African-American Hbp an Effective Health Education Program

African-American HBP

An effective health education program must be culturally aware, sensitive to the history and specific needs of the community. Within the African-American community, there is an unfortunate history of mistrust with regards to the healthcare system and establishment. As Thomas & Quinn (1991) point out, "there remains a trail of distrust and suspicion" that hampers health education in Black communities (p. 1498). The root cause of the specific mistrust of healthcare system, policy, and practice can be traced to the Tuskegee Syphilis Study. Lingering effects of the Tuskegee Syphilis Study include a resistance to education and intervention related to HIV / AIDS among African-Americans. Therefore, health education related to heart disease and high blood pressure must be treated with sensitivity and awareness of this historical conflict between Black communities and healthcare, which is largely viewed as a white institution. The proposed health education program is for a neighborhood.

It is critical to focus on creating positive ties between healthcare workers and community leaders. Positive perceptions of healthcare as a social institution can come from developing trust. I would want to work with persons in the role of enabler and nurturer, to help activate the positive perceptions necessary to promote health-seeking behaviors among African-American men. "Positive experiences, trust in the clinician, and empathy improve patient motivation and satisfaction." (Chobanian, Bakris, Black…et al., 2003 p. 1206). Nurturers and enablers in the community include preachers and other religious figures, businesspersons and respected members of the community, and social leaders ranging from barbers to teachers. As cultural bridges between the healthcare establishment and community members, the nurturers and enablers will help to reframe healthcare and shape positive attitudes and perceptions. This will in turn make health education easier because there will be much less resistance and mistrust of the information. We need to overcome the deep-rooted mistrust that causes conspiracy theories like those described by Thomas & Quinn (1991).

The health education program is built on principles of cultural empowerment. We want to reinforce ideas that Black individuals and communities can take control of their own health, and engage more readily with preventative medicine techniques and health-seeking behaviors. Likewise we want to help community residents overcome their resistance to change, which is based on fear and mistrust. While acknowledging the reality of past injustices, it is still possible to promote trust in the current and future healthcare leaders.

Activities and habits that are linked to positive health outcomes need to be discussed, outlined, and encouraged formally. For example, there may be a community center where residents are playing sports together regularly, dancing regularly, or otherwise getting exercise. These activities promote cultural empowerment and health at the same time. Eating together in extended family groups or at parties can also be a source of cultural empowerment, but there is a need to show how to incorporate healthy eating within the culturally empowering framework. For example, traditional African-American food can be made with less oil or better quality oil. Quantities of meat can be reduced in favor of a greater variety of vegetarian side dishes. When nutrition is framed as something integral and not incompatible with culture, the men most at risk for high blood pressure are likely to view the education program as being personally meaningful to them.

Granted, there are some aspects of cultural empowerment that need to be overcome or transformed. Depending on the rates of alcohol and drug use in the community, it might be feasible to discuss these matters and show why substance abuse is not a matter of cultural empowerment but of cultural endangerment. Anger and other emotional issues might need to be addressed in a sensitive manner, because these are issues that related directly to heart health.

There are many existential issues at stake that need to be acknowledged but not changed. Spiritual values, whether Christian or otherwise, shape the worldviews and values of community members. Speaking openly about these existential issues can help ease the communication process. Leaders in the spiritual community can be called upon to serve as health role models. It is important to know what the existential framework of individuals in the community might be, so that education materials and approaches are meaningful.