Project Title: What Health Looks Like: Using Graphic Medicine to Bring Underrepresented Voices Forward Through Public Library Health Literacy Programs

The recent pandemic has brought mainstream attention to the health disparities beneath the surface of our wealthy nation. Researchers attending to these issues know that underserved populations such as Black, Latinx, and Indigenous communities and those from lower socioeconomic backgrounds suffer not only from lack of access to health care but also access to health information. This paucity of information is actually a two-way street - while these populations receive less health information, their health experiences remain underrepresented in medical research. The health perspectives and experiences of underserved groups must be brought forward and made visible to decrease persistent health inequalities.

An effective tool for addressing this inequality in health information comes from the emergent field of graphic medicine. Graphic medicine refers to health narratives and medical information created and shared in the format of comics, which, when collected, create a sequential art story called a graphic novel. Originally conceived as a way to increase the empathy of medical students, it has expanded to include the communication of health information to various populations as well as a tool for participatory personal expression of health experiences. In their Graphic Medicine Manifesto, the interdisciplinary field's founders state, “Graphic medicine is also a movement for change that challenges the dominant methods of scholarship in healthcare, offering a more inclusive perspective of medicine, illness, disability, caregiving, and being cared for” (Czerwiec, et al, 2015).

In this project, our interdisciplinary team of health information scientists will research impacts of a health literacy program designed on the principles of graphic medicine. This program will expand the use of graphic medicine into the public library, a space focused on equal and equitable access to information, but that has not yet been utilized in this research. Graphic communication has proven effective for spreading information in underrepresented communities, such as outreach to Latinx populations through fotonovels by the Rural Women's Health Project, the Federal Trade Commission, and the University of Southern California School of Pharmacy.

In collaboration with library partners, the team will identify an underserved community in three different geographical areas. Community members will be invited to participate in an 8 to 12-week comics program that includes discussions of two graphic novel narratives of health and illness relevant to their community. Example texts include Cancer Vixen: A True Story by Marisa Acocella Marchetto and Marbles: Mania, Depression, Michelangelo, and Me: A Graphic Memoir by Ellen Forney. The discussions will be followed by a brief course in comics creation in which community members create their own narrative of health experiences in the graphic format. The goals for participants include increased empathy for others' experiences with illness, increased knowledge of health care systems, increased communication skills using both the verbal and comic format, and increased awareness of their own experiences with health and wellness.

The collaborative research team includes Drs. Sarah A. Evans and Daniella Smith (Information Science), Dr. Joanna Davis-McElligatt (English), and Dr. Sara Champlin (Journalism). Each brings valuable expertise to the project. Dr. Evans researches informal learning experiences and public library programs. Dr. Smith examines information-seeking behaviors and libraries. Dr. Davis-McElligatt's expertise includes both comics studies and critical race studies. Dr. Champlin studies health literacy and communication strategy to improve public wellbeing.

Together, the team is well-placed to initiate an investigation of health literacy through graphic medicine.

This project was developed through the Center for Racial and Ethnic Equity in Health and Society at the University of North Texas.