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TB Contact Investigation Interviewing Skills Course

Day 2: Cultural and Diversity Considerations 508 Compliance

  • Cultural and Diversity Considerations (20 slides)
  • Working with Interpreters (6 slides)

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Slide Number



508 Compliance Text



1



(Title Slide).Cultural and Diversity Considerations





2



Learning Objectives



After this session, participants will be able to:



Define cultural competency



State the four elements of cross cultural communication





3



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.



4



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.





5



What is Cultural Competency?



Cultural competency refers to an ability to interact effectively with people of different cultures.





6



What are Some Examples of Diversity Categories/Cultural Groups?



  • Geography
  • Culture
  • Gender
  • Spirituality
  • Parental Status
  • Homeless persons
  • Substance users
  • Language
  • Disability
  • Sexual orientation
  • Age
  • Incarcerated persons
  • Profession (e.g., healthcare workers)

7



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?





8



Four Elements for Cross-Cultural Communication



Development of cultural knowledge



Are you familiar with the worldviews 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?





9



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





10



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





11



Cultural Diversity Exercise



Refer to Appendix M





12



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?





13



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





14



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





15



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.





16



Cultural and Diversity Concerns in Contact Investigation (1)



Culture affects:



Knowledge



Attitudes and beliefs about TB transmission



Beliefs about the BCG vaccine



Risks and benefits of LTBI treatment



Identification of contacts





17



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



Visitors





18



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





19



Naming Systems



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





20



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 Guidefrom 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.]



21



[Title Slide] Working with Interpreters



22



Language Access Barrier



45 million people in the United States speak a language other than English at home



[Image: Globe]



23



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





24



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!





25



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.]



26



Review



What is cultural competency?



What are the four elements of cross cultural communication?



 
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