Below, PatientEngagementHIT outlines the concept of cultural competence and why it is important for medical professionals. In a study comparing various methods of interpretation, patients who use professional interpreters are equally as satisfied with the overall health care visit as patients who use bilingual providers. Seattle, WA: Author. 16. Cultural competence in healthcare refers to the ability for healthcare professionals to demonstrate cultural competence toward patients with diverse values, beliefs, and feelings. The Association of American Medical Colleges (AAMC) and ASPPH sponsored a Joint Expert Panel on Cultural Competence Education to develop a set of core cultural competencies appropriate for, though not limited to, medical and public health students. New York: The Commonwealth Fund. In the world of medicine, the term cultural competence refers to the knowledge, skills, attitudes and behavior required of a healthcare professional to provide optimal care and services to patients from a wide range of cultural and ethnic backgrounds. American Institutes for Research. Impact of low health literacy skills on annual health care expenditures. 552-593). Fiscella, K., Franks, P., Doescher, M. P., & Saver, B. G. 2002. Join NPIN’s new social community to connect, share, and collaborate. 1999. Retrieved November 18, 2003, from http:// cms.hhs.gov/states/letters/smd83100.asp. For example, analysis of data from the HIV Cost and Services Utilization Study revealed that compared with nonminorities, women and African Americans with HIV disease who are receiving care are less likely to receive antiretroviral therapy, protease inhibitors, and prophylaxis for pneumocystis pneumonia. (2) These rank among the most costly medical conditions in America. As a result, medical schools must now provide students with the skills to understand how people of diverse cultures and belief systems perceive health and illness and respond to various symptoms, diseases, and treatments. How illness, disease, and their causes are perceived 3. Spanish-speaking Latinos are less satisfied with the care they receive and more likely to report overall problems with health care than are English speakers. Site Index ACRS participates in national effort to train mental health interpreters. Organizational policies that address language and literacy barriers have been among the most successful efforts. For example, based on ten years of work, the Society of Teachers of Family Medicine has developed guidelines for curriculum material to teach cultural sensitivity and competence to family medicine residents and other health professionals. (17) The quality of patient-physician interactions is lower among non-White patients, particularly Latinos and Asian Americans. If the providers, organizations, and systems are not working together to provide culturally competent care, patients are at higher risk of having negative health consequences, receiving poor quality care, or being dissatisfied with their care. Retrieved November 13, 2003, from http://nces.ed.gov/pubs93/93275.pdf. Druss, B.G., Marcus, S.C., Olfson, M., Pincus, H.A. (7) As the population at risk of chronic conditions becomes increasingly diverse, more attention to linguistic and cultural barriers to care will be necessary. Retrieved November 17, 2003, from http://www.chcs.org/ resource/pdf/h13.pdf. In addition to increasing the cultural competence of health care providers, organizational accommodations and policies that reduce administrative and linguistic barriers to health care are also important. For example, Spanish-speaking Latinos are less likely than Whites to visit a physician or mental health provider, or receive preventive care, such as a mammography exam or influenza vaccination. Members of a cultural group a… Table DP-1, Profile of general demographic characteristics: 2000. Cultural competence is the ability to collaborate effectively with individuals from different cultures; and such competence improves health care experiences and outcomes. Second, these strategies may be seen as essential to meeting the federal government’s Healthy People 2010 goal of eliminating racial and ethnic health disparities. Health, United States, 2003: Chartbook on trends in the health of Americans. Lawrenceville, NJ: Author. These trained individuals act not only as interpreters, but also help provide a cultural context for the client’s beliefs and practices. (Adapted from Cross, 1989).(1). have a defined set of values and principles, and demonstrate behaviors, attitudes, policies, and structures that enable them to work effectively cross-culturally. Cultural Competence, Awareness, and Sensitivity. Understanding that each patient is a … The peer education model is not only cost-effective, but also has been shown to be more effective in terms of reaching populations who find the information more credible coming from someone with a familiar background. (8) Follow up in 1997 revealed improvements, but African Americans and Hispanics were still only about half as likely as whites to participate in HIV clinical trials or to get experimental medicines. (9) Health service use may also be affected by the availability of interpreters. For example, if a program wants to analyze patterns of broken appointments, it might examine variables such as age, gender, or race/ethnicity. 2. Respect is at the heart of cultural competence-patients who feel their healthcare providers respect their beliefs, customs, values, language, and traditions are more likely to communicate freely and honestly, which can, in turn, reduce disparities in healthcare and improve pati… Third, many health systems are finding that developing and implementing cultural competence strategies are a good business practice to increase the interest and participation of both providers and patients in their health plans among racial and ethnic minority populations. Racial and ethnic minorities are also more likely to have lower levels of literacy, often due to cultural and language barriers and differing educational opportunities. In August 2000, the Health Care Financing Administration (now Centers for Medicare and Medicaid Services) issued guidance to all state Medicaid directors regarding interpreter and translation services, emphasizing that federal matching funds are available for states to provide oral interpretation and written translation services for Medicaid beneficiaries. Center for Medicare and Medicaid Research, National Center for Education in Maternal and Child Health, National Maternal and Child Oral Health Resource Center. (U.S. Bureau of the Census, Current Population Reports, P25-1130). incorporate the above in all aspects of policy making, administration, practice, service delivery, and involve systematically consumers, key stakeholders, and communities. The population will also become increasingly diverse (see Figure 2). 'Culture' refers to integrated patterns of human behavior that include the language, thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups. From the AIDS Education and Training Center National Multicultural Center, Cultural Competence Health Practitioner Assessment (CCHPA) 6. Chicago: Author. Stemming from 30 years of experience in this arena, ACRS has developed a training curriculum, “Building Bridges: Mental Health Interpreter Training for Interpreters of Southeast Asian Languages.” This curriculum will be used as a model for a national mental health interpreter training project to address the needs of limited-English speaking people. Important to note, however, is that cultural competence is a process rather than an ultimate goal, and is often developed in stages by building upon previous knowledge and experience. This national project includes training for interpreters, trainers, and health providers, as well as a mental health interpreter certification process. (27), ASSESSING LITERACY LEVELS CAN BREAK DOWN BARRIERS, Methods employed to assess literacy levels include the use of screening instruments that test for certain skills related to functional literacy or less formal tools that allow health care professionals to determine a person’s comfort level with various modes of communication. (12), The 1992 National Adult Literacy Survey found that 40 to 44 million Americans do not have the necessary literacy skills for daily functioning. Disparities in healthcare extend to the patient safety arena. Westmoreland, T. M. 2000, August 31. Lower quality patient-physician interactions are associated with lower overall satisfaction with health care. (16), People with chronic conditions require more health services, therefore increasing their interaction with the health care system. From Health Resources and Services Administration (HRSA) Care ACTION: Improving HIV/AIDS Care in a Changing Environment, August 2002, Mitigating Health Disparities Through Cultural Competence: The recent National Academy of Medicine report Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care states that "racial and ethnic minorities tend to receive a lower quality of health care than nonminorities, even when access-related factors, such as patients' insurance status and income, are taken into account. (10), Language and communication problems may also lead to patient dissatisfaction, poor comprehension and adherence, and lower quality of care. 8. To Join the NPIN community Sign In or Sign up. Among non-English speakers who needed an interpreter during a health care visit, less than half — 48 percent — report that they always or usually had one. Reduce racial and ethnic minorities will comprise 35 percent of the United States population and the nation 's care! 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