Applying the concept of culture to reduce health disparities through health behavior research

Singer, Marjorie Kagawa

doi:10.1016/j.ypmed.2012.02.011

Cited by 162 publications

(46 citation statements)

References 49 publications

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“…Rather, an implication of our findings is that cultural processes may explain some variation in health and should be considered in understanding the production of health inequalities and the process individuals undertake to make meaning of their world and the extent to which this cultural process of meaning-making is shaped by broader socioeconomic conditions. 48,63 This area of research also opens opportunities to shift our conceptual framework from one that only considers the health deficits operating in marginalized and socioeconomically disadvantaged populations, to a perspective that recognizes and harnesses the positive attributes disenfranchised communities possess to ensure that proposed health interventions are culturally meaningful, respectful and sustainable. 64 …”

Section: Discussionmentioning

confidence: 99%

Social norms and its correlates as a pathway to smoking among young Latino adults

Echeverría

Gundersen

Bover-Manderski

et al. 2015

Social Science & Medicine

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Socially and culturally embedded norms regarding smoking may be one pathway by which individuals adopt smoking behaviors. However, few studies have examined if social norms operate in young adults, a population at high risk of becoming regular smokers. There is also little research examining correlates of social norms in populations with a large immigrant segment, where social norms are likely to differ from the receiving country and could contribute to a better understanding of previously reported acculturation-health associations. Using data from a nationally representative sample of young adults in the United States reached via a novel cell-phone sampling design, we explored the relationships between acculturation proxies (nativity, language spoken and generational status), socioeconomic position (SEP), smoking social norms and current smoking status among Latinos 18–34 years of age (n=873). Specifically, we examined if a measure of injunctive norms assessed by asking participants about the acceptability of smoking among Latino co-ethnic peers was associated with acculturation proxies and SEP. Results showed a strong gradient in smoking social norms by acculturation proxies, with significantly less acceptance of smoking reported among the foreign-born and increasing acceptance among those speaking only/ mostly English at home and third-generation individuals. No consistent and significant pattern in smoking social norms was observed by education, income or employment status, possibly due to the age of the study population. Lastly, those who reported that their Latino peers do not find smoking acceptable were significantly less likely to be current smokers compared to those who said their Latino peers were ambivalent about smoking (do not care either way) in crude models, and in models that adjusted for age, sex, generational status, language spoken, and SEP. This study provides new evidence regarding the role of social norms in shaping smoking behaviors among Latino young adults and suggests distinct influences of acculturation proxies and socioeconomic condition on smoking social norms in this population.

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Section: Discussionmentioning

confidence: 99%

Social norms and its correlates as a pathway to smoking among young Latino adults

Echeverría

Gundersen

Bover-Manderski

et al. 2015

Social Science & Medicine

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“…As expressed more than a decade ago in the Surgeon’s General report on ‘Culture, Race, Ethnicity and Mental Health’ [2], ‘culture counts’ in mental health care, as it shapes how people seek help, engage in health behaviors, and how providers communicate with clients and deliver services. Culture is more than race and ethnicity, as it encompasses ‘a shared way of being and interacting’ [3] that shapes lifestyle patterns and structures human thoughts, emotions, interactions, social norms, and behaviors [4]. Culture is not a static set of values, norms and practices that reside solely within the individual; it is dynamic, as it is learned, transmitted and transformed by social interactions, conflicts, and power relations [5-8].…”

Section: Introductionmentioning

confidence: 99%

A two-way street: bridging implementation science and cultural adaptations of mental health treatments

2013

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BackgroundRacial and ethnic disparities in the United States exist along the entire continuum of mental health care, from access and use of services to the quality and outcomes of care. Efforts to address these inequities in mental health care have focused on adapting evidence-based treatments to clients’ diverse cultural backgrounds. Yet, like many evidence-based treatments, culturally adapted interventions remain largely unused in usual care settings. We propose that a viable avenue to address this critical question is to create a dialogue between the fields of implementation science and cultural adaptation. In this paper, we discuss how integrating these two fields can make significant contributions to reducing racial and ethnic disparities in mental health care.DiscussionThe use of cultural adaptation models in implementation science can deepen the explicit attention to culture, particularly at the client and provider levels, in implementation studies making evidence-based treatments more responsive to the needs and preferences of diverse populations. The integration of both fields can help clarify and specify what to adapt in order to achieve optimal balance between adaptation and fidelity, and address important implementation outcomes (e.g., acceptability, appropriateness). A dialogue between both fields can help clarify the knowledge, skills and roles of who should facilitate the process of implementation, particularly when cultural adaptations are needed. The ecological perspective of implementation science provides an expanded lens to examine how contextual factors impact how treatments (adapted or not) are ultimately used and sustained in usual care settings. Integrating both fields can also help specify when in the implementation process adaptations may be considered in order to enhance the adoption and sustainability of evidence-based treatments.SummaryImplementation science and cultural adaptation bring valuable insights and methods to how and to what extent treatments and/or context should be customized to enhance the implementation of evidence-based treatments across settings and populations. Developing a two-way street between these two fields can provide a better avenue for moving the best available treatments into practice and for helping to reduce racial and ethnic disparities in mental health care.

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“…Despite over 40 years of research and intervention in the United States, disparities in health-related outcomes among racial/ethnic populations not only continue, but are widening (CDC, 2011; Kagawa Singer, 2012). Strategies to diminish such health disparities become even more pressing given the exponential increase, in the past decade, of the populations of ethnic minorities in the United States.…”

mentioning

confidence: 99%

“…First, the vast majority of these studies were based on Caucasian or European American samples, leaving Asian Americans, either as a whole or as specific ethnic subpopulations, largely understudied (Allen et al., 2010). Second, there is a growing recognition in public health that an individual’s culture plays a critical role in shaping their health-related decisions and overall well-being (Kagawa Singer, 2012; Sherman, Uskul, & Updegraff, 2011). This appears to be especially true for racial/ethnic minority populations (Kreuter & McClure, 2004).…”

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confidence: 99%

Self-construal as a predictor of Korean American women’s intention to vaccinate daughters against human papillomavirus.

Zhao¹,

Huh²,

Murphy³

et al. 2014

Asian American Journal of Psychology

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Korean Americans represent one of the fastest growing Asian subpopulations in the United States. Despite a dramatic reduction in incidence nationwide, cervical cancer remains a major threat for Korean American women. By preventing the strains of the Human Papillomavirus (HPV) known to cause cervical cancer, the HPV vaccines appear to be a promising solution to reduce the persistent disparities in cervical cancer among not only Korean Americans, but also other racial and ethnic minorities more generally. However, current literature lacks a better understanding of how cultural and behavioral factors influence Korean American women’s intention to vaccinate their adolescent daughters against HPV. This manuscript presents the results of testing the mechanisms through which interdependent self-construal (an orientation of self in which individuals define themselves primarily through their relationships with others), attitudes, and subjective norms impact Korean American mothers’ intention to vaccinate their daughters. Our findings suggest that self-construal holds promise for health communication research to not only uncover the rich variance of health-related beliefs among individuals of shared cultural descent, but also to understand the context in which these beliefs are embedded.

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Applying the concept of culture to reduce health disparities through health behavior research

Cited by 162 publications

References 49 publications

Social norms and its correlates as a pathway to smoking among young Latino adults

Social norms and its correlates as a pathway to smoking among young Latino adults

A two-way street: bridging implementation science and cultural adaptations of mental health treatments

Self-construal as a predictor of Korean American women’s intention to vaccinate daughters against human papillomavirus.

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