Relationships and Expectations Essay

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Relationships and expectations form one of the three main domains of the PEN-3 model. These three factors, perceptions, enablers, and nurturers, refer to the cultural component of health-seeking behaviors. The relationships and expectations domain can inform healthcare workers about how to encourage health-seeking behaviors in patients, and is a culturally sensitive approach. The PEN-3 concept shows how culture is a major determinant of both individual and public health.

Perceptions refer to the individual's perceptions about health, disease, medication, doctors, and healthcare systems. The perceptions are related directly to the cultural values, beliefs, and norms that are already embedded in the community. Individual and collective group health behaviors may be strongly determined by perceptions. For example, is there a perception that heart disease is not a serious problem in the African-American community? Or, is there a perception that healthcare is too expensive, or that doctors are too paternalistic? Perceptions might also impact lifestyle choices such as diet and exercise. Among African-American men, it may be important first to understand health-related perceptions, and then to work to change those perceptions to encourage health-seeking behaviors.

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The enablers component refers to the institutions, structures, or people that facilitate health-seeking behaviors among the target population. The existence of a clinic that specializes in African-American men would, for example, enable African-American men to seek out regular checkups. The existence of affordable healthcare enables those without health insurance to seek healthcare. Community organizations that work together to promote the growth of parks and recreation services can enable African-American men to exercise more and therefore reduce risk of heart disease. Likewise, the government investment in the community small business development might enable the growth of healthy food resources -- also enabling African-American residents to shift their eating choices away from fast food. Other enablers include exposure to health education from a young age onward, exposure to African-American role models in the community that talk about their experience with heart disease and how to incorporate healthy lifestyle choices. Public policy and health education serve as….....

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