Culture and Prevention I

     Cultural perceptions and health beliefs would greatly affect health promotion and disease prevention. Every ethnic group faces particular health challenges due to genetics, cultural practices, and epidemiologic difference. Thus it is important to understand the role and influences of culture and tradition on health. For example, Chinese culture emphasizes harmony, self-control, interdependency, and yin-yang balance. The cultural norms are achieved by social relationship, balancing the state of mind and body, and health-seeking behaviors. Therefore, coherence between the cultural values and the disease prevention strategies can accomplish acceptance of health information.

     As Donohew (1998) argued that adolescents who are high sensation seekers – the ones who seek for novel, exited, and complex experiences and sensations – would be difficult to reach through conventional and rational approaches, I was thinking about some questions: why some people pursue novelty? How to reach high sensation seeker? People are attracted by novelty sensation may be due to the needs for detecting risk and design strategies for survival. But the sensation seeking behavior also potentially puts people in the risk. Reaching high sensation seeker and avoid risky behavior, such as drug use among adolescents, is very difficult. At least, I was thinking, is to reduce the number of individuals who use drug for the first time, and to intervene with those who are using. The two target groups should be quite different in designing prevention. For example, training peer group resistance may be effective in nonusers groups, but it may not in users. Various factors should be identified, such as family environment, physical abuse, and poor performance in school. We need to find ways to attract attention of target audiences and persuade them to engage in positive behaviors. For example, high sensation seekers may be more likely attracted to messages that are creative, complex, fast-paced, and emotionally powerful.

     The term of self construal reminded me of the difference of Western and Eastern conceptualization of the self. In Western culture, specifically, people seem to construe the self independently as separate from social context, emphasizing autonomy, whereas Eastern culture construes the self as an interdependent part of social context. I recall the example of Confucianism. Confucianism might be the most influential philosophy in traditional Chinese culture due to its systemic and detailed norms in social, interpersonal, and familiar relationships. Confucianists focus on collectivism, in contrast to individualism in the West. Collectivist values affect Chinese people’s health beliefs and behaviors. So how does self-construal affect the strength of attitudinal and normative component of the TRA (Park, & Levine, 1999)? Self-construal seems to vary across individuals and contexts. It also influences cognitive performance, social interaction, and other facets of behavior. When people observe social icons, and family norms, they might change preferences, which alternatives are adequate on the attributes. For example, Chinese people believe in the group identity, interdependency, thus their health behavior is largely affected by social context and family members. It is correspondent with what Parrott (1998) assumed in the behavior adaptation model, that an individual tends to behave in a certain way when significant others expect one to adapt his/her behavior to reduce risk resulted from a particular action. In decision-making process, elderly parents usually leave important family decision to adults children, especially son.  

     In addition, behavior adaptation emphasizes building habitual practices with the adoption of particular prevention to reduce the harm in relation to the risky behavior. I was reminded of the situation of Chinese American. Acculturation levels of Chinese American into the Western lifestyle were linked to access to and utilization of health services. However, the processes Chinese Americans underlying adaptation to residency in the US are complicate. For example, Chinese immigrants may follow some recommended health treatments, but may not comprehend why many Western diagnostic tests are necessary. Many Chinese immigrants integrate traditional Chinese medicine and conventional Western medicine as “alternative medicine” to heal illness. But as to disease prevention, they usually believe diseases are preventable or controllable through maintaining balanced state and proper eating habits.