Respect for Diversity

Designing Culturally-Situated Community Programs

Designing programs in the community needs to start with an understanding of the diverse cultures and communities in which they will be situated. To that end, collaborative and ecological systems approaches used by community psychologists are incorporated throughout the design of community prevention and intervention programs. Altogether, these approaches situate culture at every level of planning a program from the conceptualization to the implementation. In Case Study 8.3, Trickett provides a cautionary example of what can happen when culture is not more deeply considered in community interventions.

Case Study 8.3

Water Boiling in a Peruvian Town

In "Water Boiling in a Peruvian Town" by Ed Wellin, a three-year public health intervention was implemented to decrease the water-related health risks in Los Molinos, a rural Peruvian town. The promotion of the evidence-based practice of boiling water targeted women, with the assumption that increased knowledge about the health benefits of boiling water would persuade them to change. The intervention was delivered by a health worker who took up residence in Los Molinos and her goal was to have the women boil their water before using it. The intervention turned out to be unsuccessful - the majority of women did not start this practice, due to several factors steeped in cultural beliefs and local customs or conditions. For example, the cultural meanings of hot and cold in their culture meant that boiled water was used for certain health issues, but it was not associated with germs or diseases. Over time, boiled water was culturally linked to illness and very much disliked by the local people. The intervention's impact was also further affected by the women's inability to boil because of their daily routines, social ostracization for boiling because of the meanings of cold and hot water, and lack of interest in women's lives by the gendered town's leadership.

This case study demonstrates the significant impact of culture on well-intentioned and scientifically-based interventions meant to improve community health and well-being. For that reason, Trickett provides recommendations about how Community Psychology can contribute more to the understanding of culture in research and practice. Some of these recommendations include focusing on communities more than programs, understanding that choice is more important than change, working with local experts in the community, and using research designs and methods that are appropriate for diverse cultures and populations.

Another approach proposed by Resnicow and colleagues considers surface structure and deep structure for designing culturally-anchored community programs. Surface structure includes aspects of the program that are observable such as gender, race, and ethnicity of the staff members; setting; language(s) used; and choices of cultural components, such as music or food. Deep structure includes knowing the historical, social, and psychological aspects of the culture to understand core cultural values, beliefs, and practices. However, attending to both surface and deep structures will not guarantee the success of the program. Matching the race or ethnicity of the staff to program participants is not always enough to establish trust or resolve all cultural differences. Similarly, programs using deep structures may appeal differently to those with different acculturation statuses; therefore, more research is necessary to determine the effectiveness of these culturally anchored programs.

Overall, as our knowledge and work with diverse communities continues to expand, the culturally-situated and anchored approaches used by community psychologists will continue to be very important for designing programs. Central to this will be the evolving development of a cultural Community Psychology which incorporates theories and methods from cross-cultural and cultural psychology in research and practice.