Enhancing the Impact of Research by Telling Stories

Background

Misinformation abounds in relation to fluoridation and vaccines, including the most recent COVID-19 vaccination hesitancy problem. Usually public health organizations try to counter this misinformation with facts and data-centric messages, but widely held myths tend to be persistent and not dissipated by the truth. An approach involving storytelling can engage audiences and convey facts in a way that sticks with those who listen to the tale. The characteristics of good storytelling in oral health literacy efforts and recommendations for the best way to engage in storytelling were offered.

Characteristics

In storytelling, a narrative describing the experiences of people as they move through several events is used to communicate truths. Stories are easier for people to understand than lists of facts, and the information tends to stay with people longer than fact-centered approaches.

Improved oral health literacy is crucial to managing oral health care challenges. The use of storytelling in an oral health study may appear to contradict the “plural of anecdote is not data” tenet, but data and stories don’t have to be in opposition. Incorporating stories into scientific writing increases the audience’s willingness to base decisions on evidence. Policymakers are often the audience that researchers try to inform. A barrier to reaching them may rest in the fact that most legislators, parliaments, and other policy-making bodies never conducted research or worked in academic settings. Policy decisions are often driven by values in addition to evidence, so storytelling can make information more relevant to the values of the policymaking audience.

Techniques

No template exists for storytelling, and the literature offers few insights into the process, the framework, or the tenets of using this method for reporting research. Several techniques appear to be more successful than others, however. These include identifying the story elements and using them to create a compelling story; incorporating conflict, underlying or background information, and facts the data alone may not tell; adding information on attitudes that influence health decisions; and allowing there to be no resolution of the problem.

Engaging stories include conflict that is identified in the opening sentences of the tale. These conflicts may involve obstacles to optimal oral health, which might include policy barriers, gaps in clinical knowledge, or cultural factors. Background information can be given to build the audience’s interest by pointing out the matters underlying the situation. Sometimes the data fail to include information, but the storytelling approach can allow it to be told. For example, a journal article about Canadians’ visits to hospital emergency rooms (ERs) for nontraumatic dental conditions included not only the cost of the visits but the wasted dollars because most patients are discharged without the underlying oral disease being addressed, leading to future visits. Today’s pandemic adds another layer of drama because these visits are made while ERs are experiencing extreme stress related to COVID-19 cases.

Storytelling can incorporate the traditional structure of introduction, methods, results, and discussion. However, in each section, brief stories can be part of the presentation and convey messages about challenges that had to be overcome and limitations that exist. Issues related to health equity can benefit from having information given by the community regarding attitudes, input on study design, and the incorporation of relevant concerns. Some may benefit from the use of focus groups or informant interviews that identify what factors affect health decisions.

Stories generally have a resolution of the problem, but researchers shouldn’t pretend that they have all the answers or have completely solved the problem that the story presents. Even having a null result in research can provide insights and teach lessons. Researchers can identify the mysteries that remain to be addressed by others with respect to oral disease, risk factors, or other situations. This demonstrates that science works by accumulating a body of evidence through a process of incremental building.

Application

Storytelling can strengthen the scientific process and enhance the public’s trust in research findings. The COVID-19 vaccine hesitancy is an example. One factor in hesitancy is related to the fears that safety was compromised by moving too quickly with the development of the vaccines. Storytelling can point out the decades of research on earlier coronaviruses that allowed researchers to learn much about these entities, their vulnerabilities, and how to exploit their weaknesses. Pointing out that several COVID-19 vaccine programs were launched within days of the publication of the virus’ genome sequence on the internet in January 2020 helps the audience see that vaccine developers had a critical head start even as the pandemic began. So a foundation of knowledge was enhanced by new knowledge, which is the standard approach for a scientific process.

Clinical Significance.

Oral health care researchers can gain additional guidance on storytelling by consulting with the schools of communication within their academic community. Often they have graduate courses on storytelling or they may be participating in a health-related storytelling initiative. Focusing on the numbers when telling stories keeps them anchored in an evidentiary process.