Us – Chuyện Kể Nhau Nghe on conducting participatory research (PR) with Vietnamese-Americans were presented. Finally, results of a community survey and a one-group pre- post- LR intervention design were provided. Results: First, the integrative review found strong evidence that LR interventions reduced and prevented depression by improving meaning in life, ego integrity, mastery, and positive thoughts. There was promising evidence that LR, particularly intergenerational LR, promoted participants’ connections with each other and with other people. A conceptual framework for further research with refugees and immigrants was proposed. Second, the experiences of Stories of Us – Chuyện Kể Nhau Nghe researchers confirmed lessons learned from PR literature: (1) mutual respect and trust are essential and must be gained from long-term involvement with the community, (2) utilizing community existing resources to build capacity, facilitate empowerment, and promote ownership, and (3) committed time, expertise, and personnel are necessary to sustain health promotion activies and their impact over the long-term. However, all communities have unique characteristics. Applying successful strategies in other communities without learning about and considerations of the uniqueness of the community with whom the researchers will be working may be counterproductive. Finally, results from the community survey showed that cultural displacement negatively affected SRH and the effect is mediated by community cohesion. Post-intervention results showed no significant effects of Stories of Us – Chuyện Kể Nhau Nghe on cultural displacement, community cohesion, or SRH. Evaluation showed promising results that the intervention is feasible and desirable by Vietnamese-Americans in the Greater Seattle area. Conclusion: Stories of Us – Chuyện Kể Nhau Nghe filled a community need. Future study with a larger sample, stronger design, and more sensitive instruments is needed to assess Stories of Us – Chuyện Kể Nhau Nghe effectiveness.