Abstract Title | Creating culturally authentic films about health: challenges and best practices


  1. Debra Bryan MEd
  2. Carl Patow MD MPH


International Medical Education




HealthPartners Institute for Education and Research


The films were instrumental in changing the way that viewers, all health professionals, said they interacted with patients, reflecting a deeper understanding of and respect for cultural difference.  Most importantly, what they don’t know about patients, they ask. These changes in behavior and style will, undoubtedly, improve communication and increase patient satisfaction.  Participants felt the experience was personally transformative, made them more effective in roles, increased their ability to teach others about health disparities, and heightened the value of engaging with communities. 


  Sharing stories of ethnic patients’ and families’ experiences of health and health care is one method to facilitate dialogue and encourage improved understanding among the public and health care professionals about equitable health. Creating films that capture culture authenticity, contain universal themes and promote audience reaction is a challenging task.



Summary of Work

To supplement our initative to decrease health disparities, we created four films, each depicting a family in an ethnic community as it encounters barriers and successes with the health system in the quest for quality health care.  The content was structured to stimulate an emotional response and understanding.  Stories included cultural and social factors,  social strengths, health beliefs, customs and values, languages, diet, trust, health literacy, networks of support, that influence health.  The screenplays were commissioned, each from a playwright of the ethnic community portrayed in the script, consistent with the aim of cultural authenticity. The four films, each telling the story of a family’s health related to culture, barriers and the health system, were presented at collaborative conferences, and accompanied by discussions with community members and cultural experts. 

Take-home Messages

 When producing films that include multiple cultures, special attention is needed to create a common vision for the written script, manage language and translation issues, choose sets and locations that are culturally authentic, find appropriate talent, navigate cultural preferences and expectations of actors, and maintain cultural sensitivity in postproduction.

Bottom line, the use of films capturing culturally authentic stories of health, helped collaborative participants to recognize that while patients may be quite similar physiologically, awareness of cultural differences plays an important role in how effectively they treat and care for patients from diverse cultures.

Summary of Results

Over the course of the creation and production of the films, specific issues and best practices related to culturally specific health films emerged. They can be organized into six themes:

1.      Creating a common vision for the written script.

2.      Managing language and translation issues.

3.      Choosing sets and locations that are culturally authentic.

4.      Finding talent.

5.      Navigating cultural preferences and expectations of actors.

6.      Maintaining cultural sensitivity in postproduction.


The authors would like to acknowledge the following organizations and individuals for their contributions to this work:


  • Mixed Blood Theater, Minneapolis, Minnesota, USA


  • Twin Cities Public Television


  • 120 members of the EBAN Experience Teams from HealthPartners, Regions Hospital, HealthPartners Medical and Dental Groups and Twin Cities ethnic communities.




“Healthy Acts.” A documentary, filmed by TPT Television, created from films of commissioned ethnic screenplays created for the EBAN Experience, and interviews with Minnesota state health leaders and community partners. 26 min. Premiered February 10, 2012, Twin Cities Public Television. Nominated for a Midwest Emmy Award for Best Topical Documentary. 


Patow C, Bryan D. The EBAN Experience: An Equitable Health Collaborative. AAMC R4R (Readiness for Reform)Website.  (Accessed July 8, 2012).



Patow C, Bryan D. Connecting hearts and minds: Four ways to improve learning through interactive storytelling. Medical Meetings. September/October 2011, 20-25.



Patow C, Bryan D. The Play’s the Thing: Theater performances enhancing physician education. Minnesota Physician. May, 2012, 14-15.


In March 2011, HealthPartners engaged teams of health professionals and community members in a yearlong collaborative, the EBAN Experience, to improve health equity in preventive services, including pediatric immunization, mammography, colon cancer screening, advanced directives and fluoride varnish applications. Nine teams with 110 members (20 of which were community members) examined cultural aspects that might contribute to inequity, proposed improvements, tested ideas using quality improvement cycles and followed clinical data to assess the impact of care improvements. To assist teams in understanding the influence of culture on health, and to promote discussion four films were commissioned. The intent was to provide films with cultural authenticity, from the perspective of a story of one family in a cultural community, that raised issues related to health and the care system.

Summary of Work

The scripts were written in English. The writers were instructed to enter a dialogue with members of their communities, including health advocates and patients to better understand culture specific health issues.  In addition, meetings were scheduled for each playwright to meet with healthcare professionals to understand health issues.  Actors, who were both professionals and amateurs, were engaged through a relationship with a local theater that also provided direction for the performances.  The performances were in English and in the native spoken language of the culture, depending on the actor’s facility with English. Production for the films was through public television. Filming was on location, in clinics, homes, streets and workplaces. Postproduction at public television involved not only film editing, but often translation of the actor’s spoken words back into English for sub-titling.

The screenplays were performed in partnership with Mixed Blood Theater in Minneapolis, MN, and filmed by TPT Minnesota Public Television. Films are used for educational purposes in The EBAN Experience and for viewing in health disparities workshops. Filming completed in 2011. The films are titled:


"Hmong Kitchen."  A Hmong family experiences conflict between health beliefs and western medicine.  Written by May Lee Yang.  Directed by Jack Reuler. 8 min.


Which Exit.” The African American experience of health in North Minneapolis. Written by Syl Jones. Directed by Jack Reuler. 40 min.


Alberto’s Chicken Dinner.” A family of Latino service workers with health issues. Written by Joe Minjares. Directed by Jack Reuler. 25 min.


From Head to Toe.”  A Somali family deals with intergenerational health issues. Written by David Grant. Directed by Jack Reuler. 28 min.


Healthy Acts.” A documentary, filmed by TPT Television, created from films of commissioned ethnic screenplays created for the EBAN Experience, and interviews with Minnesota state health leaders. 26 min. Premier February 10, 2012, Twin Cities Public Television.





Take-home Messages
Summary of Results

1.      Creating a common vision for the written script. Manage the intent, limitations on the number of actors, length, content issues, language, and universal message of one playwright’s impression of a single character and/or family and not a representation of an entire culture, nationality or community.  Develop license agreements with playwrights.

2.      Managing language and translation issues. The films varied in the length from 8 to 30 minutes when finally produced. Each included sub-titles where needed to be understood by English speakers.  This required multiple translations.

3.      Choosing sets and locations that are culturally authentic. Special attention to selection of filming location is necessary.  Gaining permission to film in someone’s home requires the need to balance authenticity with limited space for equipment, camera angles, lighting, microphones, etc.  Limit the number of people on the set. Watch for noise in work environments.  Create agreements with the homeowner or landlord that detail expectations.  Develop list of props needed and gather ahead of time.

4.      Finding talent. Work through a known source, a local theater and college for example. Directors are able to screen talent and assess acting talent. Working through a trusted third party may or may not work. Talent may unexpectedly walk out. Solicit assistance from community leaders or translators if you are working with non-English speaking populations.

5.      Navigating cultural preferences and expectations of actors. Understand the impact of religious holidays, native dress, microphone placement, food issues, etc.  Amateur actors may see themselves as representing the entire culture, and have expectations about the set and their role. On the positive side, actors from a specific culture can bring nuances to the performance that would otherwise not be known.

6.      Maintaining cultural sensitivity in postproduction. Editors in postproduction may not be of the culture being depicted in the screenplay. Choices made by the postproduction editor may influence the impact of the film in unexpected ways. Supervision of the postproduction process is needed to assure continued emphasis on cultural authenticity for the entire film process.  Including playwrights in postproduction ensures that the context is properly established and that the background music fits with their vision of the story.

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