FELLOWSHIP for INTERNATIONAL SERVICE and HEALTH
Collaborating with our local and global communities to provide sustainable health and educational services.
Cultural Competency, Imperialism, White Saviorism, and Global Health Ethics:
Improving FISH’s Associate Training and Operational Ethics
Review by: Tessa Fier, Presentation by: Shivangi Goswami, Erika Gonzalez
History of Maclovio Rojas
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Why is this important: To be more culturally aware of the origins and current realities of the community we enter to serve
Understanding Imperialism
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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
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Modern Imperialism - The US and Mexico
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Maquiladoras as engines of modern imperialism
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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
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Global Ethics and FISH
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FISH has integrated global health ethics training and resources
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Effort to include the rationale of this training
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Examples:
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Documentaries created for international clinical programs
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Case study scenarios used to train medical students abroad
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Despite being more clinically oriented, lessons and perspectives are applicable to FISH
On FISH’s To-Do List...
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Broadening its curriculum with information on history, imperialism, and global health ethics
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Create a curriculum for associates that is adapted to the realities of the pandemic
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Make available a list of vetted and reliable resources relating to these topics for associates in search of more information
Discussion Questions
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Have to remember the group is the unit of analysis! (not the individuals)
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Ascertain whether something was a view of one member or a theme for the group
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Note whether a specific discussion emerged as a result of moderator prompting or spontaneously from the group
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More text/discussion does not necessarily mean the topic is more important
Health Education Efficacy
Overview
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Questions Faced:
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What makes people act on the health education they receive?
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What are common reasons why people do not act on health information they receive?
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What is the best way to disseminate information so that the message sticks?
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Art
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Main Idea: Health education is more effective if visual and artistic elements are implemented into the dissemination of the curriculum.
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Applications:
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Use animated videos to explain a certain topic or scenario
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Use a music and pictures to engage the audience
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Explain a concept visually through pictographs and flowcharts
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Culture
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Main Idea: People motivated to change behavior if that change fits within their perceived identity
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Applications:
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Use correct language
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Include characters & representation that matches target population
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Include appropriate cultural symbols
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Science
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Main Idea: Health education based on science will be more memorable if messaging is simple, concrete, credible, and relatable.
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Applications:
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Create messages that have influences such as community culture/norms, art, family & friends, etc
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Keep complex scientific ideas simple and easy to understand
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Focus on “how” individuals can improve in addition to “why” person engages in behavior and “what” needs to be targeted to intervene
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Conclusion/Discussion
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Possible Questions:
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What are some specific ways that FISH can implement art, culture, and science to increase the effectiveness of its health education?
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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?
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What are some challenges that could arise when trying to implement science and use statistics and evidence-based tactics to explain concepts?
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Transtheoretical model of Behavioral Change
By Daniel Zoleikhaeian
Background: SCT + SEM
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Social Cognitive Theory (SCT): self-efficacy
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Achievable goals, track progress, self-reward
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Social Ecological Model (SEM):
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Good environment = good behavior
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5 Stages of Behavioral Change
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1. Pre-contemplation
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Individual thinks change is not important or necessary
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2. Contemplation
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Individual realizes the problem but does not implement change
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3. Preparation
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Individual makes formal plan for implementing the change
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4. Action
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Individual executes their plan for change
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5. Maintenance
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Individual has successfully executed plan. Goal is to now maintain the healthy behavior
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The Progression towards Maintenance
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Pre-contemplation
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Consciousness Raising
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Environmental Re-evaluation
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Preparation
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Self-liberation
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Counterconditioning
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Stimulus control
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Contemplation
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Self-evaluation
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Action
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Contingency Management
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What FISH Can Do: Motivational Interviews
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Discussion Questions
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What additional training may be needed to implement motivational interviews during consultations?
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How would we implement motivational interviewing in our health fairs?
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Bibliography
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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
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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
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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
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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