Cultural Appropriateness in Interventions for Racial and Ethnic Minorities

Eliminating racial and ethnic disparities in health is one of the two overarching goals of Healthy People 2010 and injuries are a leading cause of death for all Americans and the leading cause for those aged 1–44 years (U.S. Department of Health and Human Services [HHS], 2000). Significant disparities exist in rates of both intentional and unintentional injury; racial and ethnic population subgroups usually bear an excess burden of morbidity and/or mortality. The most highly publicized of these disparities has been violence victimization. Homicide is the leading cause of death for African Americans aged 15–34 years (Centers for Disease Control and Prevention [CDC], 2003/2004), the second leading cause of death for Hispanics aged 10–24 years, and the third leading cause of death for American Indians/Alaskan Natives and Asian/Pacific Islanders aged 10–24 (Anderson & Smith, 2003). Overall, American Indian/Alaska Native women and men report more violent victimization than any other racial/ethnic group. American Indians/Alaska Natives aged 15–24 also have the highest rates of suicide of any group in the United States (CDC, 2003/2004).

This chapter reports results from a systematic literature review of injury prevention and control interventions in racial and ethnic population subgroups. Using a recently proposed typology of strategies to enhance cultural appropriateness in health promotion programs (Kreuter, Lukwago, Bucholtz, Clark, & Sanders- Thompson, 2003), we examined studies for their use of fi ve distinct approaches: peripheral, evidential, linguistic, constituent involving, and sociocultural (see next section). The chapter describes the extent to which and how each approach is used and provides recommendations for applying these fi ndings to injury prevention and control research in racial and ethnic population subgroups.