Tan Naomi Q P, Cho Hyunyi
a School of Communication, The Ohio State University , Columbus , OH , USA.
J Health Commun. 2019;24(5):492-502. doi: 10.1080/10810730.2019.1620382. Epub 2019 May 28.
A revised framework for cultural appropriateness is offered on the basis of a systematic review of operationalizations in 44 cancer screening interventions for Asian Americans. Studies commonly conveyed the epidemiological bases of the intervention (97.7%) and used the language of the population (95.5%). Less commonly reported were strategies central to health communication: cultural features of the intervention messages (77.3%) and the cultural beliefs and values that the intervention focused on (43.2%). Few used cultural tailoring (4.5%) and none aimed to address acculturation or cultural identity. The theoretical framework most frequently used was the health belief model (27.3%) which does not explain the role of culture. More studies focused on cultural barriers (20.5%) than cultural strengths (9.1%). Our revised framework comprises six cultural appropriateness strategies of cultural identity, linguistic, perceptual features, content, constituent-involving, and socioeconomic context-adaptive. It prioritizes cultural identity to recognize the dynamics within racial ethnic groups and to inform adaptive efforts for cultural appropriateness. It emphasizes examining cultural strengths that can facilitate change, as well as reducing cultural barriers. Future research and action should address the disparities in extant health disparities research in which theory and methods are underdeveloped and underutilized for Asian Americans.
在对44项针对亚裔美国人的癌症筛查干预措施的实施情况进行系统综述的基础上，提出了一个关于文化适宜性的修订框架。研究通常传达了干预措施的流行病学依据（97.7%）并使用了目标人群的语言（95.5%）。较少被报道的是健康传播的核心策略：干预信息的文化特征（77.3%）以及干预措施所关注的文化信仰和价值观（43.2%）。很少有人采用文化调适（4.5%），且没有人旨在解决文化适应或文化认同问题。最常使用的理论框架是健康信念模型（27.3%），但该模型并未解释文化的作用。关注文化障碍（20.5%）的研究比关注文化优势（9.1%）的研究更多。我们修订后的框架包括文化认同、语言、感知特征、内容、利益相关者参与和社会经济背景适应这六种文化适宜性策略。它将文化认同置于优先地位，以认识种族群体内部的动态变化，并为文化适宜性的适应性努力提供信息。它强调审视有助于改变的文化优势，以及减少文化障碍。未来的研究和行动应解决现有健康差异研究中的差距，在这些研究中，理论和方法对于亚裔美国人来说发展不足且未得到充分利用。
