The Mechanics of Storytelling: Preliminary Findings from the Our Stories, Our Medicine Archive Narrative Engagement Survey

Background: Native American and Indigenous communities experience persistent health disparities, particularly in diabetes and cardiovascular disease (CVD), driven, in part, by historical and ongoing disruptions to cultural health practices and inequitable access to culturally responsive care. Urban populations, representing approximately 70% of Native Americans, face unique barriers, including limited access to culturally grounded health information and underfunded urban Indian health programs. Digital narrative-based health promotion grounded in Indigenous knowledge offers a promising strategy to promote engagement, cultural relevance, uptake, and dissemination of health information. The purpose of this study was to examine narrative engagement, mechanisms of influence, and intentions to share and use health information among Indigenous adults interacting with story-based digital health content from the Our Stories, Our Medicine Archive (OSOMA).

Methods: OSOMA is a community- and ceremony-based participatory digital archive developed in partnership with a Native and Indigenous community advisory board. For this evaluation, 119 Native American and Indigenous adults completed a survey after viewing five story-based health knowledge videos (3–5 minutes each) representing cultural domains related to traditional medicine, physical movement, nutrition, mindfulness, and cultural reconnection. Survey measures were adapted from the Narrative as Culture-Centric Health Promotion Model and assessed narrative engagement, cultural embeddedness, transportation, identification, social proliferation (intentions to seek, share, and use information), and story resonance using 4-point likert scales. Quantitative analyses included descriptive statistics, one-way ANOVAs, and multivariable regression using SPSS. Open-ended responses were thematically analyzed to contextualize quantitative findings.

Results: Participants reported consistently high levels of narrative engagement, transportation, identification, and perceived cultural resonance across all five stories (mean scores generally > 3.3 on a 4-point scale). Ratings of narrative engagement and cultural embeddedness did not significantly differ by demographic characteristics, indicating broad resonance across Indigenous identities and contexts. Social proliferation outcomes were strong: 96% of participants reported intentions to seek similar health information, and over 90% expressed intent to share stories with others and try identified practices. A multivariable regression model examined predictors of social proliferation using engaging story, cultural embeddedness, transportation, and identification as independent variables. Researchers found statistical significance: F(4, 95) = 10.27, p < .001, r²=.30, with identification being a significant predictor of social proliferation (p=.03), while engaging story trended toward significance (p=.09). Qualitative findings reinforced quantitative results, with participants describing emotional resonance, cultural affirmation, and motivation to reconnect with Indigenous health knowledge. Participants also rated the OSOMA website as highly usable and accessible, with nearly all reporting positive user experiences.

Conclusions and Implications: Findings suggest that culturally grounded, narrative-based digital health content can effectively engage Indigenous audiences and foster strong intentions to share and apply health information. Identification with storytellers appears to be a key mechanism linking storytelling to dissemination-related intentions. These results highlight the potential of Indigenous storytelling as a culturally responsive digital health strategy and support further research examining longitudinal impacts on health behaviors and outcomes. OSOMA offers a promising, community-driven model for advancing health equity among urban Native and Indigenous populations.