Culturally responsive health promotion in puerto rican communities: a structuralist approach.

This literature review discusses the value of the structuralist approach as an integrated theoretical and methodological framework for participatory cultural assessments designed to capture the cultural dynamics of those affected by health disparities. Drawing from principles of the Lévi-Straussian strand of structural anthropology found in contemporary cultural studies, and using the Puerto Rican cultural experience as an example, the authors present the distinction between deep and surface structures of cultural knowledge and meaning and highlight information-processing and behavioral systems influenced by the complexity of cognitive and social representations of cultural structures. To understand and address the deeply rooted web of ideology, norms, and practices that influence health decision making and behavioral responses, the authors show the need for ethnographic narrative inquiry beyond surface manifestations of culture. Finally, the authors discuss the implications of the structuralist approach for culturally responsive health education and other health promotion interventions.

Diabetes self-management: perspectives of Latino patients and their health care providers.

UNLABELLED: Lifestyle modification programs tailored to experience, culture, psychosocial characteristics, and world-view can improve knowledge, self-care behaviors, and glucose control among Latinos with diabetes. Few data exist, however, on improving diabetes self-management among Latinos. In addition, views and practices of practitioners caring for these patients have received little attention. OBJECTIVE: This study describes findings from qualitative research to inform the refinement of self-management interventions tailored to Latino patients with type 2 diabetes. METHODS: Two practitioner focus groups assessed perceptions of patients' knowledge, attitudes, and behaviors. Four patient focus groups examined knowledge, beliefs, practices, barriers, and facilitators. Data were transcribed and subjected to content analysis. RESULTS: Thirty-seven patients seeking care at a community clinic participated, along with 15 health care practitioners. Important knowledge gaps regarding diabetes causation and self-management were identified. Negative attitudes towards self-management were common among patients. Key facilitators included strong religious faith and support of medical practitioners. Families both facilitated and prevented adoption of self-management practices. CONCLUSION: This study provides unique insights into the knowledge, attitudes, practices, and perceived barriers facing Latino patients and their providers regarding diabetes self-management. PRACTICE IMPLICATIONS: Study findings underscore the need to develop tailored programs for this population and to train practitioners on their implementation.