Cultural sensitivity
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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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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


Cultural competence

Cultural Competence

Resnicow et al., 2002

Capacity of individuals to exercise interpersonal cultural sensitivity


Cultural humility

Cultural Humility

Minkler, 2005, p. 10

Lifelong commitment to self evaluation & self critique to redress power imbalances


Surface structure

Surface Structure

Resnicow et al., 2002

Observable social & behavioral characteristics of a target population


Deep structure

Deep Structure

Resnicow et al., 2002

How cultural, social, psychological, environmental, & historical factors influence health behaviors differently across racial & ethnic populations


Examples in the african american community

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


Why cultural sensitivity

Why Cultural Sensitivity?

  • Ethical/moral argument

  • Economic argument

  • Pragmatic argument (health communication perspective)


Why target tailor interventions

Why Target & Tailor Interventions?

  • Disease prevalence

  • Risk factor prevalence

  • Socio-economic distribution

  • Physiological differences

  • Environmental differences

  • Behavioral differences

  • Socio-cultural differences


Inequality exists

Inequality Exists


Definitions of health disparities

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.”


Health disparities inequalities

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


Ethnic variation in heart disease mortality

Ethnic Variation in Heart Disease Mortality

Age-adjusted per 100,000

National Center for Health Statistics, 2004


Ethnic variation in cancer mortality

Ethnic Variation in Cancer Mortality

Age-adjusted per 100,000

SEER Cancer Statistics Review, 1975-2002


Cultural sensitivity

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


What can we do

What Can We Do?


Community based participatory research cbpr

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


Translation

Translation

  • All vested parties work jointly to achieve a common goal by contributing different

    • Instruments

    • Talents

    • Knowledge

    • Expertise


Key principles

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


Key principles1

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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