|508 Compliance Text
||(Title Slide).Cultural and Diversity Considerations
After this session, participants will be able to:
- Define cultural competency
- State the four elements of cross cultural communication
The Importance of Cultural Competency
- Health care workers need to be aware of, and sensitive to, cultural diversity, life situations, and other various factors that shape a person’s identity.
- The first step is an open, non-judgmental attitude.
What is Culture?
Culture has been defined in a number of ways, but most simply, as the learned and shared behavior of a community of interacting human beings.
What is Cultural Competency?
Cultural competency refers to an ability to interact effectively with people of different cultures.
What are Some Examples of Diversity Categories/Cultural Groups?
- Parental Status
- Homeless persons
- Substance users
- Sexual orientation
- Incarcerated persons
- Profession (e.g., healthcare workers)
Four Elements for Cross-Cultural Communication
- Awareness of one’s own cultural values
- Are you attentive to your own preconceived notions of other cultural groups?
- Awareness and acceptance of cultural differences
- Do you look for opportunities to meet and interact with individuals who are from cultures other than your own?
Four Elements for Cross-Cultural Communication
- Development of cultural knowledge
- Are you familiar with the world views of cultural groups other than your own?
- Ability to adapt to the cultural context of the case
- Do you know how to navigate cross-cultural interactions?
What Can Culture Affect? (1)
- Description and communication of symptoms
- Perceived causes of illness; understanding of infection, transmission, and contacts
- Health-seeking behavior
- Understanding of disease process, treatment expectations, and decision making
What Can Culture Affect? (2)
- Interaction with the health care system and health care professionals
- Attitudes towards helpers and authorities; reluctance to reveal contacts
- How a person identifies and describes their contacts
Cultural Diversity Exercise
Refer to Appendix M
Ask Questions to Get to Know the Individual Case
- How do you prefer to be addressed?
- Where were you born?
- How long have you been in the U.S.?
- Are you more comfortable reading information in your native language or in English?
- How are important healthcare decisions are made in your family?
- Are there certain health care procedures and tests that your culture prohibits?
What do You Want to Find Out? (1)
- Language and literacy level
- Health knowledge and health beliefs
- Health seeking behaviors
- Daily routine activities
- Relevant relationships
- Living situation
- Visitors and/or travel
What do You Want to Find Out? (2)
- Decision making preferences
- Perception of and knowledge of U.S. health care system
- Perception of “western” medicine
- Other health belief systems
- Relevant incentives
Use Open-Ended Questions to Generate Helpful Conversation
- How did you feel when you learned you had TB?
- How do you feel about knowing that you may have infected others with TB?
- What matters most as you are being treated for TB?
- Tell me about anything that may affect your treatment, home visits, etc.
Cultural and Diversity Concerns in Contact Investigation (1)
- Attitudes and beliefs about TB transmission
- Beliefs about the BCG vaccine
- Risks and benefits of LTBI treatment
- Identification of contacts
Cultural and Diversity Concerns in Contact Investigation (2)
Understanding who a contact is:
- Nuclear family, extended family
- Members of a group living situation
- Residents of a nursing home, shelter, or jail
- Fellow drinkers, substance users
- Members of a church, temple, or mosque
- Co-workers, supervisor, or boss
Cultural and Diversity Concerns in Contact Investigation (3)
Cultural background may influence the case’s willingness to reveal names:
- Immigration status
- Reasons not to give correct name
- Reasons to hide someone or not name them
- Reluctance to identify contacts
- Different cultures have different naming systems
- First, middle, last?
- Two last names?
- Family name first?
- Ask for all names, nicknames, aliases
- Make sure forms and registry can accommodate
- Have the case agree to always use the same name
Cultural Competency Resources
[Image: Front cover of the Country Specific Guides from the Southeastern National TB Center.]
[Image: Front cover of Promoting Cultural Sensitivity - A Practical Guide for Tuberculosis Programs from CDC.]
[Image: Front cover of the CDC TB Education and Training Network (TB ETN) Cultural Competency Resource Guide.]
[Image: Front cover of Beyond Diversity: A Journey to Cultural Proficiency Facilitator's Guide from the Heartland National TB Center.]
[Image: Front cover of Cultural Competency and Tuberculosis Care: A Guide for Self-Study and Self-Assessment from the New Jersey Medical School Global Tuberculosis Institute at Rutgers.]
[Image: First page of the Quick Reference Guide for the Philippines from the Southeastern National TB Center.]
||[Title Slide] Working with Interpreters
Language Access Barrier
45 million people in the United States speak a language other than English at home
Impact of Language Barriers
- Less likely to receive care
- Less likely to understand care
- Increased risk of medical errors
- Reduced quality of care
- Less satisfied with care
Using an Interpreter
- Make sure you agree on ground rules with both the case and the interpreter before the interview begins
- Always speak directly to the case
- Ask for clarification as needed
- Children should not be used as interpreters!
Resource for Interpretation
Video and viewer’s guide
Making the Connection: www.currytbcenter.ucsf.edu
[Image: Front cover of Making the Connection: An Introduction to Interpretation Skills for TB Control from the Curry International TB Center.]
- What is cultural competency?
- What are the four elements of cross cultural communication?