Читать книгу A Companion to Medical Anthropology - Группа авторов - Страница 51

The research on aspects of the internal–external connections between thought and behavior has developed predominantly within psychological anthropology and cognitive anthropology, although other approaches have also played a part in this area of midrange theory development. The midrange theories that appear to be in the most common use include Cultural Models, Cultural Beliefs Systematic Comparison, and Cultural Cognition (domain analysis). Some specific examples of the use of a cultural models or cultural health beliefs models include research on building culturally congruent prevention systems which are more than models; they are actual structural programs that test the models and their gender sensitivity for use in intervention programs (Weeks et al. 1996).

Cultural Domain Analysis provides an arena within which midrange theories have been successfully applied to both research questions and the development of HIV and drug interventions among other applied efforts. These approaches can provide excellent models for providing culturally competent, and locally motivated information prevention information, as in the case of a Puerto Rican study of what individuals wanted to know about substance abuse and AIDS education from risk reduction programs. They can also provide key information for qualitative–quantitative bridges to find predictors of risk perception, as seen in the work of Singer et al. (1996) among women drug users.

Systematic explorations of mental health and other illness domains have been pursued through the use of three interlocked cognitive anthropology methods. These are techniques for (1) exploring the content and limit of cultural domains (e.g., freelistings, sentence frame completion, contrast sets); (2) techniques for establishing the structural and cognitive relationships among the elements of cultural domains (e.g., pile sorts, dyad and triad tests, Q sorting, matrix profile analysis); and (3) techniques for establishing the cultural consensual framework for these systems of knowledge and belief (Trotter 1991, 1995). These techniques are amenable to being used in a standard pre-test/post-test design to analyze changes in cultural models or cognition over time as a result of intervention or culture change. Many of these techniques provide a format for systematic ethnographic rapid assessment. They also provide a methodological basis for bridging between ethnographic and standard survey or experimental (quantitative) research designs, since they are typically analyzed using both qualitative (description of meaning) and quantitative (cluster analysis, multidimensional scaling, correspondence analysis) algorithms. As an example, Trotter and Potter (1993) conducted an HIV risk pile sort with Navajo teenagers, using a list of risks that had been generated in focus groups and ethnographic interviews with Navajo cultural consultants. The project was offered as a service component of the Flagstaff Multicultural AIDS Prevention Program, and it explored the ways that the teenagers related the risks in their lives (including alcohol, drug, and HIV-related risks) to other risks (violence, school problems, sexuality). The results of the project demonstrated that the students were linking risks within bounded risk areas (e.g., drug risks, school risks, violence risks, etc.), and that the linkages between those areas were weakly associated. The models of risk for the teenagers were then valuable in constructing HIV and other risk prevention programs which improved the students understanding of the need to link among risks in order to prevent negative outcomes, and the need to strengthen boundaries between risks to avoid them.