Erasing stigmas through storytelling: why interactive storytelling environments could reduce health-related stigmas

Abstract

In this article we describe how designers can apply storytelling to reduce health-related stigmas. Stigma is a pervasive problem for people with illnesses, such as obesity, and it can persistently hinder coping, treatment, recovery, and prevention. Reducing health-related stigma is complex because it is multi-layered and self-perpetuating, leading to intertwined vicious circles. Interactive storytelling environments can break these vicious circles by delimiting the narrative freedom of stigma actors. We theoretically explain the potential of interactive storytelling environments to reduce stigma through the following seven functions: 1) expose participants to other perspectives, 2) provide a protective frame, 3) intervene in daily conversations, 4) persuade all stigma actors, 5) exchange alternative understandings, 6) elicit understanding and support for stigma victims, and 7) support stigma victims to cope with stigmatization. We elaborate on these functions through a demonstration of an interactive storytelling environment against weight stigma. In conclusion, this article is a call on designers for health and wellbeing, scientists, and practitioners from various disciplines to be sensitive to the pervasiveness of stigma and to collaboratively create destigmatizing storytelling environments.

Keywords:

• Health-related stigmas
• storytelling
• weight stigma
• design

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Niko Vegt

Niko Vegt is a Post-Doctoral Researcher at the Faculty of Industrial Design Engineering. His research revolves around social change and the interaction between people through interactive storytelling, serious gaming, and gamification, particularly in healthcare. Niko holds a MSc and BSc degree from Eindhoven University of Technology, faculty Industrial Design. In 2018, he obtained his PhD degree in Industrial Design Engineering at the Delft University of Technology. Niko worked as a human-centered design researcher at the Leiden University Medical Centre. Throughout his career his work is characterized by the research through design approach where the design process is as valuable as analysis and evaluation processes for generating knowledge.

Valentijn Visch

Valentijn Visch is Associate Professor at the Faculty of Industrial Design Engineering at TU Delft. His research is focused on Design for Health Motivation. He coordinates Persuasive Game Design research, chairs the IDE eHealth research lab, and is project leader of several health-related interdisciplinary research projects including subjects like storytelling, digital twins, eHealth & game design, health literacy, obesity prevention, reaching people with low SEP and health journeys.

Wilbert Spooren

Elisabeth F. C. van Rossum is internist-endocrinologist and professor in the field of obesity and biological stress research at the Erasmus University Medical Centre, Rotterdam, Netherlands. She is co-founder of the Obesity Centre CGG. She obtained her MD and PhD (both cum laude) in Rotterdam, and performed an obesity research fellowship in Baltimore, USA. Currently, she holds various societal/board positions: European lead of the theme Obesity and Diabetes of the European Society for Endocrinology, Chair of the National Obesity Guideline, and President of the Partnership Overweight Netherlands with an advisory role to the Ministry of Health Welfare. She published with colleague Mariette Boon an international bestseller and award-winning book ‘VET belangrijk’ or -the international edition- ‘FAT, the secret organ’. In 2020 and 2021 she was appointed as Top10 most influencing women in health care in the Netherlands.

Elisabeth F. C. van Rossum

Andrea W.M. Evers is professor of Health Psychology and chair of the Institute of Psychology at Leiden University, the Netherlands. She is also affiliated to the Technical University Delft and Erasmus University Rotterdam as Medical Delta Professor Healthy Society. After her PhD (cum laude), Andrea Evers obtained several personal grants and awards) for her innovative, interdisciplinary and translational research on psychoneurobiological mechanisms and treatments for health and disease. She was elected as a lifetime member of the Dutch Royal Academy of Science and Arts (KNAW) as well as the Royal Dutch Society of Science (KHMW). Since 2021, she is also a member of the supervisory board of the VU University Amsterdam.

Andrea W. M. Evers

Annemiek van Boeijen is Assistant Professor Industrial Design at the faculty of Industrial Design Engineering at the Delft University of Technology. Her research isfocused on the role of culture in design processes, with the goal of designing methods and tools, geared to support designers in cultivating a culture-sensitive approach. She is initiator and co-editor of the Delft Design Guide, an overview of perspectives, models, approaches and methods for design, and author of the book Culture Sensitive Design - A guide to culture in practice.

Annemiek van Boeijen

Wilbert Spooren is professor of Discourse Studies of Dutch at Centre for Language Studies (CLS), Radboud Universiteit Nijmegen. His research concerns the use of language in different genres, and its effect on communication. He has a special interest in the role of language in new media. He obtained his PhD in 1989 at Radboud University. He was one of the initiators of the NWO thematic program Comprehensible Language and Effective Communication (2010-2018). He currently supervises various PhD projects that focus on the role of language in medical communication, specifically with lower literacy target groups.