Davison, Burke, Castillo, Scanlon, and Rivera, 1990), and alcohol abuse among Native Americans (Thurman, Jones-Saumty, and Parsons, 1990; Walker, Walker, and Kivlahan, 1988).
Preparing the content, format, and delivery of preventive interventions. Individuals and groups are adapted to ethnocultural niches, defined in familial, social, political, and economic terms. To ignore the historical and evolving nature of these niches is to court failure, if not disaster, for prevention research. There is ample documentation that unintended negative effects can accrue from cultural insensitivity and incompetence (McCord, 1978). Thus considerable effort should be expended to inform intervention efforts along these lines. Pilot work and pretesting ought to accompany all attempts to transfer prevention technology across cultural boundaries. In this regard, ethnography stands out among the available methods (Trotter, Rolf, Quintero, Alexander, and Baldwin, in press; Gilbert, 1990; Montagne, 1988). For example, anthropological field work with Native Hawaiian children revealed that peer assistance was important in children's daily activities, that learning occurred most often in “child-constructed” contexts, and that children were seldom individually directed and monitored by adults (Gallimore et al., in press). These observations shaped a remedial school program, aimed at improving the educational attainment of Native Hawaiians, that encouraged peer teaching in independent learning centers in which groups of three to seven children studied together. This design of the educational environment resulted in higher frequencies of on-task behavior, peer assistance, and work completion in contrast to other classroom designs (Tharp and Gallimore, 1988). Hence the infusion of local knowledge permits social validation of intervention goals and procedures, enhances compatibility with valued ends, and increases participation.
Adopting appropriate narrative structures and discourse. What people are willing to discuss, how they talk about it, and with whom they share certain matters vary in important ways across ethnic minority and cultural groups (Kleinman, 1988, 1980). For example, there often is a great deal of discomfort in Hispanic families with respect to sexual issues (Marin and Marin, 1991). Thus an AIDS prevention program intended to reach Hispanics must recognize that discomfort talking about sexual behaviors is normative and approach the topic carefully or risk losing audience participation. How individuals refer to and discuss a given disorder or problem also can differ markedly by ethnicity and culture. “Down in the dumps,” “feeling blue,” and “feeling low”—idioms, metaphors, and labels commonly used in white, middle-class America to refer to depression—do not have the same currency among