It is a truism of health education that programs and interventions will be more effective when they are culturally appropriate for the populations they serve. In practice, however, the strategies used to achieve cultural appropriateness vary widely. This article briefly describes five strategies commonly used to target programs to culturally defined groups. It then explains how a sixth approach, cultural tailoring, might extend these strategies and enhance our ability to develop effective programs for cultural groups. The authors illustrate this new approach with an example of cultural tailoring for cancer prevention in a population of lower income urban African American women.
Get full access to this article
View all access options for this article.
References
1.
1. Hughes D, Seidman E, Williams N: Cultural phenomena and the research enterprise: Toward a culturally anchored methodology. Am J Community Psychol21: 687-703, 1993.
2.
2. Orlandi MA, Landers C, Weston R, Haley N: Diffusion of health promotion innovations, in Glanz K, Lewis FM, Rimer BK (eds.): Health Behavior and Health Education: Theory, Research, and Practice. San Francisco: Jossey-Bass, 1990.
3.
3. Betancourt H, Lopez S: The study of culture, ethnicity, and race in American psychology. Am Psychol48: 629-637, 1993.
4.
4. Rohner R: Toward a conception of culture for cross-culture psychology. Journal of Cross-Cultural Psychology15: 111-138, 1984.
5.
5. Herkovits M: Man and His Works. New York: Knopf, 1948.
6.
6. Triandis H, Lambert W, Berry J, et al: Handbook of Cross-Cultural Psychology. Boston: Allyn & Bacon, 1980.
7.
7. Pasick RJ, D’Onofrio CN, Otero-Sabogal R: Similarities and differences across cultures: Questions to inform a third generation for health promotion research. Health Educ Q23(suppl.): S142-S161, 1996.
8.
8. Gurak D, Rogler L: New York’s new immigrants: Who and where they are. The Hispanics. New York University Education Quarterly11: 20-24, 1980.
9.
9. Zimmerman R, Vega W, Gil A, Warheit G, Apospori E, Biafora F: Who is Hispanic? Definitions and their consequences. Am J Pub Health84: 1985-1987, 1994.
10.
10. Huerta E, Macario E: Communicating health risk to ethnic groups: Reaching Hispanics as a case study. J Natl Cancer Inst Monogr25: 23-26, 1999.
11.
11. Marin G, Van Oss Marin B, Perez-Stable EJ, Sabogal F, Otero-Sabogal EJ: Changes in information as a function of a culturally appropriate smoking cessation community interventions for Hispanics. Am J Community Psychol17: 847-864, 1990.
12.
12. Rimer BK: Interventions to increase breast screening: Lifespan and ethnicity issues. Cancer74: 323-328, 1994.
13.
13. Marin G, Burhansstipanov L, Connell CM, et al: A research agenda for health education among underserved populations. Health Educ Q22: 343-363, 1995.
14.
14. Sabogal F, Otero-Sabogal EJ, Pasick RJ, Jenkins CNH, Perez-Stable EJ: Printed health education materials for diverse communities: Suggestions learned from the field. Health Educ Q23(suppl.): S123-S141, 1996.
15.
15. Petty R, Cacioppo J: Attitudes and Persuasion: Classic and Contemporary Approaches. Dubuque, IA: W.C. Brown, 1981.
16.
16. Bechtel G, Davidhizar R: Integrating cultural diversity in patient education. Semin Nurse Manag7: 193-197, 2000.
17.
17. Schiffman C: Ethnovisual and sociovisual elements of design: Visual dialect as a basis for creativity in public service graphic design. Journal of Visual Literacy14: 23-39, 1995.
18.
18. Moriarty S: Visual communication as primary system. Journal of Visual Literacy14: 11-21, 1995.
19.
19. Kostelnick C: Supra-textual design: The visual rhetoric of whole documents. Technical Communication Quarterly5: 9-33, 1996.
20.
20. Resnicow K, Baranowski T, Ahluwalia J, Braithwaite R: Cultural sensitivity in public health: Defined and demystified. Ethnicity and Disease9: 10-21, 1999.
21.
21. Weinstein N: The precaution adoption process. Health Psychol7: 4, 1988.
22.
22. Weinstein N, Sandman P: A model of the precaution adoption process: Evidence from home radon testing. Health Psychol11: 170-180, 1992.
23.
23. Rogler LH, Malgady RG, Costantino G, Blumenthal R: What do culturally sensitive mental health services mean? Am Psychol42: 565-570, 1987.
24.
24. Eng E, Parker EA, Harlan C (eds.): Lay Health Advisors: A Critical Link to Community Capacity Building (Special issue). Health Educ Behav24: 407-510, 1997.
25.
25. Thomas J, Eng E, Clark M, Robinson J, Blumenthal C: Lay health advisors: Sexually transmitted disease prevention through community involvement. Am J Pub Health88: 1252-53, 1998.
26.
26. Altpeter M, Earp J, Bishop C, Eng E: Lay health advisor activity levels: Definitions from the field. Health Educ Behav26: 495-512, 1999.
27.
27. Green L, Kreuter M: Health Promotion Planning: An Educational and Ecological Approach (3rd ed.). Mountain View, CA: Mayfield, 1999, p. 621.
28.
28. Rimal R, Adkins D: Using Computers to Narrowcast Health Messages: The Role of Audience Segmentation, Targeting, and Tailoring in Health Promotion. Paper presented at the American Public Health Association annual meeting, Atlanta, GA, 2001, p. 100.
29.
29. Kreuter M, Skinner C: What’s in a name? Health Education Research15: 1-4, 2000.
30.
30. Perez-Stable EJ, Otero-Sabogal R, Sabogal F, Napoles-Springer A: Pathways to early cancer detection for Latinas: En accion contra el cancer. Health Educ Q23: S41-S59, 1996.
31.
31. Glanz K, Lewis F, Rimer B: Health Behavior and Health Education. San Francisco: Jossey-Bass, 1997, p. 496.
32.
32. Kreuter M, Strecher V, Glassman B: One size does not fit all: The case for tailoring print materials. Ann Behav Med21: 1-9, 1999.
33.
33. Kreuter M, Farrell D, Olevitch L, Brennan L: Tailoring Health Messages: Customizing Communication With Computer Technology. Mahwah, NJ: Lawrence Erlbaum, 1999.
34.
34. Michielutte R, Sharp PC, Dignan MB, Blinson K: Cultural issues in the development of cancer control programs for American Indian populations. Journal of Health Care for the Poor and Underserved5: 280-296, 1994.
35.
35. Kreuter M, Skinner C, Haire-Joshu D, Clark E: Cultural Tailoring for Cancer Prevention in Black Women, Health Communication Research Laboratory (ed.) (National Cancer Institute Funded Grant #CA 81872), St. Louis, Missouri, 1998.
36.
36. Jagers RJ, Smith P: Further examination of the spirituality scale. Journal of Black Psychology22: 429-442, 1996.
37.
37. Landrine H, Klonoff EA: The African American Acculturation Scale II: Cross-validation and short form. Journal of Black Psychology21: 124-152, 1995.
38.
38. Nobles WW: African philosophy: Foundations for Black psychology, in Jones RL (ed.): Black Psychology. 3rd ed. Berkeley, CA: Cobb & Henry, 1991.
39.
39. Jackson JS, Gurin G: National Survey of Black Americans, 1979-1980. Ann Arbor, MI: Interuniversity Consortium for Political and Social Research, 1987.
40.
40. Haire-Joshu D, Auslander W, Houston C, Williams J: Religiosity in urban African-American women in St Louis—Pilot data. Personal communication, 1998.
41.
41. Klonoff EA, Landrine H: Belief in the healing power of prayer: Prevalence and health correlates for African Americans. Western Journal of Black Studies20: 207-210, 1996.
42.
42. Brown D, Gary L: Stressful life events, social support networks, and the physical and mental health of urban Black adults. Journal of Human StressWinter: 167-174, 1987.
43.
43. Mathews HF, Lannin DR, Mitchell J: Coming to terms with advances breast cancer: Black women’s narratives from Eastern North Carolina. Soc Sci Med38: 789-800, 1994.
44.
44. Campbell M, Bernhardt J, Waldmiller M, et al: Varying the message source in computer tailored nutrition education. Patient Education and Counseling36: 159-167, 1999.
45.
45. Lukwago S, Kreuter M, Bucholtz D, Holt C, Clark E: Development and validation of scales to measure collectivism, religiosity, racial pride and time orientation in urban African American women. Family and Community Health24: 63-71, 2001.
46.
46. White J, Parham T: The Psychology of Blacks: An African-American Perspective. 2nd ed. Englewood Cliffs, NJ: Prentice Hall, 1990.
47.
47. Jagers RJ, Mock LO: The communalism scale and collectivistic-individualistic tendencies: Some preliminary findings. Journal of Black Psychology21: 153-167, 1995.
48.
48. Baldwin JA, Hopkins R: African-American and European-American cultural differences as assessed by the worldviews paradigm: An empirical analysis. Western Journal of Black Studies14: 38-52, 1990.
49.
49. Parker KD, Calhoun T: Predictors of life satisfaction among Black Americans. Western Journal of Black Studies20: 134-139, 1996.
50.
50. Landrine H, Klonoff E: Traditional African American family practices: Prevalence and correlates. Western Journal of Black Studies20: 59-62, 1997.
51.
51. Boyd-Franklin N: Black Families in Therapy. New York: Guilford, 1989.
52.
52. Hays W: Extended kinship relations in Black and White families. J Marriage Fam35: 51-57, 1973.
53.
53. Lozoff B, Wolf A, Davis N: Cosleeping in urban families with young children in the United States. Pediatrics74: 171-182, 1984.
54.
54. Mandansky D, Edlebrock C: Cosleeping in a community sample of 2- and 3-year old children. Pediatrics86: 197-203, 1990.
55.
55. Grills C, Longshore D: Africentrism: Psychometric analyses of a self-report measure. Journal of Black Psychology22: 86-106, 1996.
56.
56. Asante M: Afrocentricity: The Theory of Social Change. Buffalo, NY: Amulefi, 1980.
57.
57. Thompson VLS: African American race consciousness and racial identification. Western Journal of Black Studies15: 154-158, 1991.
58.
58. Stokes JE, Marray CB, Peacock MJ, Kaiser RT: Assessing the reliability, factor structure, and validity of the African self-consciousness scale in a general population of African Americans. Journal of Black Psychology20: 62-74, 1994.
59.
59. Landrine H, Klonoff EA: The African American Acculturation Scale: Development, reliability, and validity. Journal of Black Psychology20: 104-127, 1994.
60.
60. Klonoff EA, Landrine H, Scott J: Double jeopardy: Ethnicity and women’s health, in Landrine H (ed.): Bringing Cultural Diversity to Feminist Psychology: Theory, Research, Practice. Washington, DC: American Psychological Association, 1995, pp. 335-360.
61.
61. Graham R: The role of perception of time in consumer research. Journal of Consumer Research7: 335-342, 1981.
62.
62. Cottle T: Perceiving Time: A Psychological Investigation With Men and Women. New York: John Wiley, 1976.
63.
63. Bergadaa M: The role of time in the action of the consumer. Journal of Consumer Research17: 289-302, 1990.
64.
64. Harwood A: Ethnicity and Medical Care. Cambridge, MA: Harvard University Press, 1981.
65.
65. Leshan L: Time orientation and social class. Journal of Abnormal and Social Psychology47: 589-592, 1952.
66.
66. Akbar Ni: The evolution of human psychology for African Americans, in Jones RL (ed.): Black Psychology. 3rd ed. Berkeley, CA: Cobb and Henry, 1991.
67.
67. Brown C, Segal R: Ethnic differences in temporal orientation and its implications for hypertension management. J Health Soc Behavor37: 350-361, 1996.
68.
68. Brach C, Fraser I: Can cultural competency reduce racial and ethnic health disparities? A review and conceptual model. Med Care Res Rev57: 181-217, 2000.
69.
69. Pasick R: Socioeconomic and cultural factors in the development and use of theory, in Glanz K, Lewis F, Rimer B (eds.): Health Behavior & Health Education: Theory, Research & Practice. San Francisco: Jossey-Bass, 1997.
70.
70. U.S. Department of Health & Human Services: Healthy People 2010 Objectives. Washington, DC: Government Printing Office, 2000.
