Influence channels are the ways in which mes- sage materials are transmitted to the target audi- ence. They include television, video, computers, radio, magazines, newspapers, newsletters, direct mail, and telephones.
Each cultural group demonstrates distinct media-use patterns and is best approached through those influence channels. Oral traditions are strong among some populations, while writ- ten messages are favored by others. Most African Americans (97 percent) listen to the radio for more than thirty hours each week; Latinos enjoy television programs focusing on family and rela- tionship issues, watching on average fifteen hours of Spanish programming and ten hours of English programming each week.65, 78 Asians
watch about six hours of native-language televi- sion weekly. In a study of Native Americans in California, a majority of respondents reported that they would prefer receiving nutrition infor- mation through newsletters (69 percent) or videotapes (67 percent); approximately one- quarter indicated they would like to receive a visit from a health professional, and only 6 percent selected a workshop with family and friends.46
Computer-based, interactive nutrition education programs are an emergent educational tool, par- ticularly suitable for audiences with low literacy or limited English language skills, as was found in a study of rural Appalachian women.91The
Internet is another promising technology, offer- ing twenty-four–hour access to health education materials and easy access to group support through bulletin boards and chat rooms, and individualized therapy through e-mail.1, 34, 99
According to marketing experts, the most effective presentation of a message requires a combination of pictures, sounds, and words in the broadcast and print media.78The use of multiple
influence channels and frequent repetitions of the message at times when the target audience is lis- tening or watching is also important. Beyond the mass media, health fairs, neighborhood clinics, farmers’ markets and grocery stores, traditional healers, churches, schools, food banks or social
service centers, carnivals, and sporting events are a few of the locations where culturally relevant nutrition education materials can be successfully distributed on a smaller scale. Low-income, hard- to-reach whites, blacks, and Latinos express interest in nonjudgmental small-group support meetings similar to Alcoholics Anonymous and Tupperware-style home meetings with food sam- ples and cooking demonstrations as settings for nutrition education programs.97
Marketing Mix
The four Ps of the marketing mix are product, price, placement, and promotion.54They refer to
a well-developed message (product) that advances program goals and objectives at mini- mal economic or psychological cost to target audience members (price) and presents this mes- sage in a method congruent with target audience media preferences (placement) in such a way that the target audience members are encouraged to become more involved in the program, either through phone numbers for further information or through attendance at group meetings (pro- motion). Attention to all four areas of the mar- keting mix assures that the health care message is fully accessible to the target audience.
Evaluation
Process evaluation keeps track of progress throughout the program, especially the identifica- tion of larger community conditions that may be presenting barriers to dissemination of the mes- sage. Summative evaluation is used to assess pro- gram results after completion of the effort. Evaluation data are useful in refining intercultural nutrition education strategies both during imple- mentation and in future programs. Publication of culturally sensitive nutrition education program results greatly benefits other health professionals and their clients through shared knowledge about intercultural communication techniques and tools.
CHAPTER 3 REVIEW QUESTIONS
1. Why is communication with another person
or group described as an action chain? Give an example of an action chain that might occur when you meet (1) a friend, (2) your new boss, and (3) a young child.
2. Why is it important to become familiar with
other cultures’ communication behaviors? 80 INTERCULTURAL COMMUNICATION
Interpersonal follow-up is believed to increase efficacy in communicating a com- plex health care message.11
Use of a self-reported shelf inventory was found to be an effective method in eval- uating community nutrition intervention programs with Hispanics, blacks, and whites.6
Give three examples of nonverbal communi- cation behaviors.
3. What is meant by low- or high-context and
uncertainty avoidance in describing verbal communications? Name one culture that is low- context and one culture that is high-context. How may an individual’s relationship to the group differ between high- and low-context cultures? How does uncertainty avoidance differ from risk avoidance? Give an example.
4. What would be the culturally appropriate
verbal address for when you meet the follow- ing individuals: an African American, a Latin American, a Vietnamese, and an Asian?
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