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Developing Culturally Appropriate Needs Assessments and Planning 127

mainstream Americans (white and middle - class); however, health education profes-

sionals often find it difficult to use these best - practice models when their intended

populations are culturally diverse. Among the most commonly reported problems
encountered in working with a diverse population are the different subgroups ’ differ-
ing education levels, health beliefs, value systems, and socioeconomic conditions.
Some of the challenges that health educators face given the increasing racial and eth-

nic diversification of the U.S. population can be illustrated by considering the follow-
ing questions. When working with a subgroup of Hispanics made up of indigenous
migrants from Mexico, what is the best way to collect data on this group? If offi cial
statistics on the health problems of this particular population are not available, what
are the best methods for collecting primary data? What are the more effective inter-

ventions when working with a population whose first language is not English or even
Spanish? How do you provide written information to a population whose native lan-
guage does not have a written version?
To help health education professionals and students overcome challenges such as
these, this chapter provides practical ideas for taking a culturally competent approach
to designing health education and promotion programs. It also explores five of the most

recognized health planning models — PRECEDE - PROCEED, MATCH, CDC - Cynergy,
SMART, and intervention mapping — and provides recommendations on how to use
them to understand the cultural characteristics and meet the cultural needs of diverse
populations.

IDENTIFYING CULTURAL FACTORS AFFECTING
HEALTH EDUCATION
When working with diverse populations, health education and promotion specialists

should have an appropriate definition of culture and should have identified the aspects

of culture they should take into consideration when developing health education pro-
grams (Luquis & Pérez, 2003).

Various definitions of culture have been published in the professional literature;
this chapter uses one provided by Spector (1996), who defi nes culture as “ the sum of
beliefs, practices, habits, likes, dislikes, norms, customs, rituals and so forth that we
learn from our families during the years of socialization ” (p. 68). Spector ’ s defi nition
implies that culture is a complex and dynamic concept that encompasses many aspects
of the life of a person or social group.
Given the cultural diversity in the United States, health education professionals
who are in the process of planning health education and promotion programs often
find it very challenging to determine what aspects of the culture of the populations

they are working with they should consider to maximize the chances of program suc-
cess. The following discussion offers recommendations in the areas of language and
communication, health beliefs and practices, and religious practices. It is important
for health education professionals to make sure that they are using appropriate

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