The DOI matches its Crossref record; 63 of the 64 references it cites were found in a registry or an index; 6 of the 22 sources its claims cite were checked for support.
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
Open accessAbstract
OBJECTIVE: This paper reviews available studies that applied the PEN-3 cultural model to address the impact of culture on health behaviors. METHODS: We search electronic databases and conducted a thematic analysis of empirical studies that applied the PEN-3 cultural model to address the impact of culture on health behaviors. Studies were mapped to describe their methods, target population and the health behaviors or health outcomes studied. Forty-five studies met the inclusion criteria. RESULTS: The studies reviewed used the PEN-3 model as a theoretical framework to centralize culture in the study of health behaviors and to integrate culturally relevant factors in the development of interventions. The model was also used as an analysis tool, to sift through text and data in order to separate, define and delineate emerging themes. PEN-3 model was also significant with exploring not only how cultural context shapes health beliefs and practices, but also how family systems play a critical role in enabling or nurturing positive health behaviors and health outcomes. Finally, the studies reviewed highlighted the utility of the model with examining cultural practices that are critical to positive health behaviors, unique practices that have a neutral impact on health and the negative factors that are likely to have an adverse influence on health. DISCUSSION: The limitations of model and the role for future studies are discussed relative to the importance of using PEN-3 cultural model to explore the influence of culture in promoting positive health behaviors, eliminating health disparities and designing and implementing sustainable public health interventions.
Overview
AI snapshot
Written from the paper’s full text.
TL;DR
This systematic review of 45 studies finds that the PEN-3 cultural model was used to centralize culture in health behavior research and interventions, often as a theoretical framework and qualitative analysis tool. It highlights cultural context, family as an intervention entry point, and positive aspects of culture, while noting limited quantitative testing and transferability concerns.
Key findings
- Of 153 unique references initially retrieved after duplicate removal, 45 articles met inclusion criteria for the review.
- Reviewed studies used PEN-3 as a theoretical framework to centralize culture in health behavior study and intervention development, and as an analysis tool to categorize themes, cross-tabulate the Relationships and Expectations domain with the Cultural Empowerment domain into a 3 × 3 table, and recontextualize findings.
- Three key themes consistently emerged: the importance of context, the role of family as an intervention point of entry, and the need to explore positive aspects of culture on health behaviors.
- The model was applied across health issues including HIV/AIDS, cancer, hypertension, diabetes, malaria, nutrition, smoking, reproductive desires, physical inactivity, stress, and domestic violence.
Methods
- Systematic search of literature published between 1989 and 2013 using Google Scholar, Medline, Proquest, Psyinfo, Social Science citation index, Sociological abstracts, and Web of Science, with keywords including “PEN-3 cultural model” and “PEN-3 cultural model + Disease.”
- Inclusion criteria required use of PEN-3 as a theoretical framework, reported health behavior or health outcome data illustrating its use in data collection and/or analysis and presentation of results, and inclusion of men, women, children, or communities in data collection; review articles, books, and dissertations were excluded.
- PRISMA guidelines guided reporting; abstracts were initially screened by one reviewer, full texts were retrieved and re-screened independently by two reviewers, quality was appraised, and thematic analysis identified common themes across the literature.
Limitations
- The paper states that almost all reviewed studies used PEN-3 to generate and analyze formative/qualitative data, and none appeared to test any construct or domain of the model quantitatively.
- The paper states a transferability limitation: findings from qualitative studies using PEN-3 may not transfer from one context to another, so caution is recommended and PEN-3 should always begin with qualitative study to capture each context’s uniqueness.
- The paper states it is not clear which studies returned to the community to share lessons learned from the assessment phase, and recommends this as a critical part of using PEN-3; evident from the text, the review also excluded review articles, books, and dissertations, which may omit relevant applications.
Model-written summary. Check it against the paper before relying on it.
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Claims the paper makes
22 Own interpretation · 13 No basis given · 11 No full text of the sources · 10 Own result · 5 Supported · 5 Not checked yet · 4 Sources not found · 4 Own method · 1 Supported so far
Every source the paper cites for this claim was checked and supports it.
In the paper
“In tailoring their overall recruitment and study protocol, the authors reinforced positive themes and revised negative themes in a variety of ways.”
§ 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 > Results > Positive aspects of culture as a critical domain in PEN-3
What the sources say
- Supportedcites Ochs-Balcom, Rodriguez, and Erwin 2011 source
The Data analysis passage says the authors used themes to tailor the study protocol, reinforcing positive aspects and controlling negative ones where possible. The Results describe several ways they emphasized positive themes, while the Discussion confirms that they tailored the recruitment protocol and materials in response to the findings. Page numbers are not provided in our copy. (LLM, conf=0.93)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“For example, among Native Hawaiian women, Ka’opua (2008) utilized talk story, a culturally familiar style of discussion to engage women in dialog on the importance of breast cancer screening.”
§ 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 > Results > Positive aspects of culture as a critical domain in PEN-3
What the sources say
- Supportedcites Ka’opua 2008 source
The Theoretical and Conceptual Frameworks section says the study engaged women in dialogues patterned on talk story, which it describes as a culturally familiar style of discussion. The Method section says those discussions addressed beliefs and experiences related to breast cancer screening. Page numbers were not provided. (LLM, conf=0.94)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Ochs-Balcom, Rodriguez, and Erwin (2011) utilized the PEN-3 model to identify positive and negative themes relevant to establishing community partnership to optimize recruitment of African-American women in a breast cancer epidemiology study.”
§ 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 > Results > Positive aspects of culture as a critical domain in PEN-3
What the sources say
- Supportedcites Ochs-Balcom, Rodriguez, and Erwin 2011 source
The Introduction states that the authors used focus groups and the PEN-3 model to identify themes for a family-based genetic epidemiology study. The Discussion says those themes guided culturally tailored recruitment of African American women through a community network. The paper describes reinforcing positive aspects and addressing negative ones. Page numbers are not provided in our copy. (LLM, conf=0.93)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“PEN-3 model was also significant with exploring not only how cultural context shapes health beliefs and practices, but also how family systems play a critical role in enabling or nurturing positive health behaviors and health outcomes.”
§ 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 > Abstract > Results
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“The importance of centralizing cultural contexts in the study of health behaviors or health outcomes was significant in research studies utilizing the PEN-3 cultural model.”
§ 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 > Results > Themes on culture and context
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Forty-five studies met the inclusion criteria.”
- Also stated in: § Results · plain
“45 articles meeting the inclusion criteria were retained for this review.”
§ 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 > Abstract > Methods
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Results · plain
None of the sources cited for this claim have been checked yet.
In the paper
“Indeed, studies using the PEN-3 model demonstrated how cultural context matters when developing interventions and/or clinical trials focused on addressing health behaviors such as nutrition attitudes”
§ 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 > Results > Themes on culture and context
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“PEN-3 model was also significant with exploring not only how cultural context shapes health beliefs and practices, but also how family systems play a critical role in enabling or nurturing positive health behaviors and health outcomes.”
§ 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 > Abstract > Results
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The reviewed studies vary greatly in their application of the PEN-3 cultural model to address health behaviors through a cultural lens.”
§ 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 > Results > Application of PEN-3 cultural model in studies reviewed
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Data analytical approaches that emerged with the use of PEN-3 include: (1) Categorization, (2) Cross-Tabulation, and (3) Recontextualization.”
§ 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 > Results > Application of PEN-3 cultural model in studies reviewed
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Another data analysis approach commonly used with the PEN-3 cultural model in reviewed studies was cross-tabulation.”
§ 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 > Results > Application of PEN-3 cultural model in studies reviewed
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“With categorization, it was common for studies to utilize the PEN-3 model as an organizing framework to categorize themes generated from qualitative data into one of the three domains of the model.”
§ 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 > Results > Application of PEN-3 cultural model in studies reviewed
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Additionally, several studies also used the PEN-3 cultural model to guide data collection, analysis, and interpretation of qualitative data generated.”
§ 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 > Results > Application of PEN-3 cultural model in studies reviewed
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The model was also used as an analysis tool, to sift through text and data in order to separate, define and delineate emerging themes.”
§ 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 > Abstract > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“With this approach, it was common for existing studies to cross-tabulate the Relationships and Expectations (i.e., perceptions, enablers, nurturers) domain with the Cultural Empowerment (i.e., positive, existential, and negative) domain of the PEN-3 model to generate a 3 × 3 table containing nine categories.”
§ 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 > Results > Application of PEN-3 cultural model in studies reviewed
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“there were no differences in the application of the model by language or country studied”
§ 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 > Results > Application of PEN-3 cultural model in studies reviewed
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“In the context of HIV and AIDS, the PEN-3 cultural model was used to examine the influence of cultural context in explaining stigma and HIV disclosure in South Africa.”
§ 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 > Results > Themes on culture and context
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“None of the studies reviewed appear to actually test any construct or domain of the model in a quantitative manner.”
§ 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 > Limitations and future directions of the PEN-3 model based on reviewed studies
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Various studies used the PEN-3 model as an ‘analysis tool’ to sift through text and data in order to separate, define, and delineate the comments of participants into themes that illustrate how culture influences health behaviors.”
§ 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 > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“For example, the studies reviewed showed that the model provided the opportunity to challenge the assumption that positive health behavior is solely the function of individual responsibility.”
§ 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 > Discussion
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“almost all of the studies reviewed utilized PEN-3 model to generate and analyze formative/qualitative data.”
§ 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 > Limitations and future directions of the PEN-3 model based on reviewed studies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Like individual behaviors, positive aspects of culture can help promote healthy behaviors (i.e., knowledge of screening and testing, dietary habits, etc.) that lead to improved health outcomes.”
§ 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 > Results > Positive aspects of culture as a critical domain in PEN-3
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“A central feature of the PEN-3 cultural model is that it provides researchers and interventionists a strategy for identifying and encouraging positive health behaviors (Airhihenbuwa and Webster 2004).”
§ 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 > Results > Positive aspects of culture as a critical domain in PEN-3
What the sources say
- Not checked — no full text of the sourcecites Airhihenbuwa and Webster 2004 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“While addressing individual behaviors is necessary, a focus on individual behavior alone at the exclusion of the cultural context limits the success of public health interventions.”
§ 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 > Conclusion
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The findings reported here demonstrate that the PEN-3 model is critical in developing and implementing health interventions anchored in culture.”
§ 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 > Discussion
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“As evidenced through its use in these studies, the PEN-3 model has opened space for researchers to discuss behavior and culture from a positive perspective.”
§ 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 > Results > Positive aspects of culture as a critical domain in PEN-3
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“findings from formative/qualitative data do underscore the model’s foundation and premise in offering a strategy to excavate and unpack rich descriptions of the complex array of factors whether positive or negative, or at the individual, family, or community levels for influencing health behaviors.”
§ 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 > Limitations and future directions of the PEN-3 model based on reviewed studies
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Similarly, in describing breast cancer treatment experiences, Sheppard et al. (2008) noted that cultural values such as personalismo (warm and personal relationships with individuals, i.e., clinicians) were central in enabling Latinas to expand their knowledge of treatment options and create a better understanding and willingness to take chemotherapy.”
§ 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 > Results > Positive aspects of culture as a critical domain in PEN-3
What the sources say
- Not matchedcites Sheppard et al. 2008
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Whether it is HIV/AIDS, cancer, or smoking, the findings of this review indicate that for different conditions/behaviors/experiences, culture remains the key to effectively examining their impact on health and thus framing solutions.”
§ 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 > Discussion
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Probably not a substantial claim. 36
- It may state two separate claims as one. 23
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“This approach which is often referred to as the assessment phase of the PEN-3 model provided the opportunity to arrange the emerging themes at the intersection of two domains to assess for any domain interactions (Airhihenbuwa et al. 2009; Airhihenbuwa and Webster 2004).”
§ 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 > Results > Application of PEN-3 cultural model in studies reviewed
What the sources say
- Supportedcites Airhihenbuwa et al. 2009 source
The PEN-3 Model section defines the assessment phase as crossing two dimensions to form nine cells. The Results section says researchers placed themes in the resulting categories and that some themes appeared in more than one category, supporting the description of examining their intersections. Page numbers were not supplied in our copy. (LLM, conf=0.90)
- Not checked — no full text of the sourcecites Airhihenbuwa and Webster 2004 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“In describing the impact of AIDS-related stigma, using the PEN-3 model, Airhihenbuwa et al. (2009) noted that understanding how families cope with health and illness is central to developing sustainable public health interventions aimed at reducing HIV and AIDS stigma, particularly with identifying key members of the family who have made a difference in the lives of PLWHA.”
§ 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 > Results > Family as a common intervention entry point for culture
What the sources say
- Supportedcites Airhihenbuwa et al. 2009 source
Split into 2 atoms — 2 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“While the need for more information about breast cancer and potential benefits to younger generations were among the positive themes identified, negative themes included lack of knowledge regarding research participation, issues related to confidentiality of data, and breast cancer research in general (Ochs-Balcom, Rodriguez, and Erwin 2011).”
§ 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 > Results > Positive aspects of culture as a critical domain in PEN-3
What the sources say
- Supportedcites Ochs-Balcom, Rodriguez, and Erwin 2011 source
Split into 2 atoms — 2 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Indeed, three key themes consistently emerged and appear to help provide an in-depth understanding of how PEN-3 centralizes culture in the study of health behaviors and health outcomes. These themes include the importance of context, the role of family as an intervention point of entry, and the need to explore the positive aspects of culture on health behaviors.”
§ 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 > Results > Common themes that emerge with the PEN-3 cultural model in reviewed studies
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Also, while some studies utilized all three domains of the model to categorize the themes generated for data analysis, it was not uncommon for studies to use only one of the domains to be applied depending on the nature of the study.”
§ 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 > Results > Application of PEN-3 cultural model in studies reviewed
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The studies reviewed used the PEN-3 model as a theoretical framework to centralize culture in the study of health behaviors and to integrate culturally relevant factors in the development of interventions.”
- Also stated in: § Application of PEN-3 cultural model in studies reviewed · hedged
“it was common for studies to use the PEN-3 model as a theoretical framework to centralize culture in the study of health behaviors and to integrate culturally relevant factors in the development of interventions.”
§ 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 > Abstract > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Also stated in: § Application of PEN-3 cultural model in studies reviewed · hedged
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Finally, the studies reviewed highlighted the utility of the model with examining cultural practices that are critical to positive health behaviors, unique practices that have a neutral impact on health and the negative factors that are likely to have an adverse influence on health.”
§ 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 > Abstract > Results
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“even though some of the findings in this review show similar outcomes in different study populations.”
§ 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 > Limitations and future directions of the PEN-3 model based on reviewed studies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The studies reviewed show that regardless of the health outcome or health behavior of interest, the PEN-3 cultural model provides the opportunity to examine cultural practices that are critical to positive health behaviors, acknowledges unique practices that have a neutral impact on health, and identifies negative factors that are likely to have an adverse influence on health.”
§ 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 > Discussion
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“the PEN-3 cultural model helped to focus research not only on the context that nurtures the health behavior of interest but also on the role of the collective (e.g., family) in influencing health behaviors.”
§ 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 > Discussion
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“With the PEN-3 model, authors unpacked biases regarding the health behaviors of interest, and engaged research participants themselves with efforts aimed at promoting positive health outcomes (White et al. 2012).”
§ 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 > Discussion
What the sources say
- Not checked — no full text of the sourcecites White et al. 2012
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“It is not clear which of these studies included this aspect of the model as it was not reported.”
§ 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 > Limitations and future directions of the PEN-3 model based on reviewed studies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Studies also use the model to explore not only how cultural context shapes beliefs and practices, but also how family systems play a critical role in enabling or nurturing positive health behaviors and health outcomes.”
§ 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 > Discussion
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“PRISMA guidelines were used to guide reporting of the documents reviewed and a flow diagram is shown in Figure 2.”
§ 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 > Introduction: the PEN-3 cultural model > Document appraisal and synthesis of papers
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The abstracts of all of the documents were initially screened by one reviewer; however, the full-text documents were retrieved and re-screened by two reviewers independently.”
§ 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 > Introduction: the PEN-3 cultural model > Review search methods and inclusion criteria
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Cultural context also provides a clearer lens through which researchers might view and understand health behavior, while highlighting variables that may be most salient in future intervention design.”
§ 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 > Results > Themes on culture and context
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The quality of the documents retrieved was appraised for appropriateness of the methodology used in the study including the description of the purpose, target population, and context for the study, ethics, rigor of data collection and analysis, relevance and richness of the findings, as well as the clarity of the discussions or conclusions of the overall study.”
§ 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 > Introduction: the PEN-3 cultural model > Document appraisal and synthesis of papers
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“The growth of Positive Psychology, however, which emerged in 2000 is an example of a compelling evidence of the benefit of focusing on positive aspects of behavior, actions, and indeed culture.”
§ 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 > Results > Positive aspects of culture as a critical domain in PEN-3
What the sources say
- Not checked — no full text of the sourcecites Seligman and Csikszentmihalyi 2000 source
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“This field of psychology encouraged a paradigm shift from a focus on negative aspects of individuals and related pathology to identifying and bolstering positive personal attributes for understanding how people thrive and survive even in situations and environments of adversity (Seligman and Csikszentmihalyi 2000).”
§ 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 > Results > Positive aspects of culture as a critical domain in PEN-3
What the sources say
- Not checked — no full text of the sourcecites Seligman and Csikszentmihalyi 2000 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Prevention researchers began to realize that focusing research and practice on personal weakness and symptomatology left clinicians ill-prepared for preventing illness.”
§ 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 > Results > Positive aspects of culture as a critical domain in PEN-3
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
In the paper
“In a paper on family systems and HIV and AIDS, Iwelunmor et al. (2006) reported that family systems can be sources of support, unique indigenous entities, and sources of stress when addressing the care and support needs of family members living with HIV and AIDS.”
§ 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 > Results > Family as a common intervention entry point for culture
What the sources say
- Not matchedcites Iwelunmor et al. 2006
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Not matched
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Furthermore, thematic analysis was applied across the available literature to identify common themes that emerge when the PEN-3 cultural model is applied to address cultural aspects of health behaviors.”
§ 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 > Introduction: the PEN-3 cultural model > Document appraisal and synthesis of papers
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“However, the need to take into account families’ experiences with HIV and AIDS was critical in the development of interventions aimed at reducing the burden of HIV and AIDS-related stigma in the family and improve care and support for PLWHA (Iwelunmor et al. 2006).”
§ 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 > Results > Family as a common intervention entry point for culture
What the sources say
- Not matchedcites Iwelunmor et al. 2006
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Moreover, given the overwhelming need for effective public health research and interventions that address health behaviors from a collective rather than an individual perspective, a cultural approach to health offers the opportunity to identify the broader contextual relationships and expectations whether positive, unique, or negative.”
§ 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 > Conclusion
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Together, these factors are essential to eliminating inequities in health and advancing the mission of public health research and interventions globally.”
§ 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 > Conclusion
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds. It may state two separate claims as one.
- Rests on an assumption: Every culture has something positive, something unique, and something negative.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In this way, the construction and interpretation of health behaviors are examined as functions of broader cultural contexts particularly in relation to how culture defines the roles of persons, and their expectations in family and community relationships.”
§ 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 > Discussion
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
In the paper
“Within the context of nutrition, in describing how culture impacts dietary habits, James (2004) noted that food, particularly ‘soul food’ is a positive and existential dietary behavior practiced among African Africans and used to celebrate and affirm culture.”
§ 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 > Results > Positive aspects of culture as a critical domain in PEN-3
What the sources say
- Not checked — no full text of the sourcecites James 2004 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“‘the model takes the thematic interpretation of qualitative data into an analysis process that sorts beliefs and concepts into discrete domains that can then be contextualized with specific behaviors, delivery and messages’ (Erwin et al. 2010).”
§ 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 > Limitations and future directions of the PEN-3 model based on reviewed studies
What the sources say
- Not checked — no full text of the sourcecites Erwin et al. 2010 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“With Recontextualization, Morse and Field (1995) suggest that the goal is to locate the themes generated from qualitative data within the context of established knowledge.”
§ 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 > Results > Application of PEN-3 cultural model in studies reviewed
What the sources say
- Not checked — no full text of the sourcecites Morse and Field 1995
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Underwood et al. (1997) reported that infant feeding practices among low-income African-American women were ‘learned’ from family members and others within the community and ‘shared’ with other new mothers within the community as well.”
§ 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 > Results > Family as a common intervention entry point for culture
What the sources say
- Not checked — no full text of the sourcecites Underwood et al. 1997 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“PEN-3 also enables an examination of the perceptions people may have about a health behavior, the resources or institutional forces that enable or disenable actions toward the health behavior and the influence of family, friends, and communities in nurturing the behavior.”
§ 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 > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
In the paper
“In determining targets for public health interventions as part of the Cultural Identity domain of the PEN-3 model, James (2004) reported that African-American women are key agents of cultural transformation as they are usually concerned with the family’s health, responsible for food preparation, set standards for healthful and unhealthy eating, and provide access to other family members.”
§ 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 > Results > Family as a common intervention entry point for culture
What the sources say
- Not checked — no full text of the sourcecites James 2004 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“frying foods, which is known to be harmful to health (James 2004).”
§ 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 > Results > Positive aspects of culture as a critical domain in PEN-3
What the sources say
- Not checked — no full text of the sourcecites James 2004 source
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In doing so, this approach unpacks assumptions surrounding individual responsibilities or capabilities so as to expand and examine the role other factors play in inhibiting and/or nurturing healthy behavior change.”
§ 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 > Conclusion
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Qualitative findings using the PEN-3 cultural model continue to be very important and they do provide some key outcomes on which quantitative design could be used to advance current use of the model to better understand culture and health.”
§ 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 > Discussion
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Furthermore, culturally appropriate and compelling strategies for behavior change will require an understanding not only of individual-level factors but also of factors related to cultural norms including conditions in which people live, grow, eat, and die.”
§ 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 > Discussion
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Whereas many of the conventional health behavior theories often focus on the individual to promote change, PEN-3 offers a culture-centered approach to health that extends analysis to the totality of the contexts that either inhibit or nurture the individual.”
§ 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 > Conclusion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“What is central to PEN-3, then is to ensure that interventions are developed not only with the bad in mind (as is often the case), but to begin with identifying and promoting the good while recognizing the unique aspects of culture with respect to health.”
§ 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 > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
- Rests on an assumption: Every culture has something positive, something unique, and something negative.
In the paper
“food myths, inaccurate information, and negative behaviors surrounding food choices and dietary intake are common among African-Americans”
§ 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 > Results > Positive aspects of culture as a critical domain in PEN-3
What the sources say
- Not checked — no full text of the sourcecites James 2004 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In framing the impact of culture on health, the PEN-3 cultural model offers a tool for those who are committed to addressing health issues and problems to do so by acknowledging those aspects of culture that may negatively influence health, but always identifying a strength-based approach to public health intervention and education utilizing positive aspects of culture.”
§ 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 > Conclusion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
- Rests on an assumption: Every culture has something positive, something unique, and something negative.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Discussing the positive aspects of culture and behavior, while reframing those cultural occurrences traditionally viewed as negative allows researchers to develop culturally congruent explanations and culturally relevant interventions for health.”
§ 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 > Results > Positive aspects of culture as a critical domain in PEN-3
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Taken together, the 45 articles presented in this review highlight the importance of exploring the impact of culture on health, particularly in designing effective public health interventions.”
§ 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 > Discussion
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“The PEN-3 cultural model focuses on the impact of culture on health beliefs and actions, and proposes that public health and health promotion should not focus only on the individual, but instead on cultural context that nurtures a person’s health behavior in his or her family and community (Airhihenbuwa 2007b).”
§ 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 > Discussion
What the sources say
- Not matchedcites Airhihenbuwa 2007b
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
- Not matched
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“PEN-3 offers the opportunity to view culture as the raison d’etre of health behavior as culture gives meanings to the coexistence of what is good, indifferent, and bad.”
§ 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 > Discussion
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
- Rests on an assumption: Culture gives meanings to the coexistence of what is good, indifferent, and bad.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It also represents an important approach over other efforts that primarily focus solely on Western constructs of individual factors that influence health behaviors.”
§ 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 > Limitations and future directions of the PEN-3 model based on reviewed studies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Indeed, caution should be exercised in transferring the findings generated using the PEN-3 model to other contexts as cultural aspects of health behaviors in one setting may not be applicable to other settings.”
§ 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 > Limitations and future directions of the PEN-3 model based on reviewed studies
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
The paper relies on this without support.
There is a need to understand how the PEN-3 cultural model has been applied in studies, including the approach used to guide data collection and analysis, common thematic representations, limitations, and future directions.
“There is a need, however, to understand how this model has been applied in these studies, what approach (if any) is used to guide data collection and analysis, common thematic representations generated from the application of the model, limitations associated with using this model, and future directions with respect to application of the model.”
The paper relies on this without support.
Every culture has something positive, something unique, and something negative.
“Every culture has something positive, something unique, and something negative.”
The authors state this as an assumption.
The way that people perceive their health is rooted in relationships and interactions characteristic of their culture.
“with the understanding that the way that people perceive their health is rooted in relationships and interactions characteristic of their culture”
The paper relies on this without support.
Culture gives meanings to the coexistence of what is good, indifferent, and bad.
“culture gives meanings to the coexistence of what is good, indifferent, and bad.”
Citations
Cites
Positive psychology: An introduction.
Seligman, M. E. P., & Csikszentmihalyi, M. (2000) · American Psychologist · doi:10.1037/0003-066x.55.1.5 · Cited by 11,351 · cited 1×
“…encouraged a paradigm shift from a focus on negative aspects of individuals and related pathology to identifying and bolstering positive personal attributes for understanding how people thrive and survive even in situations and environments of adversity (Seligman and Csikszentmihalyi 2000).”
BackgroundJournal of the National Medical Association
(2010) · Journal of the National Medical Association · doi:10.1016/s0027-9684(15)30622-2 · Cited by 5,338
誠一, 市. (2004) · The Journal of AIDS Research · doi:10.11391/aidsr1999.6.104 · Cited by 3,233
The Significance of Saturation
Morse, J. M. (1995) · Qualitative Health Research · doi:10.1177/104973239500500201 · Cited by 2,663
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Dutta, M. J. (2007) · Communication Theory · doi:10.1111/j.1468-2885.2007.00297.x · Cited by 442
James, D. (2004) · Ethnicity & Health · doi:10.1080/1355785042000285375 · Cited by 407
Health and Culture: Beyond the Western Paradigm
Airhihenbuwa, C. O. (1995) · Cited by 362
Self-citationHealth and Culture-Beyond the Western Paradigm
Parvanta, C. F. (1996) · Journal of Human Lactation · doi:10.1177/089033449601200332 · Cited by 335 · cited 5×
“It focuses on the role of culture as a connecting web by which individual perceptions and actions regarding health are shaped and defined (Airhihenbuwa 1995, 2007a, 2007b), while acknowledging that these perceptions and actions are building blocks in constructing health beliefs that are reproduced…”
BackgroundInfluentialThe Role of Culture in Health Literacy and Chronic Disease Screening and Management
Shaw, S. J., Torres, C. H., Armin, J. S., Orzech, K., & Vivian, J. (2008) · Journal of Immigrant and Minority Health · doi:10.1007/s10903-008-9135-5 · Cited by 257 · cited 3×
“1 Sheppard et al. (2010) In-depth interviews N = 34 (14 breast cancer patients in active treatment, 10 survivor advocates, and 10 cancer providers) Treatment decisions Breast cancer Reported key perceptions (such as sharing/hearing stories of survival, strong faith), enablers (patient-provider relationship, need/desir…”
Background
Research works printed but not linked: 8
- Airhihenbuwa C. O., 2004, Journal of Social Aspects of HIV/AIDS Research Alliance, 1, 1
- Melancon J., 2009, International Electronic Journal of Health Education, 12, 203
- 10.2190/IQ.28.3 · DOI
- Singhal A., 2003, MICA Communications Review, 1, 21
- 10.1155/2012/47806 · DOI
- Walker C., 2000, Ethnicity and Disease, 10, 165
- White K., 2012, Ethnicity and Disease, 22, 274
- Williams M. S., 2012, Ghana Medical Journal, 46, 147
Cited by
Sorted by citations
COVID-19 Confinement and Health Risk Behaviors in Spain
López‐Bueno, R., Calatayud, J., Casaña, J., Casajús, J. A., Smith, L., Tully, M. A., Andersen, L. L., & Sánchez, G. F. L. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.01426 · Cited by 259
Iwelunmor, J., Blackstone, S., Veira, D., Nwaozuru, U., Airhihenbuwa, C., Munodawafa, D., Kalipeni, E., Jutal, A., Shelley, D., & Ogedegbe, G. (2015) · Implementation Science · doi:10.1186/s13012-016-0392-8 · Cited by 219
“behaviors and interventions in the sub-Saharan Africa context [28].”
BackgroundSelf-citationOvercoming barriers to physical activity in underserved populations
Bantham, A., Ross, S. E. T., Sebastião, É., & Hall, G. (2020) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2020.11.002 · Cited by 197
Cultural and Contextual Adaptation of Digital Health Interventions: Narrative Review
Naderbagi, A., Loblay, V., Zahed, I. U. M., Ekambareshwar, M., Poulsen, A., Song, Y. J. C., Ospina‐Pinillos, L., Krausz, M. R., Kamel, M. M., Hickie, I. B., et al. (2024) · Journal of Medical Internet Research · doi:10.2196/55130 · Cited by 160
Culture Matters in Communicating the Global Response to COVID-19
Airhihenbuwa, C. O., Iwelunmor, J., Munodawafa, D., Ford, C. L., Oni, T., Agyemang, C. O., Mota, C. S., Ikuomola, O. B., Simbayi, L. C., Fallah, M. P., et al. (2020) · Preventing Chronic Disease · doi:10.5888/pcd17.200245 · Cited by 141
Self-citation
Metadata
- Authors
- Iwelunmor, J., Newsome, V., & Airhihenbuwa, C. O.
- Affiliations
- University of Illinois Urbana-Champaign (US)
- National Development and Research Institutes (US)
- Pennsylvania State University (US)
- Corresponding author
- Airhihenbuwa, Collins O.
- Venue
- Ethnicity & Health
- Publisher
- Informa UK Limited
- Published
- 2013-11-22
- Volume
- 19
- Issue
- 1
- Pages
- 20-46
- ISSN
- 1355-7858 (ISSN-L)
- 1465-3419
- PMC
- PMC4589260
- OpenAlex
- W2090486171
- Semantic Scholar
- 060f9ddb2e0d8b3412ff21c738c490917602a57c
- Cited by
- 259
- References
- 64
- Citations by year
- 2026: 29 · 2025: 36 · 2024: 33 · 2023: 17 · 2022: 20 · 2021: 22 · 2020: 22 · 2019: 26 · 2018: 14 · 2017: 15 · 2016: 9 · 2015: 13 · 2014: 2 · 2013: 1
- FWCI
- 6.46
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Ethnicity and Health (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (submittedVersion)
- Funders
- National Institutes of Health (5t32da007233-40)
- National Institute on Drug Abuse (T32DA007233)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Cultural Competency in Health Care
- Social Sciences › Health › Public Health and Social Inequalities
- Social Sciences › Health › Indigenous Health, Education, and Rights
- Keywords
- PEN-3 cultural model, culture and health, health behavior, family systems, culturally sensitive interventions, health disparities, cultural practices, health beliefs, public health interventions
- MeSH terms
- Cultural Characteristics, Family Relations, Humans, Models, Theoretical, Public Health, Health Behavior, HIV Infections, Databases, Bibliographic, Biomedical Research, Cultural Competency, Social Stigma
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-16, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-16 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Cited sources are checked with a language model’s help (gpt-6-sol).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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