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Developing Culturally Appropriate Needs Assessments and Planning 139

the target population, especially the factors described in the beginning of the chapter
(such as language, literacy level, health beliefs and practices, socioeconomic back-
ground, and communication style), because they will determine the preferred materi-
als (curriculums, brochures, posters, videos, pictures, flipcharts, PSAs, and so forth)

and also the best channel through which to deliver the messages (individual, interpersonal,
small - group, community, or organizational channels). Keep in mind that everything
should revolve around when, where, and how the target audience can be effectively
reached to pursue the desired change. For example, health education professionals who
intend to create a program to help Mexican American pregnant women increase their

access to prenatal care beginning in the first trimester—a documented public health
problem among this population (Frisbie, Echevarria, & Hummer, 2001; McGlade,

Somnath, & Dahlstrom, 2004)—might find it useful to use radionovelas (radio soap
operas), a proven method of successfully providing health education to this popula-
tion, which enjoys this type of entertainment. This is a way to build on materials that
are culturally accepted, instead of experimenting with something that might not be
attractive to a particular population.

Implementation
Implementation consists of “ converting objectives into actions by the coordination of
activities ” (Green & Kreuter, 2005, p. 194). To accomplish this all models recommend

that health education professionals develop specific plans that detail how the inter-
ventions will be executed, the actors that will be involved, and the timelines for developing
the different components of the program. The consumer - focused models — CDC - Cynergy
and SMART — recommend including a mechanism that obtains feedback from the pro-
gram participants or recipients and then using this information to refi ne the program as
needed (McKenzie et al., 2005).

DESIGNING CULTURALLY APPROPRIATE EVALUATIONS

The five models described here contemplate evaluation as an important component of
the planning and implementation of health promotion programs. The PRECEDE -
PROCEED and MATCH models recommend designing process, impact, and outcome
evaluations; CDC - Cynergy calls for formative and summative evaluation; and the
SMART and intervention mapping models suggest starting the evaluation process
early in the planning stages and engaging all stakeholders (Bartholomew et al., 2001;
Green & Kreuter, 2005; McKenzie et al., 2005). Given the relevance of this topic, the
following section is dedicated to discussing why it is important to evaluate health pro-
motion programs, identifying the different types of evaluations that exist, and examin-
ing how these evaluations are best performed when working with culturally diverse
populations.
Evaluation is one of the key components of all health education and promotion for
multiple reasons. It is through this process that planners learn whether a program ’ s
goal and objectives were accomplished and to what extent. Evaluation is also a way to

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