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)
Text Only Version
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
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?
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 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?
What Can Culture Affect? (1)
Description and communication of symptoms
Perceived causes of illness; understanding of infection, transmission, and contacts
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
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
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:
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 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.]
[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?