Qualitative focus group data from participants of an intensive, culture-specific, lead poisoning preventive education research project were analyzed to assess success of communication strategies, and, specifically, to identify barriers to and facilitators of adopting behavior changes encouraged in the project. Effectiveness of education in preventing lead poisoning is addressed elsewhere. Education focused on housecleaning, hygiene, water, and nutrition. Ninety-five participants (89% of 107 eligible) of six ethnicities agreed to participate in focus groups. Seventy-eight (82%) actually attended. Barriers to behavior change included the effort required or unpleasantness of a prevention strategy, presentation of familiar information, denial of the problem, busyness, perceived lack of control, lack of social support, cultural traditions, and misunderstandings. Requiring one-time behavior changes; teaching simple, easy strategies; making less appealing tasks fun; demonstrating concepts; and presenting novel material that piques interest were features of the education that facilitated behavior change. Factors internal to the participant, such as love of the child or cultural practices, also served to motivate the participant to change behavior or to facilitate adoption of a prevention strategy. We offer recommendations to assist others in designing effective health education and risk communication prevention or intervention programs.
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All authors were affiliated with the University of Minnesota during the research project. Thanks to the families of the Phillips Community who care so deeply about the futures of their children and generously gave their time in support of the data collection phase of this project. The University of Minnesota investigators participating in this project will forever do our work differently thanks to the thoughtful and tenacious teachings and leadership of the resident members of the Phillips Neighborhood Healthy Housing Collaborative (PNHHC): James Big Bear, Erin Bluejacket, Wendy Boppert, Lilly Bresina, Kay and René Cabrera, Rep. Karen Clark, Charles (Doc) Davis, Jody Deloria, Nicole Diaz Romero, Marc Flores, Teresa Ford, Star Grigsby, Beth Hart, Gwendolyn Hill, Keith Johnson, Mary Johnson, Mary Ellen Kaluza, Leah La Chapelle, Shannon Moon, Donna Morgan, Michelle Nickaboine, Darin Packard, Mary Par-khurst, Sheila Shavers, Cathy Strobel, Deb Terwillger, Deb Whitefeather, and Cathy Winter. We also express our tremendous gratitude to the community staff members, many of whom also served on the PNHHC, for their excellent work and dedication to the research. The work of the PNHHC and its contributions to the research could not have been accomplished without the tireless efforts of its staff over the years: Carol Flavin, Kim Kelker, Ed Petsche, Kim Rowe, and Jermaine Toney. The collection and analysis of the data presented in this article was supported by a Project REACH grant from the Allina Foundation. The Phillips Lead Poisoning Prevention Project was supported by grant MCJ 270801 from the Maternal and Child Health Bureau and grant U67/CCU510771 from the Centers for Disease Control and Prevention.