Achieving Cultural Appropriateness in Health Promotion Programs: Targeted and Tailored Approaches

Today with Canada's diverse ethnic working population it is difficult to create workplace programs that cater to the needs of all employees in the workplace.

How can we achieve culturally appropriate workplace health promotion programs? In the article by Kreuter et al. (2003) six strategies are outlined in accomplishing this. The six strategies include: peripheral, evidential, linguistic, constituent-involving, sociocultural, and cultural tailoring.

Before we get to that, it is important to consider two concepts that are vital to workplace wellness initiatives and programs: health and culture. The first concept (health) is something that means different things to different groups of people, and we cannot assume that everybody has the same definition of health. For instance, not all people consider prevention as part of their health behaviour; instead they consider health to be an absence of disease. When they become ill or diseased it is the management of the symptoms that is important to them, not anything before the occurrence of the illness or disease.

It is important to know how a particular group defines health before programs are put in place.

The second concept (culture) should not be taken for granted either. Some factors such as familial roles, communication patterns, beliefs relating to personal control, individualism, collectivism, and spirituality and other individual, behavioural, and social characteristics may not be exactly "cultural", but for a particular group may help define their culture or have special meaning, value, and help them identify themselves.

The strategies described below are ways to make workplace wellness programs and inititiatives more effective. These are especially valuable when you are in a workplace where majority of the employees do not speak English or French.

The first set of strategies is peripheral strategies which give programs or materials the appearance of cultural appropriateness by packaging them in a way that will likely appeal to a specific group. For example, using certain colors, images, fonts, pictures of group members, or declarative titles (i.e. A Guide for African Americans) that are relevant to the group. When the visual style of health education materials reflect, describe, or express the social and cultural world of the group, it makes the materials seem familiar and comfortable.

The second strategy (evidential) makes the health issue for a group more relatable to them by showing how it has had an impact on the group. Usually the evidence used is epidemiological or other data specific to the group. For example, evidential approaches to cultural appropriateness for colorectal cancer education among African Americans might include statements like "In the United States, rates of colorectal cancer are higher among Blacks than among Whites and other groups" and "This year, 14 100 African Americans will be diagnosed with colorectal cancer and 6 800 will die from it." Evidence has shown when this is done it is more likely to get them to think about the problem and may cause them to take preventative action.

The third strategy (linguistic) seeks to make health education programs and materials more accessible by providing them in the dominant or native language of the target group. The simplest way of accomplishing this strategy is to translate the material from one language to another, but it is important that when the material is translated there is consistent meaning and context.

The fourth set of strategies (constituent-involving) are those that draw directly on the experience of members of the group. These strategies include hiring staff members who are indigenous to the population served, training paraprofessionals or "natural helpers" drawn from the target group, and adhering to the "principle and process of participation" -- identifying substantive roles for lay community members in planning and decision making for the programs.

The fifth set (sociocultural) discuss health-related issues in the context of broader social and/or cultural values and characteristics of the intended audience. When this approached is used the group's cultural values, beliefs, and behaviours are recognized, reinforced, and built upon to provide context and meaning to information and messages about a given health problems or behaviour . Socioeconomic status is very important when using this strategy so that health education programs are done within the context of the group's lives. For instance, workers of certain socioeconomic status may be less prone to take up exercise due to the nature of their jobs. The same can be said in terms of nutrition, socioeconomic status is important because it does cost money to eat healthy.

The sixth strategy is cultural tailoring. This strategy looks at how programs can be targeted to cultural groups, but looks at how the level of influence and importance of culture differs for individuals within that cultural group. As well, culture does not mean the same thing for all members of a cultural group. It is important to look at how individuals perceive their own culture, the level to which they identify with it, and the specific cultural values that are important to them.

Reference:
Achieving Cultural Appropriateness in Health Promotion Programs: Targeted and Tailored Approaches. (2003). Matthew W. Kreuter, Susan N. Lukwago, Dawn C. Bucholtz, Eddie M. Clark, and Vetta Sanders-Thompson. Health Education Behavior, 30: 133-146.

Posted by: suhujitha on 2009-02-04 11:47:00

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