I began this research with a desire to understand the narrative performance of diabetes in Appalachia and the degree to which entertainment-education, specifically theater, can be used to reveal and reshape this performance. First, I wished to understand the pedagogical effects of plays which were comedies that aimed to entertain and educate the audience about type 2 diabetes. Second, I explored the role of the family in negotiating issues around type 2 diabetes. Third, I analyzed how audience members narratively constructed diabetes and ways their personal constructions coincided, collided or merged with the staged narratives; and finally, how social and cultural forces (re)shaped the narrative performance of diabetes.
This study examines diabetes through the lens of social construction and with an interpretivist orientation. My results are gleaned from a variety of qualitative research methodologies which included in-depth interviews, participatory sketching, open-ended questionnaires and informal focus group discussions. These methods were executed after the participants had viewed two plays, Sugar Bear and Lucille, which had storylines about the lived experience of type 2 diabetes in Appalachia. Over an eight week period, a total of 30 in-depth interviews were conducted with residents of six Ohio counties, which formed part of Appalachian Ohio. My findings are based upon the responses and the narratives from the interviews, which were complemented by the participants’ explanations of their personal sketches and open-ended questionnaires. Additionally, responses from focus group discussions were incorporated.
My findings illuminate much about the narrative performance and the social construction of diabetes in southeast Ohio. Among the lessons learned were the importance of family support and healthy eating, one of the seven self-care behaviors advocated by the American Association of Diabetes Educators. Additionally, the narratives from the participants reveal the social construction of diabetes or how the participants perceived diabetes. These stories ranged from narratives of fear to narratives of resistance, among others. The findings indicate that social and cultural forces influence the lived experience of diabetes. The examination of the narrative reality of diabetes must be holistic, incorporating the impact of poverty, tradition and other important cultural factors influencing rural southeast Appalachia. This dissertation positions theater as a viable alternative to be explored in the field of entertainment-education because it is inherently performative and narrative. Essentially, this medium creates the space for learning, narrative telling and reflection. Finally, as scholars, this project reminds us of the centrality of language in communicative interactions.