Page 172 - Cultural Competence in Health Education

150 Cultural Competence in Health Education and Health Promotion

The communication model involves the message, the communication medium, the
sender (teller or speaker) of the message, and the receiver (listener or audience) of
the message. Barriers to effective communication can arise from the sender, the mes-
sage, the channel of communication (medium), and the receiver of the message. Health
educators must possess the listening and speaking skills that will enable them to detect
and remove these barriers. Roman, Maas, and Nisenholtz (2003) have addressed the
question of obstacles that stand between the audience (the receivers of the message)
and the action taken (what the receivers should do) after receiving the message. When
health educators know what real or perceived barriers stand in the way of clients ’ tak-
ing action, they have a tremendous opportunity to develop effective communication
strategies. Understanding the barriers helps health educators select either implicit or
explicit action messages to which audiences are most likely to be receptive.
Communication can be verbal (spoken) or nonverbal. Nonverbal communication
can involve cultural differences in the use of body gestures, eye movements, signs,
touch, facial expressions, vocal qualities, silence, body distance, space, and time. All
these areas of cultural difference can affect communication and self - understanding.
They can serve as barriers to effective communication. For effective communication
to take place there must be a strong communication strategy. A communication strat-
egy describes how a message will be framed and delivered to the target audience. It is
based on the thorough understanding of the audience members and their knowledge,
attitude, wants, beliefs, needs, values, traditions, and the like. A communication strat-
egy describes the target audience, the action the audience members should take, the
obstacles between the audience and the action to be taken, how audience members will

benefit, and how to reach them with the message. Communication plays a major role
in many health education marketing efforts. Communication can be used to inform,
educate, and persuade. Communication can use cultural symbols, codes, images, met-
aphors, or icons to frame a particular problem affecting a distinct cultural group and
the solutions to such a problem.
Cultural kinetics involves communication codes, symbols, images, metaphors,
meanings, and the context between the sender and the receiver. Use of cultural kinetics
promotes knowledge development and comprehension. Faseke (1990) comments that
an oral tradition is generally not only the heritage of the spoken or sung word; it is the
heritage of the ear. Airhihenbuwa (1995), in his book Health and Culture, states that
“ people in oral tradition cultures (as in many African countries) are accustomed to
learning by listening. Learning by seeing is important to the extent that what is seen is
congruent with what is heard. Critical aspects of learning by listening include who was
speaking, the way the words were said, and in what context ” (p. 9). Furthermore,
many cultures have traditional ways of communicating among the group members. In
the olden days traditional news carriers were used to send messages from one place to
another and to announce special events in the community. In the Yoruba culture of
southwestern Nigeria, the town crier is a good example of how messages are transmit-
ted in the community. The oral tradition, that is, the spoken word, is one of the com-
monest ways of transmitting information in many cultures. Symbols are also used as a

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