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Community readiness as a multidimensional construct

Journal of Community Psychology
Volume 35, Issue 3, Date: April 2007, Pages: 347-365
Sarah M. Chilenski, Mark T. Greenberg, Mark E. Feinberg
ABSTRACT
Both the organizational studies literature and the community psychology literature discuss the importance of readiness when implementing change. Although each area emphasizes different characteristics, several common themes are present within the literature. The current study integrates and applies organizational and community psychology literature in evaluating community readiness in the context of a school-community-university collaborative prevention model. Results demonstrate (a) that there is substantial agreement between members of community prevention teams on the level of readiness of a community; (b) that readiness is a cohesive, but multidimensional, construct related to hypothesized community and individual characteristics; and (c) that there is small to moderate agreement between members of prevention teams and their agency directors. These results support the notion that clear theories of change need to be formulated before deciding how to assess community readiness, as assessments will vary due to several factors: the type of respondent, the level in which analyses are conducted, and the specific community domain (i.e., school, workplace collaboration, collaboration experience) investigated. © 2007 Wiley Periodicals, Inc.

Assets and obstacles in community leadership

Journal of Community Psychology
Volume 26, Issue 3, Date: May 1998, Pages: 269-280
Eneiza Hernandez
ABSTRACT                                                                                                                                                                                                                                                                                      
This article analyzes the achievements made in developing community leadership in rural areas. The dimensions considered in our analyses included empowerment, production, training, and the organization of social action. The work succeeded in developing participatory activities in which the community's members became actively involved in projects that led to positive changes in their living conditions. This work also led to the emergence, from within those communities, of a group of members whose leadership facilitated change within their community. How those leaders identified and confronted specific obstacles related to the way the leaders and members of the communities defined leadership. © 1998 John Wiley & Sons, Inc.

Providing services in remote and rural Australian communities

Journal of Community Psychology
Volume 25, Issue 2, Date: March 1997, Pages: 209-226
Lindsay Gething
ABSTRACT
A needs analysis was conducted of people with disabilities living in remote and rural areas of New South Wales (NSW), Australia. The nature o f service provision generated the widest range of comments during data collections which were conducted through consultations, interviews, and field trips. This paper integrates issues raised in the literature about the nature of work in rural and remote areas with information gathered from service providers and consumers working in country areas of NSW. Clients or consumers (people with disabilities, their families, and care-providers) reported many negative encounters with services. Many service providers said that they were working under difficult conditions and felt that they did not obtain adequate support or recognition from their organizations. Many city-based agencies had given little attention to the appropriateness of their services within remote and rural areas. Other agencies were aware of deficits but were unclear as to how to address them. The article closes with a discussion of action-oriented strategies designed to address issues associated with the nature of work in Australian rural and remote areas. © 1997 John Wiley & Sons, Inc.

Civic participation and the development of adolescent behavior problems

Journal of Community Psychology
Volume 35, Issue 6, Date: August 2007, Pages: 761-777
Alessio Vieno, Maury Nation, Douglas D. Perkins, Massimo Santinello
ABSTRACT
This study assessed the links between civic participation and adolescent behavior problems (bullying, physical fighting, and alcohol and tobacco use), and whether civic engagement could be a moderator of the negative effects of parent/family detachment. Participants were 7,097 11-, 13-, and 15-year-olds (48.6% girls) in a region of Northern Italy. Twenty percent were involved in some level of civic participation, the majority of which was faith-based. Results showed that adolescents who are involved in civic associations reported slightly less fighting and alcohol and tobacco use, but this relationship varies by sex, age, detachment from parents and family, and the frequency of adolescent participation. For the sample as a whole, a U-shaped relationship was found between civic participation and behavior problems, with the fewest behavior problems associated with moderate frequency of participation (1 to 4 times per week). The expected hypothesis that civic participation moderates the relationship between parent/family detachment and problem behaviors was suggested only for 15-year-old girls but not for younger girls or for boys. Implications for preventive interventions are discussed. © 2007 Wiley Periodicals, Inc. J Comm Psychol 35: 761-777, 2007.

Community organizing and advocacy: Increasing the quality and quantity of mentoring programs

Journal of Community Psychology
Volume 34, Issue 6, Date: November 2006, Pages: 781-799
Abraham Wandersman, E. Gil Clary, Janet Forbush, Susan G. Weinberger, Shawn M. Coyne, Jennifer L. Duffy
ABSTRACT
Although youth mentoring programs are widespread, it is clear that there is a great need to increase their quality and quantity. This article provides background on funding initiatives in mentoring, and the role of community organizing and advocacy in influencing the demand for programs. A model that examines the community's role in influencing and coordinating key stakeholder groups in planning, implementing, and sustaining programs is proposed. The need for more effective programs is examined in a second model, which relates the capacity of organizations, staff, and programs for training and technical assistance to the quality and efficacy of their programs. Recommendations for future research are made. © 2006 Wiley Periodicals, Inc.

School-linked mental health interventions: Toward mechanisms for service coordination and integration

Journal of Community Psychology
Volume 21, Issue 4, Date: October, 1993, Pages: 309-319
Howard  S. Adelman                                                                                                                                                                                                                                                                                                ABSTRACT                                                                                                                                                                                                                                                                                                                              Despite increasing activity aimed at integrating health and social services and linking them to schools, little attention has been paid to the mechanisms that must be created to accomplish this policy direction. The purpose of this paper is to highlight briefly (1) concern about inadequate interfacing among programs and (2) specific tasks and mechanisms for coordination (and eventual integration) of school-linked programs. It is suggested that community psychologists can play an important role by helping clarify essential system tasks and mechanisms and how to address these needs through judicious redeployment of existing resources.

Theory and practice in matching treatment to the special characteristics and problems of cuban immigrants

Journal of Community Psychology
Volume 21, Issue 4, Date: April, 1978, Pages: 112-122                                                                                                                                                                                                             
José Szapocznik,Mercedes A. Scopetta, Olga E. King                                                                                                                                                                                                   
ABSTRACT                                                                                                                                                                                                                                                                                       Mutuality of patient-therapist expectations for treatment can be attained by adapting treatment to the special characteristics and focusing treatment on the unique problems of client populations. Culturally sensitive treatment is defined as a treatment mode built on a set of therapeutic assumptions that complements the patients' basic value structure. The implications for treatment of the Cuban immigrants' preference for lineality in interpersonal relationships, a present-time orientation, a doing activity orientation, and subjugation to natural and environmental conditions are discussed. Acculturation problems facing Cuban immigrant families and their implications for treatment are also discussed. The authors conclude that Ecological Structural Family Therapy is a treatment of choice for acculturation-related dysfunctions of Cuban immigrant families.

Burnout among volunteers in the social services: The impact of gender and employment status

Journal of Community Psychology
Volume 34, Issue 5, Date: September 2006, Pages: 541-561
Liat Kulik
ABSTRACT
This study examines whether gender and employment status affect burnout, motives for volunteering, and difficulties associated with volunteer activity in social and community services in Israel. The sample included 375 men and women aged 16 through 80. Participants were divided into four groups by employment status: high school students, employed persons, retirees, and unemployed persons. The findings revealed that employment status had a more significant impact on the research variables than did gender. Burnout correlated positively with difficulty in relations with beneficiaries among men, and with difficulty in relations with the provider organization among women. Female students and unemployed men were found to be particularly vulnerable to burnout. © 2006 Wiley Periodicals, Inc.

Defining the nature of participation in rural Australian communities: A qualitative approach

Journal of Community Psychology
Volume 30, Issue 6, Date: November 2002, Pages: 635-646
Sheridan J. Coakes, Brian J. Bishop
Abstract
Within the literature, theories and analyses of social involvement or participation have focused primarily on the political and formal role of participation within the community or neighborhood. This study illustrates, through qualitative inquiry, that within small rural communities, individuals find it difficult to separate formal and informal participation, when both have an equally important role to play in community life. Fifty-five structured interviews were conducted with women across six rural shires in the southwest region of Western Australia. Qualitative analysis revealed that approximately 50% of women, when asked about their involvement in their community, referred initially to their informal participation within the community, rather than their participation in formal community groups or associations. These results are discussed in relation to life in small rural towns. © 2002 Wiley Periodicals, Inc.

Community-based prevention using simple, low-cost, evidence-based kernels and behavior vaccines

Journal of Community Psychology
Volume 32, Issue 5, Date: September 2004, Pages: 575-591
Dennis D. Embry
ABSTRACT
A paradox exists in community prevention of violence and drugs. Good research now exists on evidence-based programs, yet extensive expenditures on prevention have not produced community-level results. Various multiproblems are quite prevalent in the United States, such as violence, Attention Deficit Hyperactivity Disorder (ADHD), conduct problems, learning disabilities, depression, and other mood problems. Various studies have observed that intuitively appealing community-based coalitions and best practice requirements have not produced prevention gains as hoped for by many. Calls for more money, fidelity, or dose seem unlikely to succeed. Other alternatives may be possible. Most of the best practices aimed at preventing these community problems are composed of evidence-based kernels, which act on core principles of prevention (risk and protective factors). What is not widely known is that the evidence-based kernels are powerful in their own right. Evidence-based kernels are irreducible units of behavior-change technology, and they can be put together into behavioral vaccines (daily practices) with powerful longitudinal prevention results. Kernels and behavioral vaccines are simple, and they are not programs or curriculum in the conventional sense. This article presents examples of evidence-based kernels and behavioral vaccines that can be promoted easily across whole communities or states using social marketing principles. Widespread propagation of evidence-based kernels and behavioral vaccines could have a significant impact on communities and their prevention norms, providing low-cost alternatives and practical models for community psychology, public health, and policy makers. Behavioral kernels and vaccines can add needed precision to prevention science and community psychology. © 2004 Wiley Periodicals, Inc. J Comm Psychol 32: 575-591, 2004.

Models of practice in community in Brazil: Possibilities for the psychology-community relationship

Journal of Community Psychology
Volume 26, Issue 3, Date: May 1998, Pages: 261-268
Maria de Fatima Quintal de Freitas
ABSTRACT
This article deals with practices which have characterized community work by psychologists in Brazil since the 1960s. It describes the changes that have happened in such work and connects them to transformations in the nature of the practices that have developed such as political militancy, services to the underprivileged, and institutionalization of community work by the State. Invoking strictly psychological reasons to explain the phenomenon investigated, some implications affecting community work are pointed out, as well as those that attribute to sociopolitical aspects the basic responsibility for the problems suffered by the population. It is argued that the work developed in communities should be analyzed from two perspectives: one related to the procedures used and a second related to identification of the theoretical- philosophical principles guiding those practices. The practice of community social psychology would then be based on work guaranteeing a specific professional identity to psychologists, while using techniques consistent with the historical-social view of the problems experienced by the population and producing a specific impact on their daily lives. © 1998 John Wiley & Sons, Inc.

A Native American community's involvement and empowerment to guide their children's development in the school setting

Journal of Community Psychology
Volume 34, Issue 4, Date: July 2006, Pages: 435-451
Héctor H. Rivera, Roland G. Tharp
ABSTRACT
This study provides an empirical description of the dimensions of community values, beliefs, and opinions through a survey conducted in the Pueblo Indian community of Zuni in New Mexico. The sample was composed of 200 randomly chosen community members ranging from 21 to 103 years old. A principal component factor analysis was conducted, as well as a multivariate analysis of variance, to explore gender, age, education, language, and socioeconomic (SES) differences on values, beliefs, and opinions from survey participants. Overall, the findings suggest a strong agreement by the community on the direction to be taken by their school district in their efforts to improve classroom instruction, as well as in their efforts to guide their children's development as Native Americans. © 2006 Wiley Periodicals, Inc.

Communities isn't just about trees and shops : students from two South African universities engage in dialogue about community and community work

Journal of Community & Applied Social Psychology
Early View
Poul Rohleder, Leslie Swartz, Ronelle Carolissen, Vivienne Bozalek, Brenda Leibowitz
ABSTRACT
The question of what constitutes a community or even the community takes on an extra salience in a divided society such as South Africa where the entire environment remains imprinted with the legacy of enforced segregation along racial lines. Higher education institutions need to prepare emerging health and social service students for the world of practice in a context of diversity, continuing segregation and marked inequality. As one step to helping students deal with working in a divided society, academic departments from two different South African universities have been involved in a collaborative teaching and research project. Fourth year psychology and social work students from the two universities took part in a collaborative, practical course which formed part of their curricula. In this course, students were given the opportunity to engage with the notion of community and community work with each other. The students came from diverse racial, class and political backgrounds, and by engaging with one another as they did, had the opportunity to visit worlds they have rarely had access to. While this course was able to achieve a broadening awareness among students from different backgrounds about the notion of community, it will take both more engagement with courses of this kind, and a continuing history of change in South Africa, for students to feel more comfortable in transcending both physical and psychological boundaries. Copyright © 2007 John Wiley & Sons, Ltd.

Reflections on practice: Ethics, race, and worldviews

Journal of Community Psychology
Volume 30, Issue 6, Date: November 2002, Pages: 611-621
Brian J. Bishop, David Higgins, Francis Casella, Natalie Contos
Abstract
Two case studies involving Indigenous Australians are described, which pose ethical and conceptual problems. Over two decades ago Sarason (1972) gave the warning that we are socialized into a culture so well that our interventions can be ineffective or misguided unless we attempt to come to grips with history and the broader social context. Understanding worldviews of both the targeted community and ourselves is imperative if we are going to do more good than harm. The two case studies involve White practitioners working with Indigenous people, and as such, bring into sharp relief the ethical issues and worldviews of those involved. Reflection on the process of intervention provides a mechanism for insight into informed practice and the development of professional knowledge and theory. © 2002 Wiley Periodicals, Inc.

Appreciative inquiry as a mode of action research for community psychology

Journal of Community Psychology
Volume 35, Issue 8, Date: November 2007, Pages: 1019-1036
Neil M. Boyd, David S. Bright
ABSTRACT
In this article, the authors highlight the potential for rethinking approaches to community and social change interventions that draw on participatory action research at the organizational and community level. They distinguish problem-centric from opportunity-centric approaches to social change. Theory on social norms suggests that problem-centric approaches work with the momentum of norms without substantively changing them. By contrast, opportunity-centric approaches have the potential to reframe and dramatically shift organizational and community norms. Appreciative inquiry (AI), a growing practice in organization development, is presented as an example of opportunity-centric change that induces innovation and collaboration through participatory methods. It is distinct from other methods that focus on resolving problems in organizations. The authors illustrate how an AI Summit, a large-scale inquiry designed with four phases: Discover, Dream, Design, and Destiny, can assist in an opportunity-centric process. They conclude by describing how opportunity-centric methodologies like AI fit well with the tenets and concerns of community psychologists. © 2007 Wiley Periodicals, Inc. J Comm Psychol 35: 1019-1036, 2007.

A media-based stress management intervention

Journal of Community Psychology
Volume 17, Issue 2, Date: April 1989, Pages: 155-165
Leonard A. Jason, Thomas Curran, Daniel Goodman, Michael Smith
ABSTRACT
From May 5th to May 16th. 1986, WGN Channel 9, a Chicago-based television station, joined with the Chicago Lung Association, Pru-Care Health Maintenance Organization, and True Value hardware stores in producing a stress management program. The program was aired daily for 2 weeks on both the noon and 9:00 p.m. news. One hundred-seventy thousand manuals entitled Success Over Stress were distributed to the public. The manuals could be obtained for free at any of the over 300 True Value hardware stores in the Chicagoland area. The manuals were designed to help viewers follow the day-to-day TV broadcasts and to provide supplementary exercises and activities. The daily broadcasts featured the following components: defining stress; describing the body's response to stressors; identifying major life stressors; assessing one's social support network; and showing a variety of behavioral, cognitive, and psychological coping strategies for dealing with stress. Data from a sample of viewers interviewed before and after the broadcast indicated that many of the modeled coping strategies were tried and that significant improvements in several adjustment measures were achieved. Those viewers who experienced more serious life stressors benefitted most from the program.

A Longitudinal study of mental health consumer/survivor initiatives: Part 4 - Benefits beyond the self? A quantitative and qualitative study of system-level activities and impacts

Journal of Community Psychology
Volume 34, Issue 3, Date: May 2006, Pages: 285-303
Rich Janzen, Geoffrey Nelson, John Trainor, Joanna Ochocka
ABSTRACT
The purpose of this article is to report on the system-level findings of a longitudinal study of four mental health consumerñrun self-help organizations. Quantitative and qualitative data revealed that staff and members of the four Consumer/Survivor Initiatives (CSIs) participated actively in system-level activities, including community planning, public education, advocacy, and action research. The qualitative data revealed a number of perceived system-level outcomes related to these activities: (1) changes in perceptions (changed perceptions of the public and mental health professionals about mental health or mental illness, the lived experience of consumer/survivors, the legitimacy of their opinions, and the perceived value of CSIs) and (2) concrete changes (tangible changes in service delivery practice, service planning, public policy, or funding allocations). These findings are discussed in the context of previous work on system-level activities and impacts of consumer/survivor organizations. © 2006 Wiley Periodicals, Inc.

Community transaction analysis as a community-oriented research tool

Journal of Community Psychology
Volume 3, Issue 4, Date: October 1975, Pages: 358-364
Marie Doyle, Audrey A. Brown
ABSTRACT
The CTA was designed as a community-oriented research tool to assess the levels of three variables within and between communities. Viability (self-serving activities), Economic Exchange, and Cohesiveness (community-linking activities) measures were obtained from rural and urban communities in Alaska. Data collection was predominantly carried out by high school students from the communities surveyed, following a brief meeting on purpose, method, and practice with the CTA. Subjects translated their interpersonal transactions of the last 72 hours into the 18 CTA categories specified on individualized data collection sheets. Consistently different patterns of interaction were found for city dwellers and villagers; atypical patterns were obtained for Jaycees. Senior Citizens, the Chemically Dependent and Working versus nonworking women. Average values for V, E, and C for city dwellers were 3.5, 3.0, and 1.0, respectively. Villagers were higher in Viability than city dwellers, lower in Economic Exchange, and similar in Cohesiveness. In comparison, Senior Citizens dwelling in an urban area rate significantly lower than the general population on all three dimensions. This was attributed to the financial and physical limitations upon interaction among this population. Chemically Dependent individuals were found to rate significantly lower than the general population on the Viability dimension, indicating that drug dependency militates against having many and varied interests. Conversely, a group involved in the business community and in community action, the Jaycees, showed predictably higher interaction scores in Economic Exchange and Cohesiveness than the general population. Nonworking women scored near average V and C scores, but rated lower on Cohesiveness, as opposed to working women who scored average on E and C, but significantly lower on V. These results indicate that nonworking women were less involved than the general population as a whole in community-linking activities, whereas working women had few opportunities to engage in self-serving activities. High school students who collected CTA data were found to be valuable and effective research assistants. The CTA data provides normative data with which to compare atypical groups; such information can be used to initiate behavior change.

Faith-placed parenting intervention

Journal of Community Psychology
Volume 36, Issue 1, Date: January 2008, Pages: 74-80
Megan E. Patrick, Brittany L. Rhoades, Meg Small, J. Douglas Coatsworth
ABSTRACT
Collaboration with religious institutions is recommended as a frontier for prevention science. Little is known about the effectiveness of programs currently disseminated by churches. This pilot program investigated potential advantages and disadvantages of university collaborations in faith settings, by implementing the Staying Connected with Your Teen parenting program (N=13 parents) in a single congregation. The mixed-method assessment included surveys, a focus group, and observation to gather information about implementation. Meeting time, location, parallel youth programming, endorsement by trusted leaders, and use of existing social networks were indicated by past research and described by participants as potential advantages to an evidence-based program implementation in faith communities. © 2007 Wiley Periodicals, inc.

Community response to homelessness: Social change and constraint in local intervention

Journal of Community Psychology
Volume 20, Issue 1, Date: January 1992, Pages: 72-83
David A. Dowell, Gail Farmer
ABSTRACT
This report describes an action-research project which contributed to mobilizing a community to respond to homelessness in a large Southern California city. The project involved collaboration among a city-sponsored Task Force, a grass-roots coalition, and a university. The project core was a needs assessment which served as a basis for advocacy by the Task Force and a coalition of service providers and citizens. Empirical findings are reported along with political impacts including the ultimate fate of recommendations adopted by city government. An analysis of factors constraining policies relating to homelessness at the level of mid-size municipalities suggests that advocacy strategies must link local efforts with regional, state, and/or national levels to be effective. This conclusion, if valid and general, has significant implications for the theory and practice of community psychology.

Can't have one without the other: Mental health providers and community parents reducing barriers to services for families in urban poverty

Journal of Community Psychology
Volume 35, Issue 4, Date: May 2007, Pages: 435-446
Stacy L. Frazier, Jaleel Abdul-Adil, Marc S. Atkins, Tamara Gathright, Maudette Jackson
ABSTRACT
University-community partnerships are widely recognized as critical to the success of community research and advocacy work but difficult to form and sustain. This article will describe a unique facet of that partnership, namely the collaboration between mental health clinicians and community consultants, a partnership that our data suggest was a cornerstone of our school-based mental health service program called PALS, an ecological model designed to engage African American families living in urban poor communities in mental health services. The service model was designed to promote children's learning and positive behavior through supporting teachers and encouraging parental involvement in school. In PALS, parent representatives from the community and clinicians from the university worked together in school-based teams to support children, families, and teachers. This article will discuss the evolution of our clinician-consultant partnership and several lessons that emerged regarding the incorporation of community members into the world of academia, research, and mental health service delivery. © 2007 Wiley Periodicals, Inc. J Comm Psychol 35: 435-446, 2007.

Implementing a community intervention to reduce young people's risks for getting HIV: Unraveling the complexities

Journal of Community Psychology
Volume 32, Issue 2, Date: March 2004, Pages: 145-165
Maretha J. Visser, Johan B. Schoeman
ABSTRACT
The ineffectiveness of community-based interventions can often be traced to problems that occur during implementation. In this study, we outline the implementation of a human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) prevention program in an educational setting in South Africa. An action research approach was used in the implementation of the intervention and a process and outcome evaluation, integrating qualitative and quantitative research methods, was made. The research illustrated the various levels of interaction in the community and the complexity of the processes involved in the implementation of interventions to facilitate community change. Social ecological theory, systems theory, and the social constructional approach are used to clarify the complexities of the implementation of community interventions. © 2004 Wiley Periodicals, Inc. J Comm Psychol 32: 145-165, 2004.

Installing the communities that care prevention system: implementation progress and fidelity in a randomized controlled trial

Journal of Community Psychology
Volume 36, Issue 3, Date: April 2008, Pages: 313-332
Rose K. Quinby, Koren Hanson, Blair Brooke-Weiss, Michael W. Arthur, J. David Hawkins, Abigail A. Fagan
ABSTRACT
This article describes the degree to which high fidelity implementation of the Communities That Care (CTC) prevention operating system was reached during the first 18 months of intervention in 12 communities in the Community Youth Development Study, a 5-year group randomized controlled trial designed to test the efficacy of the CTC system. CTC installation in these communities included the delivery of six CTC trainings from certified CTC trainers at each site, the active involvement of locally selected and community-based CTC community coordinators, ongoing monitoring of progress using the CTC milestones and benchmarks, and proactive technical assistance and coaching. CTC implementation fidelity ratings averaged across three groups of raters show that between 89% and 100% of the CTC milestones in the first four phases of CTC implementation were completely met or majority met in the 12 intervention communities, indicating that the first four phases of the CTC system have been well implemented in the communities in this trial. © 2008 Wiley Periodicals, Inc.

Addressing cultural sensitivity in a smoking cessation intervention: Development of the Kick It at Swope project

Journal of Community Psychology
Volume 29, Issue 4, Date: July 2001, Pages: 447-458
Kari Jo Harris, Jasjit S. Ahluwalia, Kolawole S. Okuyemi, Janice R. Turner, Malaika N. Woods, Cathy L. Backinger, Ken Resnicow
Abstract
There are marked and growing disparities in the health status among different racial/ethnic groups. Most researchers and practitioners agree health interventions that are tailored for specific populations are ethically important and more likely to succeed, yet there are few models for how to tailor interventions. This article outlines three phases and eight activities conducted to increase the cultural sensitivity of a clinical trial assessing the efficacy of bupropion for smoking cessation among African Americans. Early in the project development (Phase I) a strong partnership was built with a community-based clinic, two Advisory Boards were formed (Community and Scientific), and materials were developed. Formative research (Phase II) included a survey to assess smoking cessation needs of clinic patients and exploratory focus groups. Through pilot testing (Phase III), clinic patients tested the intervention components and, in follow-up focus groups, discussed their experiences. Over 13 months the project successfully recruited 523 African Americans into a randomized trial, and preliminary analysis suggest acceptable follow-up rates. Successful recruitment and retention suggests the activities are promising and potentially generalizable. Discussions of these activities illustrate concrete steps researchers and practitioners can take to increase the cultural sensitivity of health promotion and prevention interventions and clinical trials. © 2001 John Wiley & Sons, Inc.

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