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Published in: Journal of General Internal Medicine 10/2012

01-10-2012 | Original Research

A Community and Culture-Centered Approach to Developing Effective Cardiovascular Health Messages

Authors: Namratha R. Kandula, MD, MPH, Neerja R. Khurana, BDS MPH, Gregory Makoul, PhD, Sara Glass, RD, David W. Baker, MD, MPH

Published in: Journal of General Internal Medicine | Issue 10/2012

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Abstract

Objective

Little is known about how best to target cardiovascular health promotion messages to minorities. This study describes key lessons that emerged from a community and culture-centered approach to developing a multimedia, coronary heart disease (CHD) patient education program (PEP) for medically underserved South Asian immigrants.

Methods

The prototype PEP integrated the surface structures (e.g. language) and deeper structures (e.g. explanatory models (EMs), values) of South Asians' socio-cultural context. Seven focus groups and 13 individual interviews were used to investigate South Asians’ reactions and obtain qualitative feedback after viewing the culturally targeted PEP. Qualitative data were organized into emergent thematic constructs.

Results

Participants (n = 56) mean age was 51 years and 48 % were Hindi speakers. Community members had a strong, negative reaction to some of the targeted messages, "This statement is a bold attack. You are pin-pointing one community." Other important themes emerged from focus groups and interviews about the PEP: 1) it did not capture the community’s heterogeneity; 2) did not sufficiently incorporate South Asians’ EMs of CHD; and 3) did not address economic barriers to CHD prevention. Feedback was used to revise the PEP.

Conclusion

A community and culture-centered approach to developing cardiovascular health promotion messages revealed tensions between the researcher’s vantage point of “cultural targeting” and the community’s perceptions and reactions to these messages. Engaging communities in every phase of message design, incorporating their EMs, recognizing community heterogeneity, and addressing economic and structural barriers, are critical steps to ensuring that health promotion messages reach their intended audience and achieve true cultural appropriateness.
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Metadata
Title
A Community and Culture-Centered Approach to Developing Effective Cardiovascular Health Messages
Authors
Namratha R. Kandula, MD, MPH
Neerja R. Khurana, BDS MPH
Gregory Makoul, PhD
Sara Glass, RD
David W. Baker, MD, MPH
Publication date
01-10-2012
Publisher
Springer-Verlag
Published in
Journal of General Internal Medicine / Issue 10/2012
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-012-2102-9

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