Nancy Muturi

Communication for HIV/AIDS Prevention in Kenya:Social-Cultural Considerations

ABSTRACT The acquired immune deficiency syndrome (AIDS) epidemic is spreading fast in Africa in spite of the various efforts and resources put in place to prevent it. In Kenya, reproductive health programs have used the mass media and other communication interventions to inform and educate the public about the disease and to promote behavior change and healthy sexual practices. This effort has led to a discrepancy between awareness and behavioral change among people of reproductive age. In this article I examine the discrepancy in Kenya from a communications perspective addressing social cultural and related factors contributing to the lack of change in behavior and sexual practices. I draw on the theoretical framework of Grunigs model of excellence in communication, the importance of understanding and relationship building between programs and their stakeholders. Data were gathered qualitatively using focus groups and in-depth interviews among men and women in rural Kenya. Key findings indicate that although awareness of sexually transmitted diseases (STDs) including human immunodeficiency virus (HIV)/AIDS is high in Kenya, a majority of the population, particularly those in the rural communities, lack understanding of the communicated messages. They also lack the knowledge of other ways of transmitting HIV particularly among those not sexually involved. Cultural beliefs, values, norms, and myths have played a role in the rapidly increasing epidemic in the rural communities and yet HIV/AIDS communication programs have not addressed these factors adequately. I conclude that successful behavior change communication must include strategies that focus on increasing understanding of the communicated messages and understanding of the audience through application of appropriate methodologies. Building a relationship with the audience or stakeholders through dialogues and two-way symmetrical communication contributes toward this understanding and the maintenance of the newly adopted behaviors and practices.

HIV/AIDS Stigma and Religiosity Among African American Women

African American women are disproportionately affected by HIV/AIDS compared with other ethnicities, accounting for two-thirds (67%) of all women diagnosed with HIV. Despite their increased risk of HIV infection, few studies have been conducted to understand culture-specific factors leading to their vulnerability. Given the central role of religious organizations in African American communities, this study explored whether and to what extent religiosity plays a role in stigma toward HIV/AIDS. Results of hierarchical regression showed that after controlling for key factors, religiosity was a significant factor predicting the level of religious stigma. Those with high religiosity displayed significantly higher stigma, associating HIV/AIDS with a curse or punishment from God. Verbatim responses to an open-ended question also revealed seemingly ingrained prejudice against HIV/AIDS from a religious perspective. The findings point to the important role of faith-based organizations (FBOs) in addressing HIV/AIDS issues within African American communities.

Older adults’ perspectives on HIV/AIDS prevention strategies for rural Kenya

HIV/AIDS is devastating sub-Saharan Africa with great impact in the rural communities. Though prevention is the mainstay of various responses to the epidemic, communication strategies used to influence risk perception and motivate behavior change are culturally inappropriate, hence the lack of success. The bulk of prevention efforts target the 15–49 age group, resulting in limited knowledge and understanding of HIV/AIDS in adults over age 50 who are considered at a lower or no risk of infection. This paper addresses older adults as a key segment of the population in HIV/AIDS prevention given the increasing number that is living with the disease or newly infected. Many older adults are also caregivers of those infected and affected by the disease. As cultural, social, political, and opinion leaders in rural Kenya, older adults are in a position to influence attitudes and behaviors of their community members, but they have not been involved in the current intervention strategies. Through application of a participatory and culture-centered approach, the study sought views of older adults on the factors contributing to the epidemic in rural Kenya and their opinions on effective prevention strategies that are culturally appropriate. Several recommendations are made for a culture-specific HIV/AIDS prevention intervention for rural Kenya.

Subjective health literacy and older adults' assessment of direct-to-consumer prescription drug ads.

Older adults are increasingly the intended target of direct-to-consumer (DTC) prescription drug ads, but limited evidence exists as to how they assess the educational value of DTC ads and, more importantly, whether their assessment depends on their level of health literacy. In-person interviews of 170 older adults revealed that those with low subjective health literacy evaluated the educational value of DTC ads significantly lower than did those with high subjective health literacy. The results prompt us to pay more scholarly attention to determining how effectively DTC ads convey useful medical information, particularly to those with limited health literacy.

Students' Expectations and Motivation for Service-Learning in Public Relations.

This study is based on a survey of public relations students and examines their attitudes, expectations, and motivations for participating in curriculum-infused service-learning projects. Results indicate that prior participation does not influence attitudes or expectations, but motivation to participate in the project was significantly associated with positive attitude and higher expectations. Students’ expectations, which include social and professional growth, and psychological and altruistic gratification through community contributions, indicate a need for discipline-focused service-learning programs and for a focus on civic engagement given the role of public relations in relationship building and in strategically addressing social issues that impact society.

The interpersonal communication approach to HIV/AIDS prevention: strategies and challenges for faith-based organizations.

This study examines the interpersonal communication approach to HIV/AIDS prevention within Faith-Based Organizations (FBOs) in Jamaica. Applying concepts from the social influence and social learning theories, the study examines communication strategies, challenges and concerns that religious leaders face in their communication efforts. Data gathered qualitatively through focus groups and in-depth interviews indicate that FBOs are social and cultural entities with potential to influence knowledge, attitude and behaviour for HIV/AIDS prevention. However, issues related to content, context, culture, the prevailing AIDS-related stigma alongside religious leaders’ personal characteristics hamper their communication initiatives. Capacity building of leaders as HIV/AIDS communicators and behaviour change facilitators and a collaborative effort between FBOs and health organizations would enhance their HIV/AIDS response.

Alcohol consumption and reproductive health risks in rural Central Kenya

OBJECTIVE The goal of the current study is to explore the perceived reproductive health risks associated with alcoholism from the perspective of rural communities in Kenya where abuse of illicit liquor especially among men has become an epidemic. METHODS Data for the study were gathered qualitatively through focus groups among community members and in-depth interviews with opinion leaders and key informants who were selected through a snowball method. All recorded data were analyzed through constructivist and interpretive techniques, which started with a line-by-line examination of transcripts for identification of emerging themes. RESULTS Rural communities are aware of the lethal nature of the illicit liquor and the severe reproductive health problems associated with it among male consumers. Alcoholism also affects womens sexual and reproductive needs and is attributed to risky sexual behaviors in alcohol-discordant relationships, which puts them at a higher risk of HIV infection. CONCLUSIONS Results indicate a need to address alcoholism in rural Kenya as a public health problem focusing on education and understanding of the long-term health consequences. Addressing the impact on male reproductive health is crucial because it impacts the wider community. Given the complex relationship between alcohol abuse and HIV/AIDS, it is also important for prevention interventions to target married women and non-alcohol consumers. Furthermore, engaging communities will ensure development of culture- and gender-specific interventions. Such engagement requires facilitation of health practitioners for development of meaningful community-based initiatives.

The theory and practice gap in participatory communication

Abstract: This article addresses the application of the participatory approach in a campaign that addressed gender-based violence in the Caribbean. The project brought together hey funding agencies in the region and seven local womens organisations to address the increasing rate of violence against women in Jamaica. Based on information gathered qualitatively from in-depth interviews, focus group discussions and project documents, the article delineates the problems that subvert well-intentioned participatory communication projects when executed using models that otherwise sound good on paper. The article makes key contributions to participatory approach theory and practice by identifying two new areas for future studies to explore, namely the motivations and gratifications of project participants as important predictors of the success or failure of development projects, and the need to focus on a societys value system and its compatibility with the philosophical assumptions behind the participatory approach.

Identifying barriers, perceptions and motivations related to healthy eating and physical activity among 6th to 8th grade, rural, limited-resource adolescents

Purpose – The purpose of this paper is to enable community members to discuss their perceptions of eating habits and physical activity in relation to sixth, seventh, and eighth graders, and reveal facilitators and barriers to healthy eating behavior and physical activity engagement. Design/methodology/approach – Nine focus groups, which included six groups from sixth, seventh, and eighth graders, two parents’ groups, and one teachers’ group, were conducted in a middle school in southwest Kansas. Individual influences, social influences, and larger contextual influences on early adolescent health were assessed by discussing behaviors, personal characteristics, and environmental factors, based on the Socio-Ecological Model (SEM). Findings – Adolescent participants’ knowledge regarding healthful foods was limited. Taste and appearance were the two leading factors that contributed to food choices. Responses from adolescents, parents, and teachers all indicated difficulties when introducing new and healthful f...

An Examination of Factors Associated With Self-Efficacy for Food Choice and Healthy Eating among Low-Income Adolescents in Three U.S. States

Background: Self-efficacy is a crucial component in effective health communication and health promotion interventions and serves as a moderator for behavior change. Although awareness and risk perception are important in the behavior change process, self-efficacy gives people the necessary confidence in their ability to engage in advocated health behaviors. In addressing childhood obesity, self-efficacy plays a crucial role in dietary decisions. Informed by the social cognitive theory, this study examines the behavioral and environmental factors that determine self-efficacy for healthy food choices and healthy eating among adolescents in low income communities. Method: A survey was administered among adolescents in 6th to 8th grades from three U.S. States -- Kansas, Ohio and South Dakota (N=410). Results: Results show a correlation between efficacy for healthy food choice and the adolescent’s perceptions of behavioral control or sense of empowerment. Attitudes towards overall health predict efficacy for healthy eating and for healthy food choice. Other predictors for healthy eating include perceptions of peers’ health concerns and perceptions on healthy food availability whereas perceived control influences efficacy for healthy food choice. Gender played a significant role in adolescents’ perceptions of peers’ health concerns whereas geographical location (state played a role in their in adolescents’ attitudes toward health. Ethnicity was a more significant factor in their perceived barriers for healthy eating, perceptions for healthy food availability and in attitudes towards health. Conclusion: The study suggests ethnic-specific nutrition education that focuses on attitudes towards health as well as community partnerships that would support a healthy food environment to enhance self-efficacy and healthy dietary behaviors among adolescents.