Sensitive Education Programs Research Articles

Culturally Sensitive Parent Education: A Critical Review of Quantitative Research

The recent growth of culturally sensitive parent education programs necessitates an evaluative look at their effectiveness. This article critically reviews the quantitative literature on culturally sensitive parent education programs, discussing issues of research methodology and program efficacy in producing change among ethnic-minority parents and their children. Culturally sensitive programs for African American and Hispanic families are described in detail Quantitative studies of culturally sensitive programs are critiqued against existing literature on the effectiveness of traditional parent education programs. Main conclusions include the prevalence of flaws in research methodology, which may contribute to the finding of somewhat lower efficacy of these programs in comparison to standard programs. Although efficacy studies of programs for Native American and Asian American parents could not be found, efforts to serve these populations are also described. Recommendations for future research are proposed.

Health beliefs of rural Appalachian women and the practice of breast self-examination.

The purpose of this study was to examine the relationship between health beliefs of rural Appalachian women and the practice of breast self-examination (BSE). The sample consisted of 130 women residing in rural Appalachia who were recruited from various groups. The mean age was 53. They completed Champion's Health Belief Scale, which consisted of six Likert subscales: Susceptibility, Seriousness, Benefits, Barriers, Health Motivation, and Confidence. The women were questioned if they did BSE and were asked to respond to the following statement: "If I had cancer, I would rather not know it." Only 34.9% reported that they did monthly BSE. Two of the six subscales correlated significantly with reports of doing monthly BSE. Women who reported more confidence in doing BSE and perceived more benefits from doing BSE were significantly more likely to do regular exams. Interestingly, 18% indicated that they would rather not know if they had cancer and another 17% had neutral feelings. The findings support the need for culturally sensitive education programs on BSE for rural Appalachian women. Consideration must be given to their health beliefs in relation to health promotion.

Using Omitted Variable Bias to Assess Uncertainty in the Estimation of an AIDS Education Treatment Effect

In a comparison of a treatment group and a control group, a difference in results can correspond to the effect of the treatment; however, the difference might also be, at least in part, a reflection of pretreatment differences between the two populations. Covariance adjustment can reduce bias in the estimate of the treatment effect ( Cochran & Rubin, 1973 ); however, baseline group differences with respect to unobserved covariates which cannot be controlled can lead to hidden bias. This article presents a simple method which uses omitted variable bias to assess the uncertainty of the hidden bias by describing what scenarios regarding the unobserved covariate can lead to a given level of hidden bias. A comparison of a culturally sensitive AIDS video education program and a standard AIDS video education program is used as an illustration.

Social and cultural aspects of infertility in Mozambique

Findings of an anthropological study of socio-cultural aspects of infertility among members of the matrilineal ethnic group Macua in the north of Mozambique are presented. Infertile women apply various strategies to have a child. Traditional healers are visited much more often than the modern hospital, and the explanations the infertile women themselves give for their infertility more often originated from the traditional healers than from the hospital staff. Almost all of the interviewed women commit adultery in the hope to conceive. Some of them apply fostering as a partial solution for childlessness. The Macua infertile women experience various consequences due to their infertility, of which exclusion from certain social activities and traditional ceremonies is perceived as a very problematic one. The matrilineal kinship system means that the husband and his family do not mistreat and repudiate her. Infertility must be considered as a serious reproductive health problem in Mozambique. For the long term preventive measures may be more influential than curative one. The findings of this study can be used to elaborate culturally sensitive health education programmes.

Effect of a Cancer Screening Intervention Conducted by Lay Health Workers Among Inner-City Women

We conducted a randomized controlled trial to determine if an in-home educational intervention conducted by lay health workers (LHWs) could increase adherence among low-income, inner-city, African-American women to breast and cervical cancer screening schedules. We recruited 321 African-American women from diverse inner-city sources. After baseline interviews, they were randomly assigned to either the intervention (n = 163) or the control (n = 158) group. Those in the intervention group were visited in their homes up to three times by LHWs who provided a culturally sensitive educational program that emphasized the need for screening. Ninety-three (93) women in the intervention group and 102 in the control group completed the postintervention interview. For Pap smears, the increase in screening was similar in both groups. For clinical breast exams (CBEs), however, there was a modest increase in the intervention group. The improvement was greatest for mammography, for which there was a 10% to 12% increase. Among women who were not on recommended schedules at baseline, the improvement was substantial and greater in the intervention group. LHWs' intervention appeared to improve the rate at which inner-city women obtained CBEs and mammograms, but had no effect on Pap smears. A high attrition rate weakened our ability to make conclusive statements about the exact impact of the intervention.

Using focus groups to characterize the health beliefs and practices of black women with non-insulin-dependent diabetes.

The purpose of this focus group intervention was to characterize the health beliefs, self-care practices, diabetes education needs, weight-loss issues, and facilitators and barriers to diabetes health care in black women with non-insulin-dependent diabetes. Major themes that emerged from the focus group were motivation to prevent complications, unrealistic weight goals set by providers, multiple barriers to diet and exercise, and a dual role of family as supporter and deterrent to diabetes management, especially related to diet. These findings suggest that culturally sensitive and appropriate patient educational programs must be provided for minority groups such as black women who have higher rates of diabetes-related complications.

Cultural issues in the development of cancer control programs for American Indian populations.

Cancer is the third-leading cause of death among American Indians. The persistent disadvantage in cancer survival rates among American Indian populations emphasizes the importance of developing effective cancer control programs for prevention and early detection. However, substantial cultural differences between American Indians and whites can affect the success of these programs. This paper examines the concept of cultural sensitivity in the context of developing cancer control programs for American Indian populations. It explores fundamental differences in beliefs, behaviors, and values between American Indian and white majority cultures, and presents examples of culturally sensitive health education programs. The paper highlights insights and experiences gained in developing the North Carolina Native American Cervical Cancer Prevention Project, and gives recommendations for the development of future programs.

An Evaluation of HIV Education Messengers in a Black Low Income Housing Complex

Abstract The purpose of this article is to describe results of a quasi-experimental study of HIV education messengers in a Black low income housing complex in Prince George's County, Maryland. AIDS is increasingly exacting a disproportionate toll on lower income, Black communities. Although Whites still constitute the majority of the AIDS cases overall, Blacks are affected by AIDS in numbers far greater than their relative percentage in the population. Community-based organizations have been funded by the federal government and private foundations to mount culturally sensitive HIV education and prevention programs in order to reach those Blacks whose behavior places them at greatest risk for HIV infection. Advocates for AIDS prevention in minority communities often assume that in order for AIDS educators to have trust and credibility, they must be of the same racial/ethnic background as participants. Results from this study demonstrated that the intuitive rationale for matching the racial identity of the ...

Diabetes Mellitus and Employment: Survey of a New Zealand Workforce

A cross-sectional survey of a 5670 multiracial New Zealand workforce aged > 40 years was used to determine the health status of people with diabetes mellitus in employment. One hundred and two workers (73 men, 29 women) had known diabetes mellitus (prevalence of 1.8%) of whom 91 individuals (89.2%) had Type 2 diabetes. Mean age of diabetic workers was 51.1 +/- 5.6 (SD) years and median duration of disease was 5.0 (range 0-51) years. Most subjects were asymptomatic, although only 31.4% of diabetic workers had fasting glucose concentrations and 35.5% had fructosamine concentrations within the mean +/- 2SD range of a matched control group. Moreover, 22.5% of diabetic participants had fasting hypertriglyceridaemia and 21.6% had microalbuminuria. Ethnicity (non-European vs European) and lack of insulin therapy were the most important predictors of poor glycaemic control. We advocate more aggressive therapy with insulin and with culturally sensitive education programmes to avert long-term macrovascular complications.

AIDS in Prisons and Jails

Anthropologists have made crucial contributions to the fight against AIDS, creating culturally sensitive AIDS education and prevention programs and documenting and contextualizing the experiences of those suffering with AIDS, as well as having an impact on AIDS policy formation and execution. Efforts have usually focused on the needs of groups of individuals having high prevalence rates of HIV, the virus that causes AIDS, within their populations. Jail and prison inmates with HIV/AIDS, a group whose numbers are increasing at an extraordinarily rapid rate, have been overlooked. Yet this group, too, would benefit immeasurably from the input of anthropological inquiry.

Health Status of the Black Community in the 21st Century: A Futuristic Perspective for Health Education

Abstract The purpose of this article is to provide a new perspective on health status of American Blacks. It is hoped that this perspective will serve as a foundation for development of scientifically sound, ethnically acceptable and culturally sensitive health education programs. As we move into the 1990s we face the challenge of improving the health status of minority Americans by developing culturally sensitive and ethnically acceptable health education programs. Health educators should be aware that this challenge must begin with a comprehensive examination of the social, economic, and political context within which minority populations are exposed to risk factors for leading causes of death in our society.

Towards rational medicine use: Is there a role for children?

Irrational, wasteful, and even dangerous medicine use is a serious problem in developing countries. It is important to work to solve it through the provision of safe, efficacious and affordable drugs, through strengthening the drug regulatory systems and through the education of health care providers. However, it is important as well that the population learns to use medicines wisely. Educating children in developing countries about appropriate use of medicines is a strategy that has the potential to improve medicine use throughout the communities where the children live and for future generations. Currently, very few children's health education curricula include anything on appropriate medicine use, and what exists has not been based on what children know, or on their behavior or expectations relative to medicines in the context of their cultures. Support is sought for the inclusion of rational medicine use in comprehensive school health curricula and researchers are encouraged to develop and evaluate culturally sensitive, age appropriate, and acceptable medicine use education programs.

Parental Attitudes Toward Adolescent Sexuality

The problem of teenage pregnancy continues to impact private and public resources, affecting all socioeconomic and cultural groups. A key factor for nurse practitioners to consider when planning sex education programs is the differing parental attitudes toward teenage sexuality. These attitudes are especially important to keep in mind when dealing with parents from minority cultural groups, as these groups are often highly influential in determining the nature of adolescent sexual behavior and attitudes toward reproduction. A study of Cuban and Haitian child-rearing practices clearly demonstrates two divergent parental views of adolescent sexuality. Nurse practitioners must recognize these differing views, and individualize their approach, in order to develop culturally sensitive sex education programs for adolescents and their parents. Suggestions are provided for development of such programs for Cuban and Haitian parents and children.