Journal of urban health : bulletin of the New York Academy of Medicine
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Contemporary discourse contains numerous examples of use of the concept of culture by social and behavioral scientists. Simple reification, where the speaker makes culture into a thing capable of action exemplifies one usage in public discourse. Some quantitative social scientists attempt to characterize people's cultural identities by means of a single categorical variable, which often "lumps" people into categories such as "Hispanic" or "Black" that in fact have numerous culturally bounded subcategories. ⋯ Examples in which investigators make appropriate use of cultural characterizations demonstrate their utility in investigating health disparities in Haitian American women, injecting and noninjecting drug users, Hispanic youth, and adult Hispanics at risk of HIV infection. Focus on culture in the study of health disparities can identify entanglements between structural factors such as poverty and lack of education and cultural factors such as beliefs about health. Qualitative methods coupled with quantitative methods have great potential to improve investigators' grasp of cultural nuance while capturing the distribution of qualitatively derived behaviors.
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The increase in the incidence of HIV/AIDS among minorities in the United States and in certain developing nations has prompted new intervention priorities, stressing the adaptation of efficacious interventions for diverse and marginalized groups. The experiences of Florida International University's AIDS Prevention Program in translating HIV primary and secondary prevention interventions among these multicultural populations provide insight into the process of cultural adaptations and address the new scientific emphasis on ecological validity. An iterative process involving forward and backward translation, a cultural linguistic committee, focus group discussions, documentation of project procedures, and consultations with other researchers in the field was used to modify interventions. ⋯ This experience demonstrates the importance of integrating culturally relevant material in the translation process with intense focus on language and nuance. The process must ensure that the level of intervention is appropriate for the educational level of participants. Furthermore, the rights of participants must be protected during consenting procedures by instituting policies that recognize the socioeconomic, educational, and systemic pressures to participate in research.
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Comparative Study
Race/ethnicity differences in the validity of self-reported drug use: results from a household survey.
Data were analyzed from a multistage probability household survey of over 600 adults, ages 18-40 from the city of Chicago conducted during 2001-2002. The survey employed audio computer-assisted self-interviews to obtain information about drug use. To investigate race/ethnicity differences in reporting validity, drug test results were compared with self-reports of past month drug use for cocaine, marijuana, and a combined indicator of both substances. ⋯ Socioeconomic status was identified as one potential mediator. With this exception, race/ethnicity differences suggesting lower levels of marijuana and cocaine concordance for African Americans as compared with Whites were sustained after controlling for potential mediators. Methodological implications for epidemiological and health disparities research are discussed.
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This article focuses on designing and evaluating drug abuse and HIV prevention interventions for subgroups of Hispanic adolescents. It describes the need for preventive interventions designed or adapted specifically for Hispanic adolescents and offers a rationale for subgrouping Hispanic adolescents based on risk and protective factor profiles rather than demographic indices. This subgrouping method is based on intrapersonal and ecodevelopmental domains of risk and protection. Finally, the article presents methods for designing, adapting, and evaluating "flexible" interventions for use with Hispanic adolescent subgroups.