According to Frontiers in Public Health, “health promotion strategies have failed to design programs…that reflect social and cultural realities.” [1]
This results in “low levels of acceptance towards an intervention [causing the audience] to adopt an attitude that is contrary to the desired behaviour.”[2]
But, by providing culturally competent and tailored health information, the audience becomes “more likely to make positive changes.”[3]
DIVERSE AUDIENCES ARE DISSATISFIED
An analysis by the Annals of Internal Medicine sought to understand why otherwise conceptually sound interventions produced “ethnic gaps” wherein diverse populations reacted negatively to campaign information.[4]
They found that, while interventions may fail for several reasons, the most prominent reason was a “lack of cultural relevance.”
CULTURALLY COMPETENT CAMPAIGNS
In response, researchers sought to develop a culturally competent intervention to improve blood pressure in African-Americans.
The trial assigned hundreds of participants into an intervention and a control group: the former were shown narrative communication presented by “members of the community and told in their natural voices” designed to inform and inspire – the latter were shown generic campaign material.
The study found that “differences in blood pressure favoured the intervention group.”[5]
Success was attributed to the “para-social interaction, created by the homophily between patient and storyteller.”
The “perceived similarity between the characters and the patients…rendered the viewers more susceptible to behaviour-change messages” as they were able to “actively engage in the [material], identify themselves with the storyteller, and picture themselves taking part in the action.”
TAILORING HEALTH INFORMATION
Reflecting on the “importance of advocating for improved health across groups in society,” Frontiers in Public Health identified “three overarching strategies” to improve cultural competency in health promotion services.[6]
1. Community-orientated strategies
Defined as “the participation of community members in the development and implementation of service-level interventions,” it is a call to involve: health workforce professionals, religious leaders, disease survivors, and family members from the target population.
2. Cultural-orientated strategies
Defined as “the inclusion of some aspect of the target group’s cultural values, beliefs, and practices/traditions,” it is a call to: recognise the role and involvement of extended families, use culturally-relevant metaphors, and include relevant activities congruent with the unique lifestyle preferences of the target culture.
3. Language-orientated strategies
Defined as “ensuring language access through bilingual or bicultural materials in preferred languages,” it is a call to undertake: full language adaption, partial language adaption, and the creation or translation of written and audio-visual resources.
IN CONCLUSION
A qualitative study by BMC Public Health found that the “perceived fairness of interventions” impacted the audience’s approval rate.[7]
Thus, campaigners must negotiate the development of interventions based on an understanding of the audience’s values, experiences and needs if they are to elicit a sense of identification that promotes the adoption of the intended behaviours.
REFERENCES
[1] Jongen, C., McCalman, J. and Bainbridge, R. (2017). The Implementation and Evaluation of Health Promotion Services and Programs to Improve Cultural Competency: A Systematic Scoping Review. Frontiers in Public Health, [online] 5(24). Available at: https://www.ncbi.nlm.nih.gov/pubmed/28289677
[2] Bos, C., Van der Lans, I., Van Rijnsoever, F. and Van Trijp, H. (2013). Understanding consumer acceptance of intervention strategies for healthy food choices: a qualitative study. BMC Public Health, [online] 13(1). Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4225717/
[3] An, L., Demers, M. and Kirch, M. (2013). A Randomized Trial of an Avatar-Hosted Multiple Behavior Change Intervention for Young Adult Smokers. JNCI Monographs, [online] 2013(47), pp.209-215. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3881995/pdf/lgt021.pdf
[4] Houston, T., Allison, J. and Sussman, M. (2011). Culturally Appropriate Storytelling to Improve Blood Pressure. Annals of Internal Medicine, [online] 154(2), p.77. Available at: https://www.ncbi.nlm.nih.gov/pubmed/21242364
[5] Ibid.
[6] Jongen, C., McCalman, J. and Bainbridge, R. (2017). The Implementation and Evaluation of Health Promotion Services and Programs to Improve Cultural Competency: A Systematic Scoping Review. Frontiers in Public Health, [online] 5(24). Available at: https://www.ncbi.nlm.nih.gov/pubmed/28289677
[7] Bos, C., Van der Lans, I., Van Rijnsoever, F. and Van Trijp, H. (2013). Understanding consumer acceptance of intervention strategies for healthy food choices: a qualitative study. BMC Public Health, [online] 13(1). Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4225717/
