An Experimental Test of the Two-Dimensional Theory of Cultural Sensitivity in Health Communication

Abstract

Based on a theoretical framework describing culturally sensitive (CS) health communication (Resnicow, Braithwaite, Ahluwalia, & Baranowski, 1999), this experiment tested the relative contributions of surface structure and deep structure in the recall of oral health information from pamphlets varied in written message and images. Using a 2×2 factorial design, Spanish speaking Mexican heritage mothers of children under six (N=160) were randomly assigned to read one of four 12-page pamphlets containing the same oral health information in Spanish: (1) standard written message/standard images; (2) standard written message/CS images; (3) CS written message/standard images; (4) CS written message/CS images. Participants completed a 22-item oral health knowledge questionnaire before and after reading the pamphlet. Controlling for the effects of pre-test scores, acculturation, and educational level on information recall, findings showed significant positive main effects for CS images (F(1, 152) = 5.03, p = .026, partial ŋ2 = .032) and CS written message (F(1, 152) = 5.21, p = .024, partial ŋ2 = .033). There was no interaction. These results support the two dimensions of CS and their independent effects. They should be applicable to a variety of health communication channels. Further research is needed to investigate the causal mechanism behind the observed effects.

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“…This modifiability further increases the ability for instructors to implement culturally responsive pedagogy, which Gay ( 2000 ) describes as “using the cultural knowledge, prior experiences, frames of reference, and performance styles of ethnically diverse students to make learning encounters more relevant to and effective for them” (p. 29). The use of culturally responsive pedagogy is not only important for creating more inclusive and accepting learning environments, but can also result in greater, more meaningful, and more sustained learning for members of targeted cultural groups (e.g., Kisker et al, 2012 ; Singelis et al, 2018 ).…”

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“…Culturally sensitive health care has been described as care that effectively responds to the attitudes, feelings, and circumstances of individuals that belong to a population group with common identifying characteristics such as race, religion, language, and socioeconomic status, and that which patients perceive as being concordant with their cultural values and beliefs [ 43 ]. Cultural sensitivity is, therefore, the extent to which ethnic or cultural characteristics, experiences, norms, values, behavioural patterns and beliefs of the target population as well as relevant historical, environmental, and social forces are incorporated into the design, delivery, and evaluation of targeted health programs [ 44 ]. In 2016, the World Federation of Critical Care Nurses made a declaration about culturally sensitive practice [ 45 ].…”

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“…The surface structure focuses on the compatibility of health promotion programs materials and messages to the observable characteristics of the target community, such as the people, language, food, places, clothing, food, etc. It prioritizes acceptance of the health promotion program's messages by the community (Resnicow et al, 1999(Resnicow et al, , 2000Singelis, Garcia, Barker, & Davis, 2018). The deep structure requires health promoters to understand the culture, historical, social, environmental and psychological aspects that are considered important by the target community, as well as their influence on the health-related behavior of the community (Resnicow et al, 1999(Resnicow et al, , 2000.…”

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