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134 Cultural Competence in Health Education and Health Promotion

as the research studies from such organizations as institutes and universities mentioned
previously and other literature that can provide a general description of the character-
istics of this population. Once the health education professionals have gained a gen-
eral understanding of this target population (the language its members speak, where
they come from, their sociodemographic profile, the health beliefs in their hometowns,

and so forth), they need to identify where this population concentrates — which is easy
because indigenous people tend to cluster in the same neighborhood — and who the
local leaders are. To work with this indigenous population it is vital to gain people ’ s
trust, and one way to do this is by approaching the group ’ s leaders. A good way to start
the needs assessment is by conducting face - to - face interviews with these leaders to
learn, according to their perspective, what the needs of the target population are. These
leaders can facilitate the implementation of focus groups that can provide additional
information on the population ’ s perceived needs. Health education professionals
should also employ a bilingual facilitator to help them overcome the language barrier.
A method that can yield complementary information is conducting windshield obser-
vations of the neighborhoods where the target population lives to assess the environ-
mental factors that affect them. Once the principal needs have been identifi ed, health
educators can conduct nominal groups to have the community prioritize these needs.
Overall, the group assessments and the face - to - face interviews, rather than any written
methods, will be the more appropriate methods for conducting a needs assessment of
the Triqui immigrant population.

PLANNING AND IMPLEMENTING CULTURALLY
APPROPRIATE PROGRAMS
The previous section explained that although the literature suggests standards for con-
ducting a needs assessment, there are different ways to translate these standards into
practice, depending on the characteristics of the target population. This is also true for
the other stages of the planning and implementation of health promotion programs.
Although models provide a framework to guide the work of health education profes-
sionals, it is up to these professionals to decide how to apply the models and to remem-
ber that, if necessary, it is possible to combine models to meet the needs and situations
of the target population or community (McKenzie et al., 2005). In Chapter Six , two
models — the cultural assessment framework (Huff & Kline, 1999) and the PEN - 3
model (Airhihenbuwa, 1995) — for planning health education programs with culturally
diverse populations are discussed. This chapter now describes the main premises of
five other well - known health planning models — PRECEDE - PROCEED, MATCH,

CDC - Cynergy, SMART, and intervention mapping — and makes recommendations on
how to use them to work with culturally diverse populations (see Table 7.1 for a sum-
mary of each model).
As Table 7.1 illustrates, each model has its own way of approaching the develop-
ment process of health promotion programs. PRECEDE - PROCEED prioritizes the

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