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Strategies, Practices, and Models for Delivering Programs 193

represent the complete picture. A highly educated, English profi cient, first - generation

immigrant may still practice alternative medicine while proficiently navigating the

U.S. health care system.

■ Be cognizant of language preference. Generally speaking, first - generation immi-
grants will require translation of written materials and spoken words into their
native language; less obvious is the need to provide materials in languages other
than English to a number of those who are the second and subsequent generations
in the United States. Meeting individuals ’ language preference is, however, a key
factor in delivering culturally appropriate health education programs because it
allows people to communicate their needs and wants in an appropriate format.
Being cognizant of language preference also refers to selecting and using the ter-
minology employed by the target population rather than the technical language
health educators are used to. Finally, it also refers to having qualifi ed personnel,
regardless of cultural or ethnic background, who are proficient in the language

needed. Do not assume that all Nisei speak Japanese.
■ Be cognizant of what you do not know. A personal experience is the most telling
illustration of the point here. As a doctoral student the author of this chapter
worked on the development of a culturally appropriate HIV/AIDS curriculum for
migrant farmworkers. Part of the process required interviews with teachers, other
school personnel, and health care professionals. The eager graduate student fol-
lowed interview protocols and attempted to reach key informants in the commu-
nity. Approximately halfway through the process, the graduate student was pulled

from the field by his adviser, who informed him that he was obtaining only socially
acceptable responses. The principle investigator took over the interviews and
those interviews yielded information, some of it racist, that could not have been
obtained by the graduate student who was a member of the target ethnic group.
This story serves to illustrate that even in today ’ s society people may hide their
true feelings and instead provide socially acceptable responses.
■ Be clear about your objectives. One of the easiest ways to lose an educational
opportunity is to be insuffi ciently organized. Your goals and objectives need to be
clear, well articulated, and developed in conjunction with the target population —
this is part of the empowerment process (Anspaugh, Dignan, & Anspaugh, 2000).
■ Remember family dynamics. Health educators tend to focus on individuals rather
than on the social networks individuals share. This process, although expedient,
goes against the basic cultural values of some groups health educators may be
called on to work with. Family members are a powerful and strong source of sup-
port to many cultural and ethnic groups in the United States. This may be a resid-

ual of having once lived in communities less affluent than their current home,
communities where, as Casken (1999) points out, “ The ties to the family ensure
that no one goes hungry or homeless ” (p. 408). Family ties continue to be a pri-
mary source of support to minority members especially those living in medically
underserved areas in the United States (Baffour, Jones, & Contreras, 2006).

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