Racial and ethnic minorities in the United States face higher risks of human papillomavirus (HPV) and are less likely to benefit from HPV vaccines. Effective HPV vaccine promotion efforts need to acknowledge and adapt to the cultural characteristics of these minority groups. 

We conducted a systematic review of all the published journal articles between 2010 and 2019 and found 26 studies reporting HPV vaccine intervention among minority populations. We further analyzed these studies to see whether and how they incorporated cultural adaptation in their interventions. Here are some of main findings:

1. Almost all of these interventions involved some cultural adaptation. (Yeah!)
2. Very often the adaptations were quite superficial, including community outreach and involvement or delivering the intervention in a location or through a venue convenient to the community.
3. There is a lack of theoretically driven intervention or cultural adaptation.  Only 6 out of 26 studies mentioned behavioral or communication theories in guiding the intervention. Even though many of these studies discussed the concepts of social behavioral theories, such as efficacy, beliefs and attitudes, the majority of the researchers did not use theories to guide the design of the interventions and merely measured the aforementioned theoretical concepts as outcome variables. Consequently, it was difficult for the authors to explain why the intervention was successful or unsuccessful in creating significant improvements in the outcome variables.

Overall, we call for more comprehensive and better-designed cultural adaptations.

Zhang, X. & Tang, L. (2021). Cultural adaptation in HPV vaccine intervention among racial and ethnic minority populations: A systematic literature review. Health Education Research. Published online first. https://doi.org/10.1093/her/cyab034 [Full Text]

African Americans have a disproportionately high risk of premature death caused by cardiovascular diseases (CVDs) and related risk factors such as hypertension, high cholesterol, diabetes, and obesity.

In this study, my advisee Felicia and I used the photovoice method. Participants took pictures for a period of time about how they live with CVDs and then are were interviewed about these pictures. We asked them what each of their pictures was about, why they were important, what these pictures say about their lived experiences with CVD. Photovoice is a super interesting research method that allows participants, especially members of the marginalized group, to voice their view of the world and their experiences. Very often a picture is worth a thousand words.

Here are a couple of pictures.

This study was informed by the culture-centered approach to communication’s (CCA), which call for community-based health solutions for marginalized populations.

Here are some of the findings of the study:

Participants demonstrate tremendous agency in their efforts to adopt a healthy lifestyle and manage their heart diseases. Structural factors such as socioeconomic status, insurance, discrimination, and knowledge enable and constrain their agency. Several cultural factors, such as food culture, reluctance to see doctors, consumerism, and religiosity, mediate the relationship between structure and agency. Public health professionals and researchers can capitalize on our findings in promoting cardiovascular health among the African American communities.

York, F. & Tang, L. (2021). “Picture me heart disease free”: Understand the cardiovascular disease experiences of African Americans through a culture-centered approach. Journal of Applied Communication Research. (Published online first.) https://doi.org/10.1080/00909882.2021.1912377