Cultural determinants of help seeking: a model for research and practice.

Increasing access to and use of health promotion strategies and health care services for diverse cultural groups is a national priority. While theories about the structural determinants of help seeking have received empirical testing, studies about cultural determinants have been primarily descriptive, making theoretical and empirical analysis difficult. This article synthesizes concepts and research by the author and others from diverse disciplines to develop the midrange theoretical model called the Cultural Determinants of Help Seeking (CDHS). The multidimensional construct of culture, which defines the iterative dimensions of ideology, political economy, practice, and the body, is outlined. The notion of cultural models of wellness and illness as cognitive guides for perception, emotion and behavior as well as the synthesized concept of idioms of wellness and distress are introduced. Next, the CDHS theory proposes that sign and symptom perception, the interpretation of their meaning, and the dynamics of the social distribution of resources are all shaped by cultural models. Then the CDHS model is applied to practice using research with Asians. Finally, implications for research and practice are discussed.