Conducting a Hispanic Health Needs Assessment in rural Kansas: building the foundation for community action.

UNLABELLED: Healthy People 2020 states ethnic health disparities are a priority for the US. Although considerable national statistics document ethnic-related health disparities, information specific to rural areas is scarce and does not provide direction for implementing chronic disease prevention programming. Therefore, the purpose of our project was to use the Hispanic Health Needs Assessment (HHNA), a tool designed by the National Alliance for Hispanic Health (NAHH), in culturally diverse, rural Southwest Kansas. Our focus areas included: access to healthcare, heart disease, diabetes, overweight, nutrition, and physical activity. METHODS: The assessment followed six steps: (1) developing the assessment team, (2) data gathering using community member surveys, existing statistics and community leader interviews, (3) assembling the findings, (4) formulating recommendations for action at individual, institutional, community and policy levels, (5) sharing findings and program planning, and (6) sharing findings with NAHH. We identified several challenges collecting health related data in rural communities, but overall, the HHNA was a comprehensive and useful tool for guiding a community level health assessment. CONCLUSION: This process has provided our community partners with locally relevant statistics regarding the current status of health, health behaviors, and perceived community needs to inform resource allocation, program planning and applications for new funding initiatives.

Religious involvement measurement model in a national sample of African Americans.

This study examined the factor structure of a brief measure of religious involvement developed previously in research with African American women. Telephone interview methods were used with a national sample of both African American women and men (N = 2,370). Confirmatory factor analyses supported the distinction between religious beliefs and religious behaviors factors and indicated that the factor loadings were equivalent for women and men. Women reported higher levels of religious involvement than men. These results support the validity of this relatively brief instrument for assessing these two dimensions of religious involvement for both African American women and men.

The role of religiosity in dietary beliefs and behaviors among urban African American women.

The relationship between religiosity and health has been investigated in many studies, with most finding positive associations. However, little is known about the role of religiosity in dietary factors, particularly among African American women. We used a self-administered questionnaire to examine the association between religiosity and dietary beliefs and behaviors among African American women. Women with strong religious beliefs and behaviors reported more interest in eating more fruits and vegetables, perceived their consumption as being more important, and consumed more fruits and vegetables than women low in religious beliefs and behaviors. These findings highlight the role of both religious beliefs and behaviors as they relate to diet-related beliefs and behaviors in this population.

Spirituality, breast cancer beliefs and mammography utilization among urban African American women.

Spirituality has been shown to be associated with health, and is an important component in the lives of many African Americans. Recent research proposes that spirituality is a multidimensional construct. The present study proposes a two-dimensional model in which spirituality encompasses a belief and behavioral dimension. This hypothesis was examined, as were relationships between these dimensions and spiritual health locus of control, breast cancer beliefs and mammography utilization among African American women. The belief dimension played a more important role in adaptive breast cancer beliefs and mammography utilization that did the behavioral dimension. These findings suggest the importance of spiritual belief systems for health, and implications for spiritual cancer communication interventions are discussed.

Sociocultural characteristics and responses to cancer education materials among African American women.

Culture has been linked to cancer-related beliefs and practices. The purpose of the present study was to examine the effects of culture on responses to cancer education materials. Religiosity, collectivism, racial pride, and time orientation were measured among 1,227 African American women. Analyses tested the hypothesis that women scoring higher and lower on each construct would differ in their liking, attention, attitude change, recall, and perceived relevance of tailored materials that did or did not frame cancer issues in a cultural context. Responses to culturally tailored materials were no different than responses to other materials, regardless of women's cultural characteristics. However, for all types of materials, women scoring high on religiosity or racial pride paid more attention to materials, liked them more, and found them more personally relevant than women low on these constructs (all ps<.005). Women scoring high on present time orientation paid less attention to materials than women low on this construct (P<.01). In this population of women, cultural characteristics appear to moderate responses to tailored health education materials.

Achieving cultural appropriateness in health promotion programs: targeted and tailored approaches.

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 forcancer prevention in a population of lower income urban African American women.