Running head: MODULE 3 - SLP 1 MODULE 3 – SLP 2 Module 3 – SLP Elizabeth Davis Trident International University Dr. Sharlene Gozalians 13 May 2019 Module 3 – SLP In a bid to control the prevalence of diabetes among the African Americans, it is important to examine a number of attributes of culture that can empower a person towards changing a behavior. The factors may be positive, existential, and negative. Existential factors may be not harmful but need to be acknowledged. The importance of a family cannot be ignored especially because of the support they provide to diabetic patients. Family is therefore a positive cultural value which will assist in managing diabetes disease. This paper therefore seeks to address how each of the PEN-3 model’s three factors within the dimension of cultural empowerment applies to the African American group. It is important to explore by identifying several cultural beliefs and practices that are positive, existential and negative. Positive factors are likely to lead to an improvement by reducing the prevalence of diabetes among the African Americans. Existential factors are existing cultural values and beliefs that may have no harmful health consequences. Cultural practices that may act as barriers in controlling the prevalence of diabetes among the African Americans are the negative factors. Example of these negative practices includes poor nutrition leading to obesity. Positive Factors The positive factors which will influence management and control of diabetes among the African Americans include spirituality and family. For example, talking about a family affair with diabetes will make a great impact in controlling diabetes among the African Americans. This is because it will create awareness of how to handle and deal with diabetes. Spirituality will have a positive impact in controlling the prevalence of diabetes among the African Americans. African Americans who have spiritual faith are likely to engage in activities which will reduce the prevalence of the disease. Existential Factors Existential factors include faith healing. A belief in faith healing is a factor which is likely to reduction in prevalence of diabetes among the African Americans. Individuals who are religious are likely to visit religious leaders to seek healing and intervention. Many individuals confess that they got healed after being prayed for by the Pastors and other religious leaders. This is attributed to believing in faith healing. Negative Factors Consumption of “comfort foods” is common in the diet of the African Americans. These foods contain high fat, sugar, and calorie contents. Example of negative cultural factors includes unhealthy traditional foods. Poor nutrition among the African Americans is more l.

1. Running head: MODULE 3 - SLP
1
MODULE 3 – SLP
2
Module 3 – SLP
Elizabeth Davis
Trident International University
Dr. Sharlene Gozalians
13 May 2019
Module 3 – SLP
In a bid to control the prevalence of diabetes among the African
Americans, it is important to examine a number of attributes of
culture that can empower a person towards changing a behavior.
The factors may be positive, existential, and negative.
Existential factors may be not harmful but need to be
acknowledged. The importance of a family cannot be ignored
especially because of the support they provide to diabetic
patients. Family is therefore a positive cultural value which will
assist in managing diabetes disease. This paper therefore seeks
to address how each of the PEN-3 model’s three factors within
the dimension of cultural empowerment applies to the African
American group.
It is important to explore by identifying several cultural beliefs
and practices that are positive, existential and negative. Positive
factors are likely to lead to an improvement by reducing the
prevalence of diabetes among the African Americans.
Existential factors are existing cultural values and beliefs that
may have no harmful health consequences. Cultural practices
that may act as barriers in controlling the prevalence of diabetes
among the African Americans are the negative factors. Example
of these negative practices includes poor nutrition leading to
obesity.

2. Positive Factors
The positive factors which will influence management and
control of diabetes among the African Americans include
spirituality and family. For example, talking about a family
affair with diabetes will make a great impact in controlling
diabetes among the African Americans. This is because it will
create awareness of how to handle and deal with diabetes.
Spirituality will have a positive impact in controlling the
prevalence of diabetes among the African Americans. African
Americans who have spiritual faith are likely to engage in
activities which will reduce the prevalence of the disease.
Existential Factors
Existential factors include faith healing. A belief in faith
healing is a factor which is likely to reduction in prevalence of
diabetes among the African Americans. Individuals who are
religious are likely to visit religious leaders to seek healing and
intervention. Many individuals confess that they got healed
after being prayed for by the Pastors and other religious leaders.
This is attributed to believing in faith healing.
Negative Factors
Consumption of “comfort foods” is common in the diet of the
African Americans. These foods contain high fat, sugar, and
calorie contents. Example of negative cultural factors includes
unhealthy traditional foods. Poor nutrition among the African
Americans is more likely to lead to obesity. Obesity is one of
the conditions which increase the risks of diabetes among the
African Americans. These negative factors act as an obstacle in
controlling the prevalence of diabetes among the African
Americans.
Conclusion
Positive cultural empowerment factors will be helpful in

3. controlling and managing the prevalence of diabetes among the
African Americans. Family is a core cultural factor that may
resonate well among the African Americans in the fight against
the prevalence of diabetes. This is because family plays a
significant role in day-to-day care of diabetic patients. Positive
factors will generally lead to a decrease in the prevalence of
diabetes among the African Americans.
References
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.
Running head: MODULE 2 - SLP
1
MODULE 2 – SLP
5
Module 2 – SLP
Elizabeth Davis
Trident International University
Dr. Sharlene Gozalians
3 May 2018
Module 2 – SLP

4. It is important to analyze the relationships and expectations of a
particular cultural group. This will help in addressing health
issue which may be facing that particular cultural group. This
paper seeks to specifically address how each of the PEN-3
model’s three factors within the dimension of Relationships and
Expectations may apply to my selected cultural group.
Relationship and expectation domain of the PEN-3 model
consists of three factors. The three elements include
Perceptions, Enablers, and Nurturers. These factors may be
applicable to a certain cultural group when attempting to
address a particular health issue. Relationships and expectations
relate to the perceptions or attitudes which the people of a
particular cultural group have towards a particular health
problem. This particular project will be examining the
perceptions and attitudes which African Americans have
towards diabetes as a health problem at hand. The available
societal or structural resources will help in reducing the
prevalence of diabetes among the African Americans. Various
health care services help in promoting good health practices.
Effective health-seeking practices will also be discouraged as a
way of reducing diabetes prevalence. The influence which
family and kin has in nurturing decisions surrounding effective
management of health problems such as diabetes will be
examined.
Perceptions
There are a number of perceptions which will affect diabetes
disease management among the African Americans. Examples of
these perceptions include feeling highly confident, fears about
diabetes complications, and denial. It will be easy to manage
diabetes disease among the African Americans who feel highly
confident. On the other hand, it will be difficult to manage
diabetes diseases among the African Americans who fear
complications of diabetes. Those who fear diabetes may not
even bother to go and seek medication. This is the same case to
individuals who deny having diabetes. These factors are

5. therefore significant in trying to manage and control prevalence
of diabetes among the African Americans.
Enablers
Enablers are also important factors in trying to manage the
prevalence of diabetes among the African Americans. Enablers
are of two types which include positive enablers and negative
enablers. Examples of positive enablers include religion and
social support. On the other hand, examples of negative
enablers include disliking needles, time consumption, and cost
of healthy foods. Religion will play a significant role in
managing diabetes among the African Americans. It will be easy
to manage this particular health problem among African
Americans who are very religious as compared to those who are
not religious. Social support will contribute positively in
managing the prevalence of diabetes among the African
Americans. This is because the people who have social support
from family members and work mates are likely to be
encouraged to seek medication. The African Americans who
dislike needles may not go and seek diabetes treatment. Those
who do not consume healthy foods may not end up living for
long. These negative enablers may make it difficult to manage
diabetes disease among the African Americans.
Nurturers
Examples of nurturers include family, friends, and health care
providers. Nurturers play a great role in managing and
controlling diabetes. Family and friends meet the cost of health
care for diabetic patients. They also play an important role of
giving moral support to diabetic patients. They may also offer
advice on how to live healthier by practicing good health
behaviors. Health care providers will provide adequate nursing
care to diabetic patients and offering guidance on the
appropriate foods to consume. Nurturers therefore positively
contribute to controlling the prevalence of diabetes disease

6. among the African Americans.
References
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.
Running head: MODULE 1 – SLP
1
MODULE 1 – SLP
6
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

7. (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

8. Women
9.9
5.3
1.9
Total
9.5
5.8
1.6
Source: CDC 2016. National Diabetes Surveillance System
http://www.cdc.gov/diabetes/statistics/prevalence_national.htm
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

9. 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

10. 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.
Conclusion
Solution
s 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.
References
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

11. education for African Americans: Using the PEN-3 model to
assess needs. American Journal of Health Education, 44(4),
203-212.