Which of the following is true of cultural proficiency on the cultural competence continuum

HLTH 236

INTRO HLTH DISPAR & DIVERSITY

Texas A & M University-College Station

Ethnicity involves all of the following, except:

genes (includes: history, language, and rituals)

Jones (2000) developed a framework to understand racism that had all of the following levels except:

Socioenviornmental (had: institutionalized, personally mediated, and internalized)

Personally mediated racism can be defined with the help of all of the following concepts, except:

Acceptance (can be: discrimination, intentional, and prejudice)

All of the following are examples of culturally and linguistic appropriate actions provided in the healthcare setting, except:

English exams (are: translation, interpretation, and medical Interpretation)

Accepting limitations to ones own full humanity, including ones spectrum of dreams defines which of the following:

According to Jones (2000), some researchers now believe that race-associated differences in health outcome are due to the effects of:

Institutionalized racism manifests itself both in material conditions and in access to power.

Which of the following is considered the first explicit commitment by the government to achieve equity in health outcomes:

Initiative to Eliminate Racial and Ethnic Disparities

Examples of material conditions when referring to institutionalized racism include which of the following:

In the example given in the Camara (2000) article, the gardener of the flowering pots would be considered who:

Broadly defined ______ as a common heritage or set of beliefs, norms and values:

culture (refers to the shared, and largely learned, attributes of a group of people)

• Defined as a biological category as a way to label different groups according to a set of common inborn biological markers
  
• skin color, shape of eyes, nose and face, etc.
• “No consistent racial groups emerge when people are sorted by physical and biological characteristics”
• Overwhelming evidence shows that greater genetic variation occurs within a racial group than across racial groups.

• Refers to a common heritage shared by a particular group
  
• Heritage includes similar history, language, rituals, and preferences for music and foods, etc.

• Refers to a group of skills, attitudes, and knowledge that allows a person, organizations, and systems to work effectively with diverse racial, ethnic, and social groups.
  
• Defined as a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals and enables that system, agency, or those professionals to work effectively in cross-cultural situations (Cross, Bazron, Dennis, & Isaacs, 1989).
• Operationally defined, it is the integration and transformation of knowledge about individuals and groups of people into specific standards, policies, practices, and attitudes used in appropriate cultural settings to increase the quality of health care; thereby producing better health outcomes (Davis, 1997).  
• Effectively operating in different cultural contexts.  Knowledge, sensitivity, and awareness do not include this concept.  
• “This is beyond awareness or sensitivity," says Marva Benjamin of the Georgetown Technical Assistance Center for Children's Mental Health.

How is cultural competence achieved?

• By identifying and understanding the needs and help-seeking behaviors of individuals and families.
  
• Designing and implementing services that are tailored or matched to the unique needs of individuals, children, families organizations and communities served.
  
• Practice is driven in service delivery systems by client preferred choices, not by culturally blind or culturally free interventions.
  
• Culturally competent organizations have a service delivery model that recognizes mental health as an integral and inseparable aspect of primary health care.

• Knowing that cultural differences as well as similarities exist, without assigning values to those cultural differences
  
• i.e., better or worse, right or wrong

• Understanding that ethnic and racial groups will have values that they hold that are specific to their culture.
  
• Example: African Americans - a spiritual component may need to be a part of health education programs.

• The capacity of an organization and its personnel to communicate effectively and convey information in a manner that is easily understood by diverse audiences including:
  
• persons of limited English proficiency
• those who have low literacy skills or
• are not literate and individuals with disabilities.

• Health disparities among Racial/Ethnic Groups exist
  
• Institute of Medicine Report on Unequal Treatment among Racial/Ethnic Groups
  
• America has a very diverse population and it is becoming more diverse.

Examples of Culturally Competent Care

• The Perinatal Program
  
• A Community Health Worker Model of La Clinica del Carino Family Health Center
• The Community Health Education Center of the Massachusetts Department of Public Health
  

Other Culturally Related Issues

• Language:
  
• “Communication is more than simply shared language it must also include a shared understanding and shared context as well.”

Providing Culturally & Linguistic Appropriate Health Care

• Key Concepts to recognize:
  
• Linguistic variation within a cultural group
• Cultural variation within a language group
• Variation in literacy levels in all language groups.
• Translation
• Interpretation
• Medical Interpretation

Cultural Competence Works

• Eight Guiding Principles:
  

1. Define culture broadly
   
2. Value clients’ cultural beliefs
   
3. Recognize complexity in language interpretation
   
4. Facilitate learning between providers and communities
   
5. Involve the community in defining and addressing service needs
   
6. Collaborate with other agencies
   
7. Professionalize staff hiring and training
   
8. Institutionalize cultural competence  
   

Conclusions and Suggestions for Cultural Competency

• Implement recommended National Standards into Organizational Health Structures
  
• Implement Culturally and Linguistically Appropriate Services (CLAS)
  
• Involve target community in decision making about health care needs.
  
• Hire target community as workers
  
• Train staff, allocate budget and time for training staff to be culturally competent
  
• Adequately document client’s cultural and linguistic histories and collect personal information during intake
  
• Partner with other agencies to combine and expand culturally competent services
  
• Culturally competency has to be on-going no one ever masters a culture
  
• Culturally appropriate programs are also community specific rather than ethnic group in general
  
• Institutionalize culturally competent policies into the organization
  

What is the continuum of cultural competence?

What are the 4 elements of cultural competence?

Which of the following is considered cultural competence?

What are the 5 components of cultural competence?