Airhihenbuwa Collins O, Ford Chandra L, Iwelunmor Juliet I
1Penn State University, University Park, PA, USA.
Health Educ Behav. 2014 Feb;41(1):78-84. doi: 10.1177/1090198113487199. Epub 2013 May 17.
Theories about health behavior are commonly used in public health and often frame problems as ascribed or related to individuals' actions or inaction. This framing suggests that poor health occurs because individuals are unable or unwilling to heed preventive messages or recommended treatment actions. The recent United Nations call for strategies to reduce the global disease burden of noncommunicable diseases like diabetes requires a reassessment of individual-based approaches to behavior change. We argue that public health and health behavior intervention should focus more on culture than behavior to achieve meaningful and sustainable change resulting in positive health outcomes. To change negative health behaviors, one must first identify and promote positive health behaviors within the cultural logic of its contexts. To illustrate these points, we discuss stigma associated with obesity and human immunodeficiency virus and acquired immune deficiency syndrome. We conclude that focusing on positive behaviors and sustaining cultural and personal transformations requires a culturally grounded approach to public health interventions, such as that provided by the PEN-3 model.
关于健康行为的理论在公共卫生领域被广泛应用，并且常常将问题归咎于或关联到个人的行为或不作为。这种框架表明，健康状况不佳是因为个人无法或不愿意听从预防性信息或推荐的治疗措施。联合国最近呼吁制定战略以减轻糖尿病等非传染性疾病的全球疾病负担，这就需要重新评估基于个体的行为改变方法。我们认为，公共卫生和健康行为干预应该更多地关注文化而非行为，以实现有意义且可持续的改变，并带来积极的健康结果。要改变负面的健康行为，必须首先在其背景的文化逻辑中识别并推广积极的健康行为。为了说明这些观点，我们讨论了与肥胖症以及人类免疫缺陷病毒和获得性免疫缺陷综合征相关的污名化问题。我们得出结论，关注积极行为并维持文化和个人转变需要一种基于文化的公共卫生干预方法，例如由PEN - 3模型提供的方法。
