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Cultural Sensitivity

Cultural Sensitivity. Resnicow et al., 2002. Ethnic or cultural characteristics, experiences, norms, values, behavior patterns, beliefs of a target population Relevant historical, environmental, & social factors Design, delivery, & evaluation of targeted health interventions.

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Cultural Sensitivity

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  1. Cultural Sensitivity Resnicow et al., 2002 Ethnic or cultural characteristics, experiences, norms, values, behavior patterns, beliefs of a target population Relevant historical, environmental, & social factors Design, delivery, & evaluation of targeted health interventions

  2. Cultural Competence Resnicow et al., 2002 Capacity of individuals to exercise interpersonal cultural sensitivity

  3. Cultural Humility Minkler, 2005, p. 10 Lifelong commitment to self evaluation & self critique to redress power imbalances

  4. Surface Structure Resnicow et al., 2002 Observable social & behavioral characteristics of a target population

  5. Deep Structure Resnicow et al., 2002 How cultural, social, psychological, environmental, & historical factors influence health behaviors differently across racial & ethnic populations

  6. Examples in the African American Community • Surface structure: • Dialect • Female head of household • Church • Deep structure: • Slavery • Tuskegee (Syphilis) Experiment • HIV/AIDS and the US government

  7. Why Cultural Sensitivity? • Ethical/moral argument • Economic argument • Pragmatic argument (health communication perspective)

  8. Why Target & Tailor Interventions? • Disease prevalence • Risk factor prevalence • Socio-economic distribution • Physiological differences • Environmental differences • Behavioral differences • Socio-cultural differences

  9. Inequality Exists

  10. Definitions of “Health Disparities” • Whitehead/WHO (1992) Differences in health that are “not only unnecessary and avoidable but, in addition, are considered unfair and unjust.” • NIH (2005) “…differences in the incidence, prevalence, mortality and burden of disease and other adverse conditions that exist among specific populations groups in the US.” • NCI (2005) “…occur when members of certain population groups do not enjoy the same health status as other groups. Disparities are often identified along racial and ethnic lines-show, [but] also extend beyond race and ethnicity.”

  11. Health Disparities/Inequalities • Population-specific differences in the presence of disease, health outcomes, or access to health care • Gaps in the quality of health & health care across populations

  12. Ethnic Variation in Heart Disease Mortality Age-adjusted per 100,000 National Center for Health Statistics, 2004

  13. Ethnic Variation in Cancer Mortality Age-adjusted per 100,000 SEER Cancer Statistics Review, 1975-2002

  14. Prevalence of Overweight* in Texas Children by Race/Ethnicity, School Physical Activity & Nutrition (SPAN) Study % of population HP 2010 Goal *Overweight is > 95th Percentile for BMI by Age/Sex Hoelscher et al., 2004

  15. What Can We Do?

  16. Community-Based Participatory Research (CBPR) • “… a partnership approach to research that equitably involves, for example, community members, organizational representatives, and researchers in all aspects of the research process” Israel et al., 2003

  17. Translation • All vested parties work jointly to achieve a common goal by contributing different • Instruments • Talents • Knowledge • Expertise

  18. Key Principles • Builds on strengths & resources within the community • Addresses health from an ecological perspective • Collaborative partnerships in all phases of research Israel et al., 1998

  19. Key Principles • Integrates knowledge & action for mutual benefit of all partners • Promotes co-learning & empowering process that attends to social inequalities • Findings & knowledge disseminated to all partners • Cyclical & iterative process Israel et al., 1998

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