2. Literature Review

2.6. Research Settings

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participation and comfort. I ran the meetings similarly to a group-therapy model, geared toward fostering support. To relieve stress and cultivate friendships between group members, we played a game of volleyball.

Laughter and smiles filled the courtyard and at the time I was very pleased with the results (Kass, J., 2013, p41).

More effective health messages can be created for each audience segment than for the entire audience. In recent years, health communication scholars have used focus groups to pretest communication messages, to design health communication interventions, and to evaluate the effects of health campaigns. Furthermore, Africa’s health systems are designed with a bias toward primary care leading to the difficulties of coping with the cost and complexity of AIDS treatment, especially in rural communities. To mitigate and overcome the barriers socially, culturally, and legally allows more Kenyans, especially women and girls, the key affected groups from accessing correct information, to increase the provision of HIV prevention via efficient and effective health promotion. Hopefully in the near future, more efforts of sustainable methods will be developed for reaching both the top-down and bottom-up communicative channel that could also reduce the country’s reliance on keep exhausting international donating funding.

2.6 Research Settings

Settings of promoting health are first explained in the Ottawa Charter for Health Promotion, WHO (1986). Besides from stressing the nature of caring, holism, and ecology in developing strategies for health promotion by saying “health is created and lived by people within the settings of their everyday life; where they learn, work, play and love” (WHO), the settings for providing health education are important to deliver programs, and provide access to specific populations and gatekeepers. Glanz, Lewis,

contemporary health education: “schools, communities, worksites, health care settings, homes, the consumer marketplace, and the communication environment (see Table 2).”

To encourage partnership working and program diffusion, community-based models of health improvement, particular settings be accompanied by non-formal work in the community are shown to develop best practice in promoting and communicating health (Hunter et al.,2000, Tones& Green 2004, p.318). To Whitelaw et al. (2001), settings implied “top down’ models of implementation, particularly when aimed at imposed outcomes, tend to be ineffective since letting claim holders to participate is more effective than taking orders from a leader or minority group.

Types of Settings Descriptions

Schools Health education can be taught in classrooms, training teachers, and changes in school environments that support healthy behaviors (Luepker et al., 1996; Franks et al., 2007).

Communities Social relationships and organizations are heavily relied to reach large populations via media and interpersonal strategies.

Community interventions are conducted in churches, clubs, recreation centers, and neighborhoods, which enable program planners to gain more support and design effective health messages (Glanz et al., 2002).

Worksites Since people spend much time at work, the workplace is both a source of stress and of social support (Israel and Schurman, 1990). Effective worksite programs can harness social support as a buffer to stress, in order to improve workers’ health and health practices. Nowadays, even enterprises provide health promotion programs for their employees (National Center for Health Statistics, 2001).

Healthcare settings Health care can be greater level nowadays including high-risk individuals, patients, their families and the surrounding community, as well as in-service training for health care

providers. Health education in these settings focuses on disease prevention and detection.

Homes Health behavior change interventions are delivered to households through traditional public health means such as home visits or multiple communication channels and media like Internet, telephone, or mail.

Consumer Marketplaces

Social marketing is used by health educators to fortify the salience of health messages and to improve their persuasive impact. Theories of Consumer Information Processing (CIP) provide a framework for understanding how consumer health information is being digested.

Communication Environment

Usage of new communications technologies from mass media changes (i.e. tabloids, blogs, social media sites) to personalized and interactive media (i.e. smartphone, animation, games, audio). These channels are not “settings”

per se but can be used in any of the settings described earlier;

however, they are gaining uniqueness and specialization, providing opportunities for intervention; they also require evaluation of their reach and impact on health behaviors (Ahern et al., 2007).

Table 2. Research Settings Type and Descriptions

The research setting in this study is Kitale Province, situated between Mount Elgon and the Cherangani Hills in Western Kenya, at the elevation of 6,000 feet.

Household economies in the province are supported by agricultural farming. The main cash crops in the area are sunflower, coffee, tea, seed beans, and maize. In fact, Kitale is prompted by growing the largest portion of Kenya’s total maize quantities. It is reported that in the region, 87.4% of homes have no electricity and 70% of homes is made up of earth, sand, and dung (Kenya Demographic and Health Survey, 2014, p.15). Kitale is populated by different ethnic groups from the local Luhya, Kalenjin, Kuo, Kikuyu, Kisii, Teso, Turkana and the international communities include Asians,

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Britains, Americans, and Sudanese from Southern Sudan. Suffer heavily from AIDS prevalence, Kenyans in Kitale fall victim into broken homes, slum life, single parenthood, drug addiction, prostitution, poverty, sexual and domestic violence, or gangs.

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