by Jacoba Poppleton

How teaching Latino men’s health education through fictional drama can take the real drama out of health care.

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Negotiating the healthcare system is a difficult task: understanding medical jargon and figuring out what medical problems are serious and need attention and which can be safely ignored can be a conundrum.

But what if the consumer, due to ethnicity and immigrant status, encounters additional barriers like poverty or lack of education? How can consumers understand healthcare if they don’t speak the language?

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USU professors Julie Gast and Terry Peak are researching the best ways to disseminate healthcare education to the 48 million Latinos in the United States, who, due to cultural and socio-economic barriers, are a difficult audience to reach. Health education must match the audience and cannot be taught the same way to every group.

Gast and Peak are investigating the best way to get the word out about some fundamental health concerns. Using established research on the efficacy of church-based health education, a model that has been very successful in teaching church-going African-American women ways to improve their health, Gast and Peak began reaching out to Latinos, the largest minority group in Cache Valley, Utah. Gast and Peak’s research on Latino men in Cache Valley soon taught them that church-based heath education is not the best way to reach this group, as it had been in the past for other minority groups, African American women, for example.

Gast, who had previously conducted research specifically on church-sponsored health education for women, applied with Terry Peak for a USU faculty seed grant to expand her research and focus primarily on Latino men.

Using the data collected in focus groups of Latino men in Cache Valley, Gast and Peak learned that Latino men are easiest to reach through wives and other family members, who are more likely to pay attention to health issues. Gast and Peak soon learned, however, that cost of care is only one of the barriers to effective use of health information. Cultural influences, in fact, can have a bigger impact on health care education and utilization.

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Machismo, for example, is a familiar concept that was identified in the research conducted by Gast and Peak and is prevalent throughout the Latino culture. Machismo maintains that Latino men are supposed to act hyper-masculine, which can mean that disseminating knowledge about men’s health education is a more complex problem than simply identifying affordable health care resources. Machismo for Latino men, then, influences their health behaviors as it has an effect on a variety of culturally held values, including taking charge of their health and planning for the future.

Latino men’s health education is a complicated problem. “Latino men are influenced by culturally-held values, machismo, for example, which influence them to live in the Now,” said Peak.

“Machismo behaviors include risky behaviors, such as not participating in preventive care for health problems like high blood pressure or taking the proper precautions to prevent pregnancy or the transfer of STDs.”

Gast and Peak learned from their research that coupling machismo with the immigrant status of many Latinos increased their likelihood to avoid seeking out preventive health care options. Preventive care isn’t possible when a heath needs assessment can’t be done because of lack of access to appropriate services or the lack of interest in prevention.

But there is hope. Gast and Peak are in the midst of a developing a creative plan to disseminate information to Latino men in the community. Using the results collected during the faculty seed grant focus groups, Gast and Peak have proposed an NIH grant to develop a program they think will work. And, if their plan is successful, Latino men and women everywhere will have better access to heath education through non-traditional, but culturally-appropriate, means.

The plan is to teach health education through a non-traditional, but highly accessible, means of communication. Using the novella, or Latin soap opera, they will create and distribute programs with a “health theme” available via the Internet. The novellas could focus on topics such as condom and birth control use, or high blood pressure screenings and are designed as an entertaining teaching medium, depending on the communities’ health needs. Using the Internet as a distribution source, these novellas will be freely available and will help begin a conversation among a group that moves past the Now and the machismo-laden cultural script into something more effective to benefit the group as a whole.

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Because Latinos are computer-savvy, despite disparities in income and education, and because they are able to access the Internet, computer literacy will become an asset. And this, according to Gast, creates an opportunity for the easy dissemination of health knowledge to groups previously unreached.

In the meantime, Gast, an associate professor of health education, and Peak, an associate professor of social work, are working with different community groups to package already existing health education information in a way that is more accessible through language translation of important health information and distribution at community health fairs and clinics.

“Now is the time to focus on men’s health issues,” said Gast. “People are beginning to understand that there are inequities in men’s health in the same way there have been for women’s health in the past. Through this new education model, we hope to begin a conversation about preventative care and planning for the future.”

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Sidebar: The Challenge of Latino Men’s Health