Online Program

Culturally Competent Behavior Change Program Development: Designing for Underserved Populations

Tuesday, November 3, 2015 : 8:30 a.m. - 8:45 a.m.

Cindy Umanzor, M.P.H., Pro-Change Behavior Systems, Inc., South Kingstown, RI
Leanne Mauriello, Ph.D., Pro-Change Behavior Systems, Inc., South Kingstown, RI
Deborah Van Marter, M.P.H., Pro-Change Behavior Systems, Inc., South Kingstown, RI
Emma de Aguiar, B.A., Pro-Change Behavior Systems, Inc., South Kingstown, RI
Background: Cultural competency is a critical element to developing an effective behavior change program that will reach, engage, and impact target populations. Healthy Pregnancy: Step by Step, an evidence-based, iPad-delivered multiple behavior change program for underserved pregnant women, will be highlighted as a successful example of infusing cultural competency throughout research and design. 

Methods: Aspects of the multicultural plan that will be presented are 1) the careful recruitment of diverse underserved women from federally-funded health centers, 2) the process of gathering and incorporating participatory feedback from focus groups, key informant interviews, and usability interviews into all aspects of design and content, 3) careful translation into Spanish relevant for diverse Latina women, and 4) strategies to successfully retain the population in a longitudinal study.

Results: The success of the approach is demonstrated by high acceptability (89.7% to 95.5% of participants agreeing with all evaluation items), the engagement of 335 women in a RCT (65.1% Hispanic; 20.9% White, 9% Black), impressive retention with over 70% completing final follow-up, and significant reduction in overall behavior risks in the treatment group compared to usual care at 1 month (0.85 vs. 1.2 risks; OR=.70) and 4 months (0.72 vs. 0.91 risks; OR=.81) postpartum.

Conclusion: Methods grounded in cultural competency contributed to high participant engagement, acceptability, impact, and retention.  A multicultural plan assisted with the development of a program that is understanding of the needs of underserved and diverse populations. Such a plan could serve others to infuse cultural competency into their own research.

Learning Areas:

Assessment of individual and community needs for health education
Communication and informatics
Diversity and culture
Implementation of health education strategies, interventions and programs
Public health or related research
Social and behavioral sciences

Learning Objectives:
Identify cultural competency best practices and how they can be infused into all aspects of research and program development for behavior change with underserved populations. Describe how a multicultural plan is followed to develop and test a multiple behavior computer tailored program for underserved pregnant women. Discuss barriers to incorporating cultural competency into research and program development (cost, time, resources) and demonstrate ways to overcome the obstacles

Keyword(s): Cultural Competency, Underserved Populations

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the Project Manager of multiple federal funded grants focusing on smoking cessation, fruit and vegetable consumption and stress management among underserved pregnant women, preventing substance abuse among active military personnel and intervening on criminal behavior and substance abuse among juvenile offenders. As a Latina woman, my interest has been developing programs that provide culturally appropriate content and Spanish translations for Latino populations.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.