CHAPTER 6 Flashcards
Planning models for diverse societies (2):
- The health belief model
- The PRECEDE-PROCEED model
Implementing your health program:
- Guidelines for developing culturally sensitive
communications - Delivering culturally sensitive
communications: Three delivery modalities
Public health:
health promotion and disease and
injury prevention through research, community
intervention, and education
Health Promotion needs to….
…take culture into consideration and be tailored to the unique needs, ideals, and goals of the community
Planning Models…
-assist with understanding the causes of behaviors,
predicting behaviors, and evaluating programs
- require systematic planning and understanding the culture of the target audience
The Health Belief Model:
• Focuses on individual attitudes/beliefs to explain/
predict health behaviors
• Attempts to gauge individual cost/benefit
assessments of adopting a given health behavior
Variables of the Health Belief Model:
Perceived Threat:
- Perceived Susceptibility
- Perceived Severity
Perceived susceptibility (HBM):
One’s subjective perception of the risk of contracting a health condition
Perceived severity (HBM):
Feelings concerning the seriousness of contracting an illness or of leaving it untreated (including evaluations of both medical and clinical consequences and
possible social consequences)
Perceived benefits (HBM):
The believed effectiveness
of strategies designed to reduce the threat of
illness
Perceived barriers (HBM):
Potential negative consequences of taking a given health action
Cues to action (HBM):
Bodily or environmental triggers to action
Self-efficacy (HBM):
Belief in one’s own ability to successfully perform a given health behavior
PRECEDE-PROCEED Model, acronym:
Planning approach that examines the factors
that contribute to behavior change
Predisposing, Reinforcing, and
Enabling Constructs in Educational/Ecological
Diagnosis and Evaluation (PRECEDE); Policy,
Regulatory, and Organizational Constructs in
Educational and Environmental Development
factors that contribute to behavior change
are (PP):
Predisposing factors, Enabling factors, Reinforcing factors
Predisposing factors (PP):
individual’s knowledge, attitudes, behavior, beliefs, and values that affect willingness to change
Enabling factors (PP):
factors in the environment or community that facilitate change
Reinforcing factors (PP):
the positive or negative effects of
adopting the behavior that influence continuing the
behavior
PRECEDE (i.e., pre-intervention) planning
steps: four phases:
- Social assessment
- Epidemiological assessment
- Educational and ecological diagnosis
- Administrative and policy assessment and
intervention alignment
PROCEED planning steps (to be performed
during and after the intervention): four phases:
- Implementation
- Process evaluation
- Impact evaluation
- Outcome evaluation
Importance of effective health communication:
- Raises awareness of health risks and solutions
- Provides positive motivation and skills
- Helps individuals find sources of care and support
- Increases demand for appropriate health services,
while decreasing demand for inappropriate
services - Helps people make complex health-related
choices - Influences public agenda, promoting positive
change - Improves delivery of services
- Encourages beneficial social norms
Past/current trends in health communication:
- Continued use of traditional dissemination media
• Mass one-way communication (billboards, radio,
TV)
• Printed educational material
• Social marketing techniques - Use of digital media (CDs, World Wide Web)
- Emphasis on community centered prevention to
promote/reinforce positive health behaviors
• Regular physical activity
• Maintenance of healthy weight
• Responsible sexual behaviors
• Reduction of substance abuse and violence
Emerging Challenges in Health Communication:
- Increase in number of communication channels
vying for public’s attention - Increase in number of health issues called to
public’s attention - Increasing ability for individuals to personalize
and control their information flow
• Mass one-way communication (billboards,
radio, TV)
• Printed educational materials
• Social marketing techniques
Responses to Emerging Health Communication Challenges:
- Multidimensional interventions targeting diverse
audiences - Public/private partnerships and collaborations
- Adoption of an audience-centered communications
perspective
• Identification of target audiences’ preferred formats,
channels, and contexts of communication
• Tailoring of messages to the culture preferences,
language, and media habits of the target audience - Use of the Internet and other interactive communications
media
Problems in the implementation of new health
communications media and techniques:
- Ensuring quality control in content of health
information available via the Internet - Protection of privacy and the confidentiality of
personal health information - Development of rigorous methods for evaluating the
effectiveness of health communication in these media - Limited Internet access in underserved communities
- Illiteracy and limited literacy
Guidelines for developing culturally sensitive
communications:
- Acknowledge culture as predominant in shaping
behaviors, values, and institutions - Understand and reflect diversity within a given culture
- Reflect and respect audience values
- Refer to target group using their preferred term(s)
- Employ testing to determine the effectiveness of
culturally specific images, terms, and other
executional details that you are planning to use
Delivering culturally sensitive communications:
Three examples of successful delivery modalities:
Promotores/as de salud, Fotonovelas, Targeted messages
Promotores/promotoras de salud:
Community members whose standing makes them
effective promoters of positive health practices
Fotonovelas:
Comic book-like publications that use photos or
drawings to convey information
Targeted messages in a variety of media:
• Images/messages on posters, billboards and buses
• Pamphlets, flyers, and messages inserted in
paycheck envelopes
Evaluating Health Communication in a
Multicultural Context:
• Apply six-step CDC guideline for program
evaluation
• Apply recognized principles of multicultural
program evaluation
• Key principles of multicultural evaluation
Six-step CDC guideline for program evaluation:
Step 1: Engage stakeholders
• Step 2: Describe program
• Step 3: Focus the evaluation design
• Step 4: Gather credible evidence
• Step 5: Justify conclusions
• Step 6: Ensure use and share the lessons
learned
Key principles of multicultural evaluation:
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- Address potential cultural/linguistic barriers to
development of reliable data collection
strategies - Assess existing evaluation methods for
cultural appropriateness - Ensure that analysis and dissemination of
findings to target audience are culturally
competent - Demystify cultural issues
- Distinguish the effects of race/ethnicity,
immigrant status, age, gender, sexual
orientation, and socioeconomic status - Facilitate community’s capacity for self-assessment
of needs, resources, and
solutions - Inclusiveness in design and implementation
- Acknowledgement/infusion of multiple world
views - Use of cultural/systems analysis
- Application of culturally appropriate
measurements of success - Relevance of results to diverse communities
Essential skills in multicultural evaluation:
- Experience in diverse communities
- Openness to learning about cultural
complexity - Flexibility in design and practice
- Ability to establish rapport and trust with
diverse communities - Ability to recognize one’s own cultural biases
- Ability to translate and mediate to diverse
groups - Understanding of historical/institutional
oppression
The spectrum of cultural competence:
cultural incompetence, cultural blindness, cultural sensitivity, cultural proficiency
Cultural incompetence:
Cultural diversity completely unacknowledged
Cultural blindness:
Some cultural awareness developed, but not to the point of being a primary factor
Cultural sensitivity:
Cultural considerations begin to be incorporated into evaluation models
Cultural proficiency:
Design and implementation of evaluation methods fundamentally honor and account for diverse cultural factors
