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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
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
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

Prevalence of Overweight* in Texas Children by Race/Ethnicity, School Physical Activity & Nutrition (SPAN) Study

% of population

HP 2010


*Overweight is > 95th Percentile for BMI by Age/Sex

Hoelscher et al., 2004

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

  • 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