Adapting health-risk communication to the specific cultural contexts of diverse populations : an assessment of malaria-treatment programs in Liberia

Drawing on theories of technical communication, rhetoric, literacy, language and culture, and medical anthropology, this dissertation explores how local culture and traditions can be incorporated into health-risk-communication-program design and implementation, including the design and dissemination of health-risk messages. In a modern world with increasing global economic partnerships, mounting health and environmental risks, and cross-cultural collaborations, those who interact with people of different cultures have “a moral obligation to take those cultures seriously, including their social organization and values” (Hahn and Inhorn 10). Paradoxically, at the same time as we must carefully adapt health, safety, and environmental-risk messages to diverse cultures and populations, we must also recognize the increasing extent to which we are all becoming part of one, vast, interrelated global village. This, too, has a significant impact on the ways in which healthcare plans should be designed, communicated, and implemented. Because communicating across diverse cultures requires a system for “bridging the gap between individual differences and negotiating individual realities” (Kim and Gudykunst 50), both administrators and beneficiaries of malaria-treatment-and-control programs (MTCPs) in Liberia were targeted to participate in this study. A total of 105 people participated in this study: 21 MTCP administrators (including designers and implementers) completed survey questionnaires on program design, implementation, and outcomes; and 84 MTCP beneficiaries (e.g., traditional leaders and young adults) were interviewed about their knowledge of malaria and methods for communicating health risks in their tribe or culture. All participants showed a tremendous sense of courage, commitment, resilience, and pragmatism, especially in light of the fact that many of them live and work under dire socioeconomic conditions (e.g., no electricity and poor communication networks). Although many MTCP beneficiaries interviewed for this study had bed nets in their homes, a majority (46.34 percent) used a combination of traditional herbal medicine and Western medicine to treat malaria. MTCP administrators who participated in this study rated the impacts of their programs on reducing malaria in Liberia as moderately successful (61.90 percent) or greatly successful (38.10 percent), and they offered a variety of insights on what they might do differently in the future to incorporate local culture and traditions into program design and implementation. Participating MTCP administrators and beneficiaries differed in their understanding of what “cultural incorporation” meant, but they agreed that using local indigenous languages to communicate health-risk messages was essential for effective health-risk communication. They also suggested that understanding the literacy practices and linguistic cultures of the local people is essential to communicating health risks across diverse cultures and populations.

Becoming most fully ourselves : gender, voice, and ritual in dissertations

The writing and defense of the dissertation serve both as demonstration one is able to do the work of a scholar and as a rite of initiation. In contrast to much academic writing, dissertations generally adhere to narrowly conceived notions of academic discourse. I explore this within the context of an academic community in which under-representation remains a serious issue. This dissertation is about women writing dissertations. I draw from conversations with fifteen women, in or beyond, the process; friends’ anecdotes; published accounts; and, autobiographically, my experience. I suggest the dissertation’s initiatory role is at least as important as its scholarly role; during the process one establishes a sense of self as scholar, writer, and researcher. Students come to the dissertation with some notion of self as writer and scholar – a culturally negotiated sense that is more, or less, congruent with the culturally established self required for successful completion of the dissertation. The degree of congruence (or alternatively, harmony and dissonance) shapes the process of doing a dissertation. I argue that both the community and the language in which dissertations must generally be written are gendered masculine. Negotiating a voice that is acceptable in a dissertation while maintain fidelity to a sense of who one is seems more problematic as one’s distance from the center of dominant culture increases. Believing that agency lies in altering the reiteration of such processes, I worked with my committee to find ways to alter the process yet still do a dissertation I write in a variety of voices – essay and poetry as well as analytical – play with visual qualities of text, and experiment with non-verbal interpretations. These don’t exhaust possibilities, but do give a sense of how the rich variety of expression found in academe cam be brought into the dissertation. I thus demonstrate that one need not reconstitute herself through characteristic academic discourse in order to be initiated into the community of scholars. I suggest both the desirability of encouraging flexibility in the language, form, and process, of dissertations, and the theoretical necessity for such flexibility if the academic community is to become diverse. The writing and defense of the dissertation serve both as demonstration one is able to do the work of a scholar and as a rite of initiation. In contrast to much academic writing, dissertations generally adhere to narrowly conceived notions of academic discourse. I explore this within the context of an academic community in which under-representation remains a serious issue. This dissertation is about women writing dissertations. I draw from conversations with fifteen women, in or beyond, the process; friends’ anecdotes; published accounts; and, autobiographically, my experience. I suggest the dissertation’s initiatory role is at least as important as its scholarly role; during the process one establishes a sense of self as scholar, writer, and researcher Students come to the dissertation with some notion of self as writer and scholar – a culturally negotiated sense that is more, or less, congruent with the culturally established self required for successful completion of the dissertation. The degree of congruence (or alternatively, harmony and dissonance) shapes the process of doing a dissertation. I argue that both the community and the language in which dissertations must generally be written are gendered masculine. Negotiating a voice that is acceptable in a dissertation while maintain fidelity to a sense of who one is seems more problematic as one’s distance from the center of dominant culture increases. Believing that agency lies in altering the reiteration of such processes, I worked with my committee to find ways to alter the process yet still do a dissertation I write in a variety of voices – essay and poetry as well as analytical – play with visual qualities of text, and experiment with non-verbal interpretations. These don’t exhaust possibilities, but do give a sense of how the rich variety of expression found in academe cam be brought into the dissertation. I thus demonstrate that one need not reconstitute herself through characteristic academic discourse in order to be initiated into the community of scholars. I suggest both the desirability of encouraging flexibility in the language, form, and process, of dissertations, and the theoretical necessity for such flexibility if the academic community is to become diverse. The writing and defense of the dissertation serve both as demonstration one is able to do the work of a scholar and as a rite of initiation. In contrast to much academic writing, dissertations generally adhere to narrowly conceived notions of academic discourse. I explore this within the context of an academic community in which under-representation remains a serious issue. This dissertation is about women writing dissertations. I draw from conversations with fifteen women, in or beyond, the process; friends’ anecdotes; published accounts; and, autobiographically, my experience. I suggest the dissertation’s initiatory role is at least as important as its scholarly role; during the process one establishes a sense of self as scholar, writer, and researcher Students come to the dissertation with some notion of self as writer and scholar – a culturally negotiated sense that is more, or less, congruent with the culturally established self required for successful completion of the dissertation. The degree of congruence (or alternatively, harmony and dissonance) shapes the process of doing a dissertation. I argue that both the community and the language in which dissertations must generally be written are gendered masculine. Negotiating a voice that is acceptable in a dissertation while maintain fidelity to a sense of who one is seems more problematic as one’s distance from the center of dominant culture increases. Believing that agency lies in altering the reiteration of such processes, I worked with my committee to find ways to alter the process yet still do a dissertation I write in a variety of voices – essay and poetry as well as analytical – play with visual qualities of text, and experiment with non-verbal interpretations. These don’t exhaust possibilities, but do give a sense of how the rich variety of expression found in academe cam be brought into the dissertation. I thus demonstrate that one need not reconstitute herself through characteristic academic discourse in order to be initiated into the community of scholars. I suggest both the desirability of encouraging flexibility in the language, form, and process, of dissertations, and the theoretical necessity for such flexibility if the academic community is to become diverse. The writing and defense of the dissertation serve both as demonstration one is able to do the work of a scholar and as a rite of initiation. In contrast to much academic writing, dissertations generally adhere to narrowly conceived notions of academic discourse. I explore this within the context of an academic community in which under-representation remains a serious issue. This dissertation is about women writing dissertations. I draw from conversations with fifteen women, in or beyond, the process; friends’ anecdotes; published accounts; and, autobiographically, my experience. I suggest the dissertation’s initiatory role is at least as important as its scholarly role; during the process one establishes a sense of self as scholar, writer, and researcher Students come to the dissertation with some notion of self as writer and scholar – a culturally negotiated sense that is more, or less, congruent with the culturally established self required for successful completion of the dissertation. The degree of congruence (or alternatively, harmony and dissonance) shapes the process of doing a dissertation. I argue that both the community and the language in which dissertations must generally be written are gendered masculine. Negotiating a voice that is acceptable in a dissertation while maintain fidelity to a sense of who one is seems more problematic as one’s distance from the center of dominant culture increases. Believing that agency lies in altering the reiteration of such processes, I worked with my committee to find ways to alter the process yet still do a dissertation I write in a variety of voices – essay and poetry as well as analytical – play with visual qualities of text, and experiment with non-verbal interpretations. These don’t exhaust possibilities, but do give a sense of how the rich variety of expression found in academe cam be brought into the dissertation. I thus demonstrate that one need not reconstitute herself through characteristic academic discourse in order to be initiated into the community of scholars. I suggest both the desirability of encouraging flexibility in the language, form, and process, of dissertations, and the theoretical necessity for such flexibility if the academic community is to become diverse.