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Strategies to Improve Culturally Effective Care

Culturally Effective Toolkit – From the American Academy of Pediatrics
This Culturally Effective Care Toolkit is a practical, hands-on resource to help practicing pediatricians and their office staff provide culturally effective care to their patients and families. Topics include:

  • Behavior and Child Development
  • Continuing Medical Education Opportunities
  • Health Beliefs and Practices
  • Interpretive Services
  • Literacy and Health Literacy
  • Medical Education
  • Nutrition, Feeding, and Body Image Perspectives
  • Tips, Tools, and Resources for Implementation
  • See more at:

Immigrant Child Health ToolkitFrom the Council on Community Pediatrics, American Academy of Pediatrics
This toolkit was designed to provide practical information and resources for pediatricians and other primary care providers to address common matters related to immigrant child health.

Think Cultural Health. Advancing Health Equity at Every Point.
US Department of Health and Human Services, Office of Minority Health.

  • Great resources for health care providers and administrators to facilitate communication with the culturally and linguistically diverse individuals receiving care and services from your organization, including those with limited English proficiency (LEP).
  • Read about the National CLAS standards and a blueprint for with guidance and implementation strategies. The National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care (the National CLAS Standards) are intended to advance health equity, improve quality, and help eliminate health care disparities by providing a blueprint for individuals and health and health care organizations to implement culturally and linguistically appropriate services. Adoption of these Standards will help advance better health and health care in the United States.
  • The Guide to Providing Effective Communication and Language Assistance Services is grounded in the National CLAS standards covers strategies for communicating in a way that considers the cultural, health literacy, and language needs of your patients and their families. Two tracks of the Guide are available:
    • One is tailored to health care administrators, with information on planning, implementing, and evaluating effective communication and language assistance services.
    • One is tailored to health care providers (or those providing direct care and services), with information on cross-cultural communication skills, working with an interpreter, and more.
  • Think Cultural Health also has helpful, succinct information on how to achieve effective communication at every point of contact within an organization, not just in direct care or service interaction.  Patient Points of Contact graphic has tips for each point of contact including initial contact, appointment scheduling, entering the organization, navigating the building, registration, preparation for the visits, waiting in the lobby, initial care or service encounter, receipt of service or care, billing, reminders and follow -up communication, feedback, complaint and incident reporting.
  • Targeted E-learning programs for health care providers including physicians, nurses, and promotoras with continuing education credits.

National Center for Cultural Competence at Georgetown University
Information for health care and mental health providers on how to incorporate cultural and linguistic competence into one’s healthcare practice or workplace.

Product Highlights:

The Provider’s Guide to Quality and Culture
The Providers Guide is a joint project of  Management Sciences for Health,  U.S. Department of Health and Human Services,  Health Resources and Services Administration and the US Bureau of Primary Health Care.

  • Key resource to assist health care providers and organizations throughout the US in providing high quality, culturally competent services to multi-ethnic populations. The site features an interactive quiz that helps users enhance their knowledge and skills. There is also a guide with 11 modules on topics such as common health problems in selected minority, ethnic and cultural groups, and understanding immigrant, refugee and minority populations. Each module contains readings, mnemonics, exercises, references and annotated links to other relevant Web resources.

Patient Provider interaction pages from the Provider’s Guide include tips for:

  • Clinical Exchanges
  • Prior Assumptions and Prejudices
  • Medical History and Diagnosis
  • Patient Adherence
  • Working with an Interpreter
  • Non-Verbal Communication
  • Relating to Patient’s Families

Providing Language Services in Small Health Care Provider Settings: Examples from the Field
Mara Youdelman, J.D., and Jane Perkins, J.D., The Commonwealth Fund, April 2005.
The National Health Law Program conducted site visits and phone interviews at small health care provider settings to identify  “promising practices”—creative, effective methods that are replicable by other small providers. These practices include recruiting bilingual staff for dual roles (e.g., front desk and interpreter positions); ongoing cultural and language competency training for interpreter staff; using community resources like hospitals, managed care organizations, students, and volunteers; and capitalizing on underutilized funding sources. The authors include an eight-step plan to help providers develop a strategy to meet the needs of their limited English proficient patients and the community. Brief summary of findings and link to full article.

Cross Cultural Health Care Program, Seattle, WA
A model for other programs nationally, the Cross Cultural Health Care Program combines cultural competency training, interpreter training, research, community coalition building, and other service to develop culturally competent models of care. The website includes texts specific to immigrant and refugee communities in Washington, to journals and reference materials on Native American and African American health care issues, and current government documents and publications on the health status of diverse communities.

Improving Cultural Competency in Children’s Health Care: Expanding Perspectives Beyond the Clinical Environment
Change package and findings from the National Initiative for Children’s Healthcare Quality (NICHQ). 36 pages.

Interpreter Services

Information and Patient Handouts for Multiple Cultures/Languages

  • Culture Clues
    Culture Clues™ are tip sheets for clinicians, designed to increase awareness about concepts and preferences of patients from the diverse cultures served by University of Washington Medical Center.  In addition to ” A Communication Guide — All Cultures,”  Culture Clues™ are available for these cultures:   Albanian,  Chinese,  Deaf,  Hard of Hearing,  Korean,  Latino,  Russian,  Somali,  and Vietnamese.
  • EthnoMed
    Developed at Harborview Medical Center, University of Washington, Seattle, Washington. Information for clinicians about cultural beliefs and medical issues pertinent to the health care of recent immigrants to Seattle, many of whom are refugees fleeing war-torn parts of the world.  Links to Patient Education materials in a variety of languages: Amharic,  Chinese,  Hmong,  Karen,  Khmer,  Oromo,  Somali,  Spanish,  Tigrinya and  Vietnamese.
  • The Provider’s Guide to Quality and Culture – Cultural Groups Pages
    Basic information on the culture, health strengths, and health challenges of people from a number of regions around the world
  • Consumer Health Information in Many Languages Resources Search Engine
    A collaboration of the National Networks of Libraries of Medicine Consumer Outreach Librarians.  Use their customized search engine to check many websites at once.

Information and Patient Handouts for Specific Cultures/Languages

African American

Asian and Pacific Islander

Native American

Somali

  • Somali Health Board
    The Somali Health Board (SHB) is a public, non-profit 501(c)3, grassroots organization in Washington State, with ambitious goals of eliminating and reducing health disparities disproportionately affecting the Somali population throughout King County and the state of Washington. Our mission is to reduce health disparities of the Somali immigrants and refugees and to and improve health outcomes within the communities by: Advocating for and  ensuring culturally/religiously appropriate and relevant policies and services within the health systems; developing and implementing meaningful partnership with the health systems; and developing mutual education for providers and community leaders.
  • Ethnomed: Somali Homepage
  • Culture Clues™  tip sheet for clinicians- Communicating with Your Somali Patient.  From the University of Washington Medical Center.

Health Literacy/Easy to Read Patient Materials

Familydoctor.org
From the American Academy of Family Physicians. One of the least complex patient education sites.

Medline Plus

Developing Health Education materials
How to write easy-to-read health materials

Additional Resources

DiversityRX

  • The purpose of DiversityRx is to improve the accessibility and quality of health care for minority, immigrant, and indigenous communities.  They support those who develop and provide health services that are responsive to the cultural and linguistic differences presented by diverse populations. DiversityRx informs, educates, and supports health care providers, policymakers, researchers, and advocates who share our goals. They worked with the Office of Minority Health to develop the National CLAS standards when DiversityRx was called Resources for Cross Cultural Health Care. They provide professional development opportunities and offer technical assistance on key practice and policy issues. They also spearhead research and policy development, and advocate for culturally responsive care.
  • Everyone with an interest in cross cultural health issues is welcome to a free membership  on the DiversityRx website. Members get additional opportunities to interact on the website and with colleagues in the U.S. and around the world.