Blood Pressure
The three factors of cultural empowerment according to the Pen-3 model can and should be taken into account when working with the target population. Each of the three factors of cultural empowerment: positive, existential/exotic, and negative, impact the overall health of the individual and community. Positive factors of cultural empowerment refer to “the perceptions, enablers and nurturers that may cause an individual, family or community to engage in health practices that contribute to improved health status and must be encouraged,” (Campbell, 1995). Within the African-American male community, these positive factors might include the eating of more leafy green vegetables, riding bicycle instead of driving to work, and participating in community projects. Positive factors promote health within the specific frameworks and reference points of the community. Therefore, these lifestyle choices and behaviors do not conflict with core values and identity. They can be an integral part of cultural empowerment as well as personal and public health. Supporting, for example, the introduction of healthy soul food dishes into a person’s diet would enable positive cultural empowerment. Health is supported via the consumption of dishes like collard greens and black-eyed peas, which are integral to the African-American culinary experience. Another example of a positive cultural empowerment would be the participation in local politics, which can uplift the entire community and mitigate the experience of racism. As the CDC (2010) points out, barbers in the African-American community can be a source of positive information dissemination about blood pressure prevention.
The existential or exotic elements of cultural empowerment have a net neutral impact on individual and community health. As Campbell (1995) puts it, “These are unfamiliar practices that have no harmful health consequences and therefore do not need to be changed.” For example, prayer and other religious practices can be viewed as existential and exotic. They certainly do not harm the individual, and as cultural icons must be supported by the healthcare team. Even those practices that seem strange and exotic — such as personal quirks and rituals — should not be changed for no apparent reason. The existential or exotic factors might be unique to the individual, such as hobbies, or they could be practices that are shared by the community such as revival meetings. Neutral factors enable cultural empowerment without having an adverse impact on health.
However, there are often negative factors that might need to be assertively addressed by the healthcare provider. Some negative factors might seem to be part of the culture but are actually not, or can be altered creatively. One example again is food. Traditional African-American soul food can be high in cholesterol and saturated fat: which would be anathema to a diet that is geared towards patients needing to control their hypertension. The healthcare worker can prepare brochures with recipes, which can even be passed out to local African-American owned restaurants. These recipes can take traditional soul food dishes and show how they can be prepared to meet the needs of men who are at risk for or already have high blood pressure. If a patient comes from a community with a high prevalence for substance abuse or violence, these factors can be curtailed via public awareness campaigns designed to get the attention specifically of African-American males. Prevention programs in high schools can help young African-American males understand how a tendency towards hypertension can combine poorly with trigger factors like poor stress management, lack of exercise, poor diet, smoking, and drug use. The healthcare worker should assertively address any negative element that remains unchecked or unchanged. Cultural empowerment means holding up a mirror to the target population, and revealing what works and what does not. To empower the individual is to arm him with knowledge.
References
Campbell, C. (1995). Human education planning models. Mississippi Agricultural and Forestry Experiment Station. Retrieved online: http://msucares.com/health/health/appa2.htm
United States Department of Health and Human Services: Centers for Disease Control and Prevention (CDC, 2010). A Closer Look at African-American Men and High Blood Pressure Control: A Review of Psychosocial Factors and Systems-Level Interventions. Atlanta: U.S. Department of Health and Human Services. Retrieved online: http://www.cdc.gov/bloodpressure/docs/African_American_Executive_Summary.pdf
Blood Pressure research proposal