Strengthening cross-cultural policy transfer
: the case of international health promotion and tobacco control

  • Albena Georgieva Kerekovska

    Student thesis: Doctoral Thesis


    The study refers to the issue of cross-cultural transfer of internationally initiated health promotion and tobacco control policies. It explores the process of cross-cultural policy transfer, analyses the difficulties, proposes methods to overcome them, and tests the approach in Bulgaria. Generally focused on international health promotion policies as a broad area of study, the work particularly concentrates on tobacco control policies as a more concrete and specific subject of investigation.

    Completion of a short piece of cross-national comparative policy transfer research, based on two case studies - the UK as a donor of policy and Bulgaria as a recipient location - is used to assist designing an empirical investigation that develops and tests an approach for strengthening the process of cross-cultural transfer. The Hofstede Model of National Cultures is used as a guiding tool to describe and classify the different cultures of the two countries, and to assess the cultural constraints and possibilities for transfer.

    The results confirm the hypothesis that through contextual interpretation of international health promotion policy language, and its specification to the cultural patterns of Bulgaria, we can increase the acceptability and assure greater effectiveness in communicating those health promotion messages. The findings indicate the need for culturally specific language interpretation and adaptation of global policies if they are to become understandable and applicable to specific cultural contexts. They help to address the question: "How can the main concepts and issues inherent in western developed health promotion policies be translated into the language of countries having different cultural patterns?"

    The main theme of this research has not been explored so far in Bulgaria and it is also a rather new topic for international policy research. The findings might assist the process of improving cross-cultural policy formulation and help to overcome the difficulties in cross-cultural policy transfer. The study takes into account the dynamic developments within Bulgaria as it prepares for European integration as a pre-Accession country; and its findings could assist in negotiations within public health policy. The work could also have some major applications on a wider policy basis. It might also be of particular importance for countries not in the western group within Europe and which are socio-culturally different.

    Some implications can also be considered for the process of accession to the EU. The Union is now expanding and is challenged by great cultural diversity, both across Europe and within the individual states. Accession countries like Bulgaria have to adapt now to international and European policies and principles, which cannot be directly translated into the language of many countries. The methodology developed here should assist the adaptation of international policy items into a language that is culturally specific for the country and the sub-national levels, and thus improve the implementation of European policies in particular localities.
    Date of AwardSep 2004
    Original languageEnglish
    SupervisorMorton Warner (Supervisor)


    • Health promotion
    • Tobacco use
    • Prevention

    Cite this