Describe the Relationships and Expectations of the group you chose.

module 2 – SLP


Continuing with the same cultural group and health issue for the Session Long Project that you began in Module 1( I have attached the paper you wrote from module 1), write a paper to address the following:

Describe the Relationships and Expectations of the group you chose. Specifically address how each of the PEN-3 model’s three factors within the dimension of Relationships and Expectations applies to your group and provide examples.

Use subheadings to clearly show that you have addressed each of the three factors. Support your discussion with references from scholarly and professional references (not just your opinion).

Length: 2-3 pages (excluding the cover page and the reference list).

SLP Assignment Expectations

Assessment and Grading: Your paper will be assessed based on the performance assessment rubric. You can view it under Assessments at the top of the page. Review it before you begin working on the assignment. Your work should also follow these Assignment Expectations.

Running head: MODULE 1 – SLP 1


Module 1 – SLP

Elizabeth J. Davis

Trident International University

Dr. Sharlene Gozalians

29 April 2019

Module 1 –SLP Health, Culture, and Identity

A number of research studies have indicated that African Americans are more likely to die from diabetes than whites. Various techniques and mechanisms have been suggested to counter this problem of diabetes among the African Americans. There are various proposed approaches that are critical for prevention and chronic disease management. These approaches include culturally sensitive diabetes self-management education (DSME), insurance coverage and access to primary care. This paper therefore seeks to assess the experiences of African Americans in managing type diabetes.

The health issue which this paper will address is type 2 diabetes among the African Americans. As compared to other racial and ethnic groups, African Americans are disproportionately burdened by high rates of deaths due to diabetes (King, Moreno, Coleman & Williams, 2018). Appropriate interventions are therefore required so as to reduce the prevalence of type 2 diabetes among the African Americans. African Americans are almost twice (2 times) as likely to be diagnosed with diabetes as compared whites. Additionally, they are more likely to suffer complications from diabetes. African Americans have the same or lower rate of high cholesterol as compared the white. However, there are high chances that they will have high blood pressure. African American adults are 80 percent more likely than the white adults to have been diagnosed with diabetes by a physician. For example, in the year 2013 research studies conducted showed that African Americans were twice as likely as Whites to die from diabetes.

The table below shows the Age-adjusted prevalence of diagnosed diabetes per 100 populations in the year 2014. The statistics below indeed confirms that there is a high prevalence rate of diabetes among the African Americans as compared to the Whites.

African Americans White African Americans/

White Ratio

Men 9.2 6.3 1.5
Women 9.9 5.3 1.9
Total 9.5 5.8 1.6

Source: CDC 2016. National Diabetes Surveillance System

Diabetes has a number of implications for health among the African Americans. The most notable one is high mortality rate. Diabetes is one of the leading causes of death among the African Americans. It is because of this reason that the issue of diabetes among the African Americans has to be dealt with accordingly.

The PEN-3 cultural model is composed of three key factors. They include cultural identity, relationships and expectations, and cultural Empowerment. Each of these three factors forms the acronym PEN. Cultural identity domain consists of aspects such as person, extended Family, and neighborhood. Relationship and expectation domain consist of elements such as Perceptions, Enablers, and Nurturers. Cultural empowerment domain consists of Positive, Existential and Negative aspects. Each of these factors of the PEN model will be applicable in dealing with diabetes among the African Americans.

Cultural Identity

Cultural identity factors outline the intervention points of entry. Diabetes interventions will occur at various levels. The interventions of preventing diabetes will start at the personal level. Individuals may be educated at the personal level. The interventions aimed at reducing the prevalence may also be implemented at the extended family level. Strategies which will be aimed at handling diabetes will also be implemented at neighborhoods level. In this particular case the point of entry of interventions will be at the community level of the African Americans.

Relationships and Expectations

Various perceptions or attitudes about the health problem which in this case is diabetes among the African Americans will be examined in detail. The available societal or structural resources which may aid in reducing the prevalence of diabetes will be identified. Some health care services may help in promoting good health practices. Effective health-seeking practices will also be discouraged as a way of reducing diabetes prevalence. It is also important to note that family and kin has a lot of influence in nurturing decisions surrounding effective management of health problems such as diabetes. This particular aspect will therefore be examined in detail.

Cultural Empowerment

The health problem (in this case diabetes) will be explored by identifying various beliefs and practices that are positive. These are the beliefs and practices that may lead to positive improvement by reducing the prevalence of diabetes among the African Americans. The existing values and beliefs that may be existential and have no harmful health consequences will be explored and highlighted. It will also be important to identify negative health practices that may act as barriers in controlling the prevalence of diabetes among African Americans. Example of these negative practices includes poor nutrition leading to obesity. In this particular way, cultural beliefs and practices that may influence health are examined in detail.

Culture influences health care various ways. This is because the aspects of culture such as practices and beliefs determine whether an individual will engage in actions which are either harmful or beneficial to an individual’s health. The knowledge which I have learned will help me to effectively interact with diverse cultures in the health care settings.


Solutions that are beneficial in reducing the prevalence of diabetes among African Americans are encouraged. The solutions that are also harmless are acknowledged. Finally, practices that are harmful and have negative health consequences should also be tackled. This will result in decrease of the prevalence of diabetes among the African Americans.


Iwelunmor, J., Newsome, V., & Airhihenbuwa, C. O. (2014). Framing the impact of culture on health: a systematic review of the PEN-3 cultural model and its application in public health research and interventions. Ethnicity & health, 19(1), 20-46.

King, C. J., Moreno, J., Coleman, S. V., & Williams, J. F. (2018). Diabetes mortality rates among African Americans: A descriptive analysis pre and post Medicaid expansion. Preventive medicine reports, 12, 20-24.

Purcell, N., & Cutchen, L. (2013). Diabetes self-management education for African Americans: Using the PEN-3 model to assess needs. American Journal of Health Education, 44(4), 203-212.

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