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Section 4. Adapting Community Interventions for Different Cultures and Communities

Questions to Consider in your Search for Information about the Community

Historical Issues

  • What is the history of the community?
  • What name or names do the cultural groups use to refer to themselves?
  • What is the significance of the different names?
  • What are the major differences between cultural groups in your target community, particularly across generational, educational, socio-economic and geographic lines?
  • What have been the major historical events which describe the target group's experiences in the United States?
  • What were and are the major conflicts between or among the cultural groups in the target community? What were the outcomes?
  • What were and are the major conflicts within each group? What were the outcomes?

Economic and Political Issues

  • What are the different socio-economic levels of groups within the community?
  • What is the political status of each group in the community (e.g. undocumented, refugee, legal immigrant, citizen)?
  • What are the different literacy levels within groups? Are they literate/illiterate in English and/or their own language?
  • What are the different education levels within groups?
  • How is their health status affected by their economic and political status? What are the predominant health problems?
  • How often is medical care used by these different groups? What types of care?
  • What are the organizations that successfully serve the different groups within the target community? Are they governmental, religious, community, social service, political or ethnic in nature?

Culture and Tradition-Specific Issues

  • What are the values of the different groups in the community?
  • How do various members of each cultural group define health and illness?
  • What are some of the more common health beliefs and practices of community groups, both in general and with respect to specific problems?
  • What are the predominant family structures within the community's cultural groups? Patriarchal, matriarchal, single parent household, extended families, etc.?
  • What are some of the traditional roles of different family members in these cultural groups, particularly where health care is concerned?
  • Who are the formal and informal leaders in the community, and what role do they have in the area of health promotion?
  • How many languages and dialects are spoken?
  • What are the formal and informal channels of communication within and between different groups?

Medical Orientation

  • What are the group's general beliefs about the cause, prevention, diagnosis and treatment of disease?
  • What are the group's attitudes towards "Western" medicine?
  • In general, what has been the experience of different groups when trying to access the health care system?
  • To what extent is there use of traditional medicine or healers?
  • Where do people go for health information?


  • What are traditional foods, and what role do they play in health, religion, and social activities?
  • How has diet here in the U.S. changed over time as compared to in their country of origin?
  • Is there access to foods that constitute traditional diet? Are there acceptable substitutes?


  • What are the different religions practiced within the cultural groups in the community?
  • How is practice of their religion influenced by their culture?
  • What is the size of membership, and who are the members?
  • Who are the religious leaders, and what is their role in the larger community?
  • Are there conflicts among or within the various religious groups?
  • What involvement do various religious groups have in the area of health education and promotion?
  • Do religious beliefs conflict with the philosophy of health promotion? Can the beliefs be incorporated into your program?
Eric Wadud
Bill Berkowitz