health promotion strategies that can be implemented upon the predictive characteristics of the family.

My health promotion strategy program will center around a Cuban-American family called the Garcias whose primary health issues center on hypertension, and the need for greater information about the importance of establishing a healthy lifestyle. This includes the importance of screening, exercise, establishing healthy habits, and monitoring ones lifestyle. Several members of the family indicate stress and hypertension whilst the grandmother also has cardiac disease and osteoarthritis, but is resilient to receiving information on how to alleviate her symptoms. In a similar way, Angelo, an addicted smoker, refuses to stop smoking and to deal with his chronic cough and mild chest pain, stating that, as man of the family, he has to continue working his overwhelming hours. Gerardo, the son, being active homosexually, seems to be vulnerable to AIDS; it is unclear whether or not he is acting upon that information. Lourdes, the mother and wife, is the only one who appears to be controlling her health. Nonetheless, she too suffers from hypertension.

Three dynamics need to be dealt with here:

1. A stress-reducing program implemented

2. A program, established in a non-intimidating manner, that can instruct the Garcias about the importance of regulating their health and ways in which to do this.

3. An overall format in which the former two goals and the specificities of each persons symptoms (specifically those of the grandmother and Angelo) can be accomplished in a manner in which they will be receptive to the information.

Since cultural factors are impacting their health, as can be evidenced by Angelo refusing to recognize and address his symptoms as per the statement that he, as male, has to protect his family and as evidenced, too, by the grandmother rejecting American knowledge, manner have to be found whereby the information can be presented to them in the context of their cultural background thus influencing them to better accept the information.

Mercedes: An unrecognized social dynamic at play here can be the distrust of Western civilization in general, and of Americans in particular, that may have been transmitted to the grandmother. Not only does Cuba have a history of harsh dictatorship (e.g. from Fulgencio Batista in the modern era), which has caused distrust against government and reliance on independence, but also worse still this Fulgencio Batista was supported by the United States. In 19561, the U.S. also warred against Cuba, and even though unsuccessful, U.S. Cuban clashes followed and many Cubans attribute Cubas economic decline to American interference with their Soviet support. This was exacerbated by Clintons intercepting migrants at sea and detaining them in migrant centers at Guantanamo Bay. It is no wonder that Mercedes, a product of that culture, and, therefore, likely ideologically imbued with their indoctrination is resilient to receiving information and advice from American health service. For all we know, she may have been told (in typical soviet-type propaganda) that their services are deceptive and destructive to Cuban survival.

Dealing with this mentality is challenging. One idea.