Improving Medical Decision Making and Health Promotion through Culture-Sensitive Health Communication

Abstract

This review introduces the concept of culture-sensitive health communication. The basic premise is that congruency between the recipient's cultural characteristics and the respective message will increase the communication's effectiveness. Culture-sensitive health communication is therefore defined as the deliberate and evidence-informed adaptation of health communication to the recipients' cultural background in order to increase knowledge and improve preparation for medical decision making and to enhance the persuasiveness of messages in health promotion. To achieve effective health communication in varying cultural contexts, an empirically and theoretically based understanding of culture will be indispensable. We therefore define culture, discuss which evolutionary and structural factors contribute to the development of cultural diversity, and examine how differences are conceptualized as scientific constructs in current models of cultural differences. In addition, we will explicate the implications of cultural differences for psychological theorizing, because common constructs of health behavior theories and decision making, such as attitudes or risk perception, are subject to cultural variation. In terms of communication, we will review both communication strategies and channels that are used to disseminate health messages, and we will discuss the implications of cultural differences for their effectiveness. Finally, we propose an agenda both for science and for practice to advance and apply the evidence base for culture-sensitive health communication. This calls for more interdisciplinary research between science and practice but also between scientific disciplines and between basic and applied research.

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

“…Considerable attention has been brought to bear on this problem over the last few decades (Betch et al, 2016; Niederdeppe, Bigman, Gonzales, & Gollust, 2013). One aspect of this attention is the increasing acceptance that enhancing the cultural sensitivity of interventions will improve their effectiveness in diverse groups (Betch et al, 2016; Institute of Medicine, 2002).…”

“…Considerable attention has been brought to bear on this problem over the last few decades (Betch et al, 2016; Niederdeppe, Bigman, Gonzales, & Gollust, 2013). One aspect of this attention is the increasing acceptance that enhancing the cultural sensitivity of interventions will improve their effectiveness in diverse groups (Betch et al, 2016; Institute of Medicine, 2002). This acceptance is evidenced in the emphasis, over the past fifteen to twenty years, on including a cultural component in communications, services, and interventions aimed at racial, ethnic, and cultural groups (for reviews see: Alizadeh and Chavan, 2016; Barrera, Castro, Strycker, & Toobert 2013; Beach, et al, 2005; Bhui, Warfa, Edonya, McKenzie, & Bhugra, 2007; Healy et al, 2017; Huang & Shen, 2016; Lie, Lee-Rey, Gomez, Bereknyei & Braddock, 2010; Nierkens et al, 2013).…”

“…Huang and Shen (2016) state “The lack of research that sufficiently controls for other influences is delaying the development of the most effective cultural adaptations” (p. 23). Several scholars (Betch et al, 2016; Harrington, 2013) correctly point out that what is needed most to advance the effectiveness of cultural adaptation is research that falls in Pasteur’s Quadrant (Stokes, 1997). Betch et al (2013) comment:

… advances in the use of culturally sensitive health communication will depend on more engaged interaction between researchers and practitioners.

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Cultural Diversity Calls for Culture-Sensitive Health Communication

“…The first article in this special section, authored by the participants of the meeting, presents the outcomes of the meeting by proposing an agenda both for researchers as well as for practitioners that aims to increase the acknowledgment of culture in health research as well as health practice. 3 It defines culture-sensitive health communication as the deliberate and evidence-informed adaptation of health communication to the recipients' cultural background to increase knowledge and improve preparation for medical decision making and to enhance the persuasiveness of messages in health promotion. This overview gives detailed insight into how culture affects determinants and processes of medical decision making and health promotion.…”

“…Being aware that the cultural background of the reader influences the way the information is processed, understood, remembered, or transferred into action poses additional challenges to the development of such tools, but it also offers the opportunity to make decision aids even more effective (e.g., by implementing a cultural tailoring approach). 3 Overall, the articles in this special section call for a better partnership between science and practice. Science needs to be more aware that research and theorizing is usually too Western focused and excludes other cultural perspectives.…”