In this article, we examine progress and challenges in designing, implementing, and evaluating culturally sensitive behavioral interventions by tailoring health communication to groups or individuals. After defining common tailoring constructs (i.e., culture, race, and ethnicity), cultural sensitivity, and cultural tailoring, we examine when it is useful to culturally tailor and address cultural sensitivity in health communication by group tailoring or individual tailoring and when tailoring health communication may not be necessary or appropriate for achieving behavior change. After reviewing selected approaches to cultural tailoring, we critique the quality of research in this domain with a focus on the internal validity of empirical findings. Then we explore the ways in which cultural sensitivity, group targeting, and individual tailoring have incorporated culture in health promotion and health communication. We conclude by articulating yet unanswered questions and suggesting future directions to move the field forward. Expected final online publication date for the Annual Review of Public Health, Volume 45 is April 2024. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Cultural Sensitivity and Cultural Tailoring: Lessons Learned and Refinements After Two Decades of Incorporating Culture in Health Communication Research.

Community-based culturally tailored education (CBCTE) programs for chronic diseases may reduce health disparities; however, a synthesis across chronic diseases is lacking. We explored (1) the characteristics and outcomes of CBCTE programs and (2) which strategies for culturally appropriate interventions have been used in CBCTE programs, and how they have been implemented.A systematic review was conducted by searching three databases to identify empirical full-text literature on CBCTE programs for Black communities with cardiovascular disease, hypertension, diabetes, or stroke. Studies were screened in duplicate, then data regarding study characteristics, participants, intervention, and outcomes were extracted and analyzed. Cultural tailoring strategies within programs were categorized using Kreuter and colleagues' framework.Of the 74 studies, most were conducted in the USA (97%) and delivered in one site (53%; e.g., church/home). CBCTE programs targeted diabetes (65%), hypertension (30%), diabetes and hypertension (1%), cardiovascular disease (3%), and stroke (1%). Reported program benefits included physiological, medication-related, physical activity, and literacy. Cultural tailoring strategies included peripheral (targeted Black communities), constituent-involving (e.g., community informed), evidential (e.g., integrated community resources), linguistic (e.g., delivered in community's dialect/accent), and sociocultural (e.g., integrated community members' religious practices).CBCTE programs may have beneficial outcomes, but a small sample size limited several. The strategies identified can be adopted by programs seeking to culturally tailor. Future interventions should clearly describe community members' roles/involvement and deliver programs in multiple locations to broaden reach.PROSPERO CRD42021245772. 

/pdf/community-based-culturally-tailored-education-programs-for-2nvlcolt.pdf

Community-Based Culturally Tailored Education Programs for Black Communities with Cardiovascular Disease, Diabetes, Hypertension, and Stroke: Systematic Review Findings.

This public health review addresses the intricate challenges posed by global nutrition and examines the impact of dietary risks on the well-being of populations worldwide. In an era marked by diverse dietary patterns, the prevalence of both undernutrition and overnutrition presents a complex public health landscape. This paper encapsulates the key aspects explored in the comprehensive analysis, emphasizing the urgent need for targeted interventions. The review delves into the multifaceted nature of global nutrition challenges, considering factors such as food insecurity, inadequate dietary diversity, and the rising prevalence of diet-related non-communicable diseases. Highlighting the interconnectedness of nutrition and public health, the document scrutinizes the disparities in nutritional outcomes across different regions, socioeconomic groups, and age categories. Moreover, the paper outlines evidence-based interventions aimed at addressing these challenges. These interventions encompass policy initiatives, community-based programs, and educational campaigns designed to promote healthier dietary choices. Special emphasis is placed on the role of stakeholders, including governments, non-governmental organizations, and the food industry, in fostering a supportive environment for improved nutrition. The paper concludes by emphasizing the urgency of a concerted global effort to tackle nutrition challenges comprehensively. It underscores the significance of adopting a multifaceted approach that integrates preventive measures, policy changes, and community engagement to foster a sustainable and equitable impact on global nutrition. The insights presented in this review serve as a call to action for policymakers, healthcare professionals, and public health advocates to collaborate in mitigating the adverse effects of dietary risks and building a healthier, more resilient global population.

Global nutrition challenges: A public health review of dietary risks and interventions

Substance use disorders (SUDs) have an enormous negative impact on individuals, families, and society as a whole. Most individuals with SUDs do not receive treatment because of the limited availability of treatment providers, costs, inflexible work schedules, required treatment-related time commitments, and other hurdles. A paradigm shift in the provision of SUD treatments is currently underway. Indeed, with rapid technological advances, novel mobile health (mHealth) interventions can now be downloaded and accessed by those that need them anytime and anywhere. Nevertheless, the development and evaluation process for mHealth interventions for SUDs is still in its infancy. This review provides a critical appraisal of the significant literature in the field of mHealth interventions for SUDs with a particular emphasis on interventions for understudied and underserved populations. We also discuss the mHealth intervention development process, intervention optimization, and important remaining questions. Expected final online publication date for the Annual Review of Clinical Psychology, Volume 20 is May 2024. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Mobile Health Interventions for Substance Use Disorders.

In recent years, the convergence of healthcare and big data analytics has opened new avenues for tailored health communication, enabling personalized interventions and improving healthcare outcomes. This systematic review investigates the impact and techniques of harnessing big data for tailored health communication. The review synthesizes findings from diverse studies spanning healthcare sectors, including public health campaigns, clinical interventions, and patient engagement initiatives. It examines the effectiveness of tailored communication strategies in addressing various health challenges, such as chronic diseases, infectious outbreaks, and mental health disorders. Key findings highlight the significant positive impact of personalized health communication on health behavior change, treatment adherence, and patient empowerment. Big data analytics enable the segmentation of diverse populations based on socio-demographic, behavioral, and clinical characteristics, facilitating the delivery of targeted messages tailored to individual preferences and needs. Personalization enhances engagement, fosters trust, and motivates individuals to adopt healthier lifestyles and adhere to medical recommendations. Furthermore, the review explores the diverse techniques and technologies employed in harnessing big data for tailored health communication. Machine learning algorithms, natural language processing, and predictive modeling are leveraged to analyze vast datasets, predict health outcomes, and tailor communication messages in real-time. Mobile health applications, social media platforms, and wearable devices serve as channels for delivering personalized interventions and collecting real-time health data. However, the review also identifies challenges and limitations, including privacy concerns, data security risks, and the digital divide. Ethical considerations regarding data collection, consent, and transparency are paramount in ensuring the responsible use of big data in health communication. This systematic review underscores the transformative potential of harnessing big data for tailored health communication. By leveraging advanced analytics and technology, healthcare stakeholders can deliver personalized interventions that resonate with individuals, ultimately driving positive health behavior change and improving healthcare outcomes on a population scale.

Harnessing big data for tailored health communication: A systematic review of impact and techniques


 
 Diabetes knowledge is associated with health, including lower A1C levels. The Diabetes Knowledge Questionnaire (DKQ-24), developed 30 years ago for Mexican-Americans with type 2 diabetes and since used with diverse samples in many countries, contains outdated items that no longer accurately assess current knowledge needed for diabetes self-management. We revised the DKQ-24 and tested psychometric properties of the DKQ-Revised (DKQ-R) with a diverse sample.
 
 
 
 We conducted a five-phase instrumentation study, as follows: 1) DKQ-24 items were revised to reflect current diabetes care standards; 2) the Delphi method was used to evaluate the DKQ-R’s content validity (n = 5 experts); 3) cognitive interviews were conducted with people with type 2 diabetes (n = 5) to assess their interpretations of DKQ-R items; 4) cross-sectional administration of the DKQ-R to adults with type 2 diabetes was carried out to assess internal consistency reliability and convergent validity; and 5) an item analysis was conducted using discrimination index and point biserial analysis.
 
 
 
 After receiving the experts’ feedback and conducting the cognitive interviews, 39 items were administered to 258 participants with type 2 diabetes (42.2% women; 29.1% Latino, 42.6% Asian, mean age 55.7 years). To select the final items, we considered the item discrimination index, as well as item-to-total correlations, content area, and participant feedback. The final 22-item DKQ-R uses the same yes/no/I don’t know response format as the DKQ-24. The DKQ-R is strongly correlated with the DKQ-24 (r = 0.71, P <0.01) and weakly correlated with diabetes numeracy (r = 0.23, P <0.01), indicating adequate convergent validity; a Kuder-Richardson-20 coefficient of 0.77 indicated good reliability.
 
 
 
 The DKQ-R is a reliable and valid updated measure of diabetes knowledge for diverse populations with type 2 diabetes.


Revision and Psychometric Evaluation of the Diabetes Knowledge Questionnaire for People With Type 2 Diabetes

People with intellectual and developmental disabilities (IDD) experience elevated risk for poor health and social outcomes in adulthood and are at risk for experiencing homelessness and housing instability. Although the exact prevalence of IDD among homeless populations is unknown, a small body of literature related to the intersection of IDD and homelessness suggests differential health needs and service use patterns, with a need for targeted health and social services. In this study, we explore the perceptions and experiences of 18 homeless or disability service providers about (a) their clients at the intersection of IDD and homelessness and (b) their role and the services provided at the intersection of IDD and homelessness. Participants struggled to provide appropriate, accessible services for this population, owing to lack of training and awareness of specific needs, fragmented systems, and inadequately funded healthcare and housing support. Our findings also reveal that clients at this intersection have high contact with public systems, which places them at risk for losing their right to self-determination. Recommendations center on systems transformation to facilitate the ability of providers to collaborate and to make data-driven decisions to deliver person-centered care.

“The System Tends to Scoop You Up and Spit You Out and They’re Done With You”: The Intersection of Intellectual/Developmental Disability and Homelessness From the Perspectives of Service Providers

Individuals with rheumatoid arthritis (RA) continually fall short of treatment targets using standard drug therapies alone. There is growing evidence that emphasizing physical and mental wellness is equally crucial for improving functioning among people with RA. The purpose of this formative study is to examine the feasibility of offering the wellness-based intervention (“KickStart30”) in patients with RA. Thirteen individuals with RA on targeted immune modulators (a biologic or JAK inhibitor) enrolled in the KickStart30 program. Participants completed self-report measures of RA-specific disability (eg, pain) and other functional areas (eg, mood) in a pre- versus post- intervention design. Paired samples t-tests (and Related-Samples Wilcoxon Signed Rank Tests for non-normal distributions) detected statistically significant results for 10 of 12 measures, including reductions in pain (M = 4.54 to M = 3.54; p = .025; BPI), functional disability (M = 0.94 to M = 0.73, p = .032; HAQ-II), cognitive and physical dysfunction (M = 25.46 to M = 13.54, p < .001; CPFQ), depressive symptoms (M = 9.31 to M = 5.54, p = .003; PHQ-9), anxiety (M = 5.69 to M = 3.23, p = .005; GAD-7), insomnia (M = 11.62 to M = 17.32, p = .007; Note: higher scores on the SCI indicate less insomnia), stress-related eating (M = 75.46 to M = 84.54, p = .021; Note: higher scores on the EADES indicate less stress-related eating), along with significant increases in mindfulness (M = 62.54 to M = 67.85, p = .040; MAAS), mental wellness (M = 4.46 to M = 5.69; HERO), and well-being (Md = 8.00 to Md = 5.00, p = .004; WHO-5). All significant measures had medium to large effect sizes (Cohen's d). The study gives preliminary support for the possibility that the adjunct intervention may have an effect.

https://journals.sagepub.com/doi/pdf/10.1177/2515690X221113330

A 30-Day Adjunct Wellness Intervention for the Management of Extra-Articular Symptoms of Rheumatoid Arthritis: A Formative Study

Abstract:A scoping review was conducted to present the state of the science regarding the health and health-related quality of life (HRQOL) effects of having a family member in contact with the criminal legal system (CLS). The review examined how the following have been studied: 1) types of family relationships, 2) the point of CLS contact, 3) mental health outcomes, 4) physical health outcomes, and 5) HRQOL outcomes. The final sample of 40 studies was largely secondary analyses of datasets (93%; n=37) that investigated a parent-child relationship (78%; n=31). Incarceration was the most frequently measured point of CLS contact (85%; n=34). Mental health outcomes were measured in 68% of the studies (n=27). Physical health outcomes were measured in 28% of the studies (n=11). Health-related quality of life outcomes were included in half of the studies (50%; n=20). Study findings indicate exposure to the CLS through a family member is associated with poorer health and HRQOL outcomes.

Investigating the Health and Health-Related Quality of Life Impacts of the Criminal Legal System on Families: A Scoping Review

SIREN 2025 National Research Meeting: Advancing the Science of Social Care.

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