Literature Reviews

Cultural Competency, Imperialism, White Saviorism, and Global Health Ethics:

Review by: Tessa Fier, Presentation by: Shivangi Goswami, Erika Gonzalez

History of Maclovio Rojas

Why is this important: To be more culturally aware of the origins and current realities of the community we enter to serve

Understanding Imperialism

Conceptual definition: “ the process whereby the dominant politico-economic interests of one nation expropriate for their own enrichment the land, labor, raw materials, and markets of another people” - Michael Parenti
Modern Imperialism - The US and Mexico
- Maquiladoras as engines of modern imperialism
- Recent attempts by the United States Department of State and associated corporate interests to force the Mexican government to reopen maquiladoras despite the coronavirus pandemic

Global Ethics and FISH

FISH has integrated global health ethics training and resources
Effort to include the rationale of this training
Examples:
- Documentaries created for international clinical programs
- Case study scenarios used to train medical students abroad
Despite being more clinically oriented, lessons and perspectives are applicable to FISH

On FISH’s To-Do List...

Broadening its curriculum with information on history, imperialism, and global health ethics
Create a curriculum for associates that is adapted to the realities of the pandemic
Make available a list of vetted and reliable resources relating to these topics for associates in search of more information

Discussion Questions

Have to remember the group is the unit of analysis! (not the individuals)
Ascertain whether something was a view of one member or a theme for the group
Note whether a specific discussion emerged as a result of moderator prompting or spontaneously from the group
More text/discussion does not necessarily mean the topic is more important

Overview

Questions Faced:
- What makes people act on the health education they receive?
- What are common reasons why people do not act on health information they receive?
- What is the best way to disseminate information so that the message sticks?

Art

Main Idea: Health education is more effective if visual and artistic elements are implemented into the dissemination of the curriculum.
Applications:
- Use animated videos to explain a certain topic or scenario
- Use a music and pictures to engage the audience
- Explain a concept visually through pictographs and flowcharts

Culture

Main Idea: People motivated to change behavior if that change fits within their perceived identity
Applications:
- Use correct language
- Include characters & representation that matches target population
- Include appropriate cultural symbols

Science

Main Idea: Health education based on science will be more memorable if messaging is simple, concrete, credible, and relatable.
Applications:
- Create messages that have influences such as community culture/norms, art, family & friends, etc
- Keep complex scientific ideas simple and easy to understand
- Focus on “how” individuals can improve in addition to “why” person engages in behavior and “what” needs to be targeted to intervene

Conclusion/Discussion

Possible Questions:
What are some specific ways that FISH can implement art, culture, and science to increase the effectiveness of its health education?
- For the cultural component of the SEM, how does one from outside the community use this tactic without appropriating the community’s culture or sounding insensitive?
- What are some challenges that could arise when trying to implement science and use statistics and evidence-based tactics to explain concepts?

By Daniel Zoleikhaeian

Background: SCT + SEM

Social Cognitive Theory (SCT): self-efficacy
- Achievable goals, track progress, self-reward
Social Ecological Model (SEM):
- Good environment = good behavior

5 Stages of Behavioral Change

1. Pre-contemplation
- Individual thinks change is not important or necessary
2. Contemplation
- Individual realizes the problem but does not implement change
3. Preparation
- Individual makes formal plan for implementing the change
4. Action
- Individual executes their plan for change
5. Maintenance
- Individual has successfully executed plan. Goal is to now maintain the healthy behavior

The Progression towards Maintenance

What FISH Can Do: Motivational Interviews

Discussion Questions
- What additional training may be needed to implement motivational interviews during consultations?
- How would we implement motivational interviewing in our health fairs?

Bibliography

Cassidy, C. A. (1999). Using the Transtheoretical Model to Facilitate Behavior Change in Patients with Chronic Illness. Journal of the American Academy of Nurse Practitioners, 11(7), 281–287. doi: 10.1111/j.1745-7599.1999.tb00578.x
Franklin, B. A. (1978). Motivating and Educating Adults to Exercise. Journal of Physical Education and Recreation, 49(6), 13-17. doi:10.1080/00971170.1978.10617817
Kennedy, A. B., & Blair, S. N. (2014). Motivating People to Exercise. American Journal of Lifestyle Medicine, 8(5), 324–329. https://doi.org/10.1177/1559827614524135
Resnick, B., Vogel, A., & Luisi, D. (2006). Motivating minority older adults to exercise. Cultural Diversity and Ethnic Minority Psychology, 12(1), 17-29. doi:10.1037/1099-9809.12.1.17