Keywords

cultural empowerment, cultural identity, cultural influences, health-seeking behavior, healthcare choices, medical pluralism, mixed-methods research, PEN-3 cultural model, qualitative thematic analysis, relationships and expectations

Abstract

This dissertation examined the role of cultural influences on health-seeking behaviors and healthcare choices among Zimbabweans, focusing on medical pluralism – where individuals simultaneously access traditional, faith-based, and allopathic medical systems. It applied the PEN-3 Cultural Model to examine Cultural Identity, Relationships and Expectations, and Cultural Empowerment. Using a convergent parallel mixed-methods design, data were collected via a Shona-language survey on WhatsApp. Multiple choice, closed-ended, and open-ended survey questions were texted to participants, and they responded by text or audio messages. Response data were collected from 137 study participants. Multinomial logistic regression was used for quantitative data analysis, while deductive coding was used for qualitative thematic analysis.

Quantitative analysis found that Cultural Empowerment (LR Chi²(9) = 68.14, p < .001) and Cultural Identity (LR Chi²(9) = 37.95, p < 0.001) significantly influenced medical pluralism, with Relationships & Expectations having a lesser impact (LR Chi²(9) = 16.02, p = 0.0666). Qualitative results showed a preference for medical pluralism driven by Cultural identity and Cultural Empowerment but also undertones of individual autonomy. Participants also expressed a desire for confidentiality of personal health information accompanied by a resentment to involve too many people in individuals’ health issues.

Study findings offer valuable insights into participants’ health behavior, with implications for formulation of appropriate health policy. Limitations included a small sample size, reducing statistical power and effect detection. Non-probability sampling limited generalizability. It underscores the need for healthcare systems that integrate culturally diverse healthcare practices to improve outcomes. Involvement of immediate family, extended family, and neighbors as triggers of entry into health care must be balanced with confidentiality. Future research should use larger, random samples to mitigate these shortcomings.

Completion Date

2025

Semester

Summer

Committee Chair

Hou, Su-I

Degree

Doctor of Philosophy (Ph.D.)

College

College of Community Innovation and Education

Department

Health Management and Informatics

Format

PDF

Identifier

DP0029590

Language

English

Document Type

Thesis

Campus Location

UCF Downtown

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