cross-Cultural Health Perspectives

THE PEN-3 Model The PEN-3 Model is a conceptual framework for planning and developing culturally appropriate health education and disease prevention programs (Airhihenbuwa, 1995; Airhihenbuwa & Webster, 2004). The model consists of three domains: Cultural Identity, Relationships and Expectations, and Cultural Empowerment. SLP “ Overall Expectations and Outcome The SLP will demonstrate the culmination of your understanding and your ability to: Choose a target cultural group Identify a health problem affecting this group Characterize the broader social cultural context in which behaviors contributing to this health problem occur Discuss how culture can be leveraged toward empowerment of your target group Discuss the implications of cultural identity in determining the most appropriate intervention point of entry Identify, analyze, and synthesize scholarly materials to inform your application of the PEN-3 Model to the development of your health education program EXAMPLE For your SLP, you are being asked to consult the scholarly literature to identify positive, existential, and negative perceptions, enablers, and nurturers related to your target cultural group€„¢s health behavior/problem of interest; you will construct a table like the one that appears below, one row at a time; and, beneath this table, you will provide a narrative explanation of the items that you have listed in each cell of the table, citing the sources consulted to arrive at this information. Here is an example of what you expected to do in constructing your own PEN-3 table for this assignment. The following is a hypothetical application of the PEN-3 Model toward the development of a breast cancer screening program intervention for Native Hawaiian women. I have completed the first two rows of this table to give you an idea of where you€„¢re heading. Beneath the table, I include an example of narrative statements that should also be provided to clarify the information furnished in each cell of your table. SAMPLE PEN-3 TABLE Target Cultural Group: Native Hawaiian women Health Problem: Breast Cancer Screening (participation rates low) Positive Existential Negative Perceptions Screening detects cancer when it is most treatable; important None Uncomfortable; cancer treatment is aversive; cancer=fear, anxiety, burden; unsure of screening guidelines; €œIf I feel good, I must be okay;€ mammography is dangerous; distrust of free services; embarrassment of disrobing. Enablers Adequate health care coverage; reminders; supportive outreach; church as a source of emotional and tangible support Church as a place of family and spiritual connection Lacks access to healthcare facilities; lacks regular transportation; culturally insensitive services Nurturers ETC. Positive Perceptions- Native Hawaiian women believe that screening detects cancer early on, when the disease is likely to be most treatable; they also perceive cancer screening to be important (Ka opua & Anngela, 2005). These beliefs are apt to encourage these women to receive breast cancer screening. Hence, the health educator should leverage these perceptions in target low breast cancer screening rates in this group. Existential Perceptions-All of the perceptions relative to breast cancer screening within this target cultural group appear to be either positive or negative (Ka opua, 2008; Ka opua & Anngela, 2005). That is, there were no discernable existential perceptions (i.e., perceptions that neither negatively nor positively contributed to the desired health behavior). Negative Perceptions-Focus group data indicate that Native Hawaiian women may believe mammography to be uncomfortable or may consider the procedure to be dangerous (Ka opua, 2008; Ka opua & Anngela, 2005). These women also expressed fear of detecting cancer as a deterrent to screening (given the perceived burden of cancer on family resources). Some opted to believe that if they feel okay, they must be okay. Others perceived free cancer screening services as suspect, likely due to prior negative experiences with the health care system. There was also a sense of embarrassment with regard to disrobing in preparation for a mammogram (Ka opua, 2008; Ka opua & Anngela, 2005). These negative feelings, attitudes, and beliefs are apt to be barriers to seeking breast cancer screening for this target cultural group. Hence, the health educator should incorporate strategies to address each of these perceptions. References: Ka’opua, L.S. (2008). Developing a culturally responsive breast cancer screening promotion with Native Hawaiian women in churches. Health & Social Work, 33(3), 169-177. Ka ̂¬opua, L.S., & Anngela, L. (2005). Developing a spiritually based breast cancer screening intervention for Native American women. Cancer Control, Cancer, Culture and Literacy Supplement. Your Task for Module 2 For Module 2, Begin the process of constructing a 3 X 3 table in which you cross the Cultural Empowerment and Relationships and Expectations domains of the PEN-3 Model (see below for an example of the format that you should use). For the current module, complete the first row of this table by identifying and listing positive perceptions, existential perceptions, and negative perceptions that influence your target cultural group’s behaviors with regard to the health problem that you, the health educator, identified in Module 1. (You will complete the remaining rows of this table in Modules 3 and 4.) DOMAINS Positive Existential Negative Perceptions X X X Enablers Nurturers Be sure to note the scholarly source(s) consulted in the course of identifying each of the items that you have listed in your table (i.e., provide a citation adjacent to each entry, and include a reference list with your completed table). For guidelines on in-text citations, visit the following web site: Upload a completed draft of your table and citations to the SLP field in CourseNet at the conclusion of this module. SLP Assignment Expectations: Use the scholarly literature to identify positive, existential, and negative perceptions among your target cultural group that may influence the problem health behavior that you have chosen to examine; use this information to complete the first row of your PEN-3 table; and provide a narrative explanation for perceptions that you have identified in your table. (An example is provided above.) LENGTH: 1-2 pages typed and double-spaced The following items will be assessed in particular: 1. PRECISION: Each of the questions of the assignment is specifically addressed in the paper. 2. CLARITY: The paper reads clearly (i.e., it is not confusing) and is well-structured. 3. BREADTH: The paper presents appropriate breadth covering the questions of the assignment. 4. DEPTH: The paper presents points that lead to a deeper understanding of the matters and/or issues being discussed and integrates several points into coherent conclusions. 5. APPLICATION: Your assignment has application for a €œreal life€ health problem facing a €œreal world€ cultural target group. Keep in mind that œA papers are truly exceptional works that go beyond simply answering the questions. Additional Guidelines: You will write the sections of your SLP and submit each at the end of each module. Enhance your research by using the web as well as the journal databases such as Proquest and EBSCO. Please conform to TUI’s writing style (see your Syllabus page): One inch margins all around and referencing sources APA style; etc.

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