TOWARDS A MODEL FOR THE IDENTIFICATION OF CULTURAL VALUES IN HEALTH COMMUNICATIONS: DISCOURSES OF FOOD AND HEALTH IN THE APPALACHIANS

Abstract

Health outcomes from food-related issues are particularly poor in Appalachian regions; obesity, malnutrition, type 2 diabetes, stroke, and heart disease are prevalent. Recognizing that "old" and "new" Appalachian culture are perhaps not the same, there still appears to be a disconnect between those whose goal is to increase the health of Southern Appalachian citizens--medical professionals, nonprofit clinicians, and rural health and advocacy groups--and those citizens themselves. In an era where culturally-sensitive persuasion is largely accepted as effective, health communications have seemingly not caught up. While health is certainly not cut-and-dry and involves complex mitigating and influential factors and circumstances, one consideration is that information is not "getting through" to the audience in a meaningful, persuasive, or actionable way. Food, cooking, and meal-making and sharing are inexorably tied to cultural values. In order to determine whether values embedded in a given nutrition-oriented health communications align with the cultural values of food and health held by the targeted audience, research must first consider how to identify values in nutrition communications targeted to a specific audience. Building on research confirming the success of culturally-sensitive approaches to health communications, this study lays the groundwork for a model of cultural value identification in targeted nutrition communications using theory and data from peer-reviewed literature that addresses cultural values within discourses of health, food, or nutrition within cultures or defined communities similar to those of Appalachia. Having this model--an accurate and applicable method of discourse analysis--will enable practitioners to both identify values within current micro and macro-level discourses and effectively tailor future communications targeted toward Appalachian people and other regionally and culturally-specific populations. This study uses meta-synthesis as an approach to explore data, theories and methods of measurement relevant to values, cultural identity, food culture, and health communications in Appalachian-like communities. The apparent cross-connection between fields (public health, health communications, public policy, and advertising for example), theoretical models, and research data produced from the 17 studies included in the synthesis indicates the need for further exploratory research linking the theories of Schwartz, Hofstede, and Inglehart (or other emergent models of cultural values) with current communications theory and practice, and validates the valuableness of this work. Many values evident in the studies on Appalachian health aligned with those proposed in Schwartz, Hofstede, and Inglehart, therefore any of these models could be potentially useful, providing a theoretical structure and/ or schema to assessments of discourses of nutrition targeted to specific populations or cultures such as those of Appalachia.