Bridging Theory and Culture: A Case Study of Smoking Cessation in Myanmar Using the Health Belief Model

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Abstract

This case study examines the culturally competent application of the Health Belief Model (HBM) to facilitate smoking cessation in Myanmar, focusing on the 18-month behavioral journey of "Mr. KS." Operating in peri-urban Myanmar, where smoking and tobacco use is entrenched in social and masculine identity, the intervention implemented elements of psychological theory, medical biomedical science, and cultural-competence to target multifactorial smoking. Occupying the five domains of the HBM, we used culturally adapted health communication, facilitators of peer support groups, nicotine replacement therapy, and mobilized community and religion. This case demonstrates the efficacy of tailored interventions designed within the COM-B system, and intended to be underpinned by culture, health professionals can promote meaningful behavioral change and improvement with populations and methods that are relative to their collective values and practices. As process-informed evaluations of the case, this case is a transferable model of bridging a patterned theory of Western health behavior and indigenous paradigms/beliefs; this case provides a new contribution to global health promotion, showing that culturally grounded interventions make positive and meaningful public health differences in collectivist cultures, and offers evidence-informed recommendations for capacity building in similar low-resourced environments.

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