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University of Utah Health Plans
Cultural Competence refers to the ability to effectively interact with people from different cultures.
1. Awareness of one's own cultural views
2. Attitudes toward cultural differences
3. Knowledge of different cultural practices and worldviews
4. Cross Cultural Skills
1. Unclear communication can cause the whole medical encounter to fall apart.
2. Racial and ethnic minorities are disproportionately burdened by chronic illness.
3. Lack of cultural competence may lead to patient dissatisfaction.
4. Stereotypes may ignore variation within groups.
Cultural Considerations
Don'ts
Do's
A patient arrives for an appointment with her twelve year-old son. Although the patient does not speak English, her son does. Should the son be used to interpret for his mother during her appointment?
Your patient stays quiet throughout the visit and does not ask questions. Should you assume that they fully understand your directions?
For more information visit:
An immigrant is a person who chooses to resettle in another country. Reasons for moving may be for job opportunities, better living conditions, education opportunities can eventually become U.S. citizens.
Dos and Donts
What you should do:
1. Use variety of instruction methods
2. Encourage questions and use Ask Me 3: What is my problem? What can I do to fix it? Why is it important for me to do it?
3. Use Teach Back: They tell you what you tell them
4/5. Office staff should confirm preferences during scheduling
6. Ask about home remedies and healers
7. Inform patients of the need for follow-up
8. Explain why patients may need to be seen by another doctor
9. Make HIPAA forms easy to understand, maybe in preferred languages
10. Approach these topics slowly and considerately.
What they don't tell you:
1. I tell you I forgot my glasses because I am ashamed to admit I don’t read very well.
2. I don’t know what to ask and I am hesitant to ask you
3. When I leave your office I don’t know what I should do next
4. I am not able to make important decisions by myself
5. I am more comfortable with a female doctor
6. I use botanicals and home remedies but don't think to tell you
7. My expectations do not align with U.S. managed care
8. I'm bewildered by requirements to visit multiple doctors
9. I fear my health information will be released to my community
10. Controversial topics like sex, pregnancy, pain management, mental illness, drug addiction, medicine, weight, domestic violence may be hard to discuss for some
Catholic Community Services: A refugee resettlement organization that aims to help refugees and immigrants adjust to life in Utah. Case managers help refugees and immigrants for 2 years; more than any other resettlement agency in the U.S. who only help for 6 months-1 year.
https://www.ccsutah.org/
International Rescue Committee: Another refugee resettlement organization that aims to help integrate refugees and immigrants into Utah. They deal with 5 major factors: health, education, economic well-being, empowerment, and safety. One of about 40 cities in the U.S. who provide these services.
https://www.rescue.org/
Asian Association of Utah: A refugee resettlement agency that helps refugees and immigrants with issues relating to education, health care, economic achievement, and legal issues among other things:
http://www.ric-aau.org/
UNHCR: A branch of the United Nations that brings refugees into the United States through a lengthy process that involves numerous interviews and background checks. Members advocate for refugee and immigrant rights.
https://www.unhcr.org/afr/
What is the difference between a refugee and an immigrant?
If you notice a client continually nodding and agreeing along with the information they are asking you, what should you do to ensure they actually understand you?
Knowing what you know about the American health care system, how would you feel if you immigrated to a new country that practices different methods of health care?
At a time when older patients have the greatest need to communicate with their physicians, life and physiologic changes make it the most difficult.
Poor communication with this vulnerable population can undermine your efforts to provide good patient care.
Tips for Physicians
Tips for Staff
What are some ways you can adjust your typical care habit when meeting new patients that are disabled or aging?
What might impact an elderly or disabled patient's perception of care?
How should the discharge summary be adjusted to fit the needs of an elderly patient?
Salt Lake County Aging & Adult Services: https://slco.org/aging-adult-services/ombudsman-program/
Aging and Disability Resource Center (ADRC): https://www.utadrc.org/
Division of Services for People with Disabilities (DSPD): https://dspd.utah.gov/
Utah State Office of Rehabilitation Administration’s Division of Services for the Deaf and Hard of Hearing: http://www.deafservices.utah.gov/
Utah Aging Alliance:
https://utahagingalliance.org/
LGBT stands for Lesbian, Gay, Bisexual and Transgender
This is a community that has traditionally faced disparties in health which include:
-Lower rates of insurance coverage
-Lack of provider knowledge about LGBT health
-Previous discrimination in healthcare
-Lack of identifying information on intake forms
-Studies show that victims of hate crimes are more likely to suffer poor health
- The increase in mental health problems in states without LGBT protection
-The shorter lifespans of LGBT people who live in states without LGBT protection
-LGBT rights vary throughout the country
Specific Health Concerns for the LGBT Communiy:
-Obesity/High BMI: Much higher in lesbian and bisexual women
-Mental health concerns including depression and anxiety
-MSM (men who have sex with men) health concerns
-Transgender health concerns
-Body image and eatings disorders in homosexual men
-Tobacco increased in all subpopulations
-Alcohol/drugs: Increased use
-STDs: Increased rate in MSM (men who have sex with men) and lack of knowledge
-HPV: Including cervical paps AND anal paps
-HIV: Highest incidence in trans women of color
-Create a safe non-judgemental environment for LGBT persons
-Remain unbiased and focus on serving your patient
-Do not ask for sexual history if not relevant
-Do not ask for private information in front of family members
You have a patient whose sex is listed as "male", but it appears that they are expressing as female. What do you do?
Your patient is accompanied by an older adult who could possibly be a parent. According to you results, you need to ask some questions about sexual history. What should you do first?
Helps prevent against HIV infection and empowers people living with HIV/Aids to live healthier and happier lives
S 1100 E, Salt Lake City, UT
(801)-487-2323
The Trevor Project is the leading national organization providing crisis intervention and suicide prevention services to lesbian, gay, bisexual and transgender young people under 25
1-866-488-7386
www.thetrevorproject.org
Thank you for completing this training!