4540 Exam 3: Cultural Influence, Competence & Public Health Nutrition

Visible forms of diversity

physical differences, abilities & disabilities, and language differences

Cultural Skill

the ability of people of one culture to understand & feel comfortable with the cultures of other people

The foundation of cultural competency

the development of an awareness of one's own cultural matrix

Acculturation

the process by which a cultural group adapts to or learns cultural norms of another group

Ethnicity

the shared feeling of people-hood among a group of individuals

Ethnocentrism

(stereotyping) - in the mildest form, it is a subconscious disregard for cultural differences - in its most severe form, it is an authoritarian dominance over groups different from one's own

Ideas for providing effective nutrition education programs to culturally diverse groups

- Assess common cultural food patterns - Complete an individual assessment to determine the main foods that the clients eat regularly - Determine nutrient contributions of these foods - Determine the main food preparation methods of these foods - Before introducing new foods, emphasize familiar or comparable foods - Know about program eligibility criteria for federal or state assistance programs and make referrals as needed

Practical guidelines for enhancing cross-cultural communication

- Be friendly, attempt to learn & use key words, ask clients to identify ethnicity - Use visual aids, ask same question in a different way, consider alternatives to written communication - Use discussions about food to open dialogue by asking about favorite foods and foods used for celebrations - Smile, show warmth & be kind - Articulate clearly; speak in normal tone; ask for clarifications

Cultural competence encompasses:

- Being aware of one's own world view - Developing positive attitudes towards cultural differences - Gaining knowledge of different cultural practices and world views

Competence implies functioning effectively as individual or organization in the context of...

- Cultural beliefs - Behaviors - Needs presented by individuals and communities

Organizations/agencies that have set educational standards and core curriculum guidelines for developing cultural competence and providing culturally competent services

- DHHS Standards for Health Care - Patient Protection & Affordable Care Act of 2010 - Healthy People 2030

Determinants of health

- Individual Behaviors - Biological & Genetic Factors - Social Environment - Physical Environment - Policies & Interventions - Access to Quality Health Care

LEARN intervention guidelines

- LISTEN w/ sympathy & understanding to a client's perception of a problem - EXPLAIN your perception of the problem - ACKNOWLEDGE and discuss the differences and similarities - RECOMMEND treatment that is relevant, concise, and practical - NEGOTIATE agreement

Health disparities exist b/w different ethnic groups for a variety of reasons

- Socioeconomic status - Lack of insurance - Culture - Access to and utilization of quality health care services - Discrimination/ racism/ stereotyping - Environment

Information needed to provide adequate nutritional guidance to people of different cultures

- Types of food available - Accepted and/or preferred foods - Safety of food supply & related health problems - Energy & nutrient quality of major foods chosen - Food storage, facilities, and methods; food safety; and garbage disposal

Cultural Knowledge

- involves adjusting to selected cultural characteristics such as history, values, belief systems, and behaviors of the members of another ethnic group - means the nutritionist understands how cultures are similar & different

4 Steps to Acquiring Cultural Competence

1) Cultural Awareness 2) Cultural Knowledge 3) Cultural Skill 4) Cultural Encounter

Cultural Competence Continuum (Stages)

1) Cultural Destructiveness 2) Cultural Incapacity 3) Cultural Blindness 4) Cultural Pre-competence 5) Cultural Competence 6) Cultural Proficiency

3 Levels of Intervention in which an organization can influence cultural competence of health care delivery

1) Macro level 2) Mezzo level 3) Micro level

5 Essential Elements necessary for an organization to provide culturally competent programming

1) Valuing diversity 2) Having the capacity for cultural self-assessment 3) Being conscious of the dynamics inherent when cultures interact 4) Having institutionalized cultural knowledge 5) Adapting service delivery based on understanding of cultural diversity

Fastest growing population group in U.S.

Hispanics

______ is a culturally appropriate intervention strategy.

LEARN

______ factors may contribute to health and illness among minority groups.

Socioeconomic (research shows that minority groups with lower socioeconomic status have reduced access to facilities)

LEARN intervention guidelines provide...

a framework for negotiating a culturally sensitive treatment plan to address a given illness episode

Organizations function at the Mezzo level by...

addressing the design and delivery of culturally appropriate and effective community programs

Cultural Destructiveness (stage 1 of the cultural competence continuum)

attitudes, practices, and policies that are destructive to other cultures

Cultural Blindness (stage 3 of the cultural competence continuum)

belief that culture makes no difference and everyone is treated the same; approaches of the dominant culture are applicable for everyone

Differences b/w cultures occur on many levels

communication, sense of time, family practices, beliefs about the cause of illness, healing beliefs, and food practices

Race and ethnicity disparities in the US are due to...

complex interactions among genetic variations, environmental factors, and specific health behaviors

Cultural Awareness

developing an understanding & sensitivity to another ethnic group's values, beliefs, practices, lifestyles, and problem-solving strategies

Gaining cultural competence in community nutrition means...

developing attitudes, skills, knowledge, and levels of awareness that enable culturally appropriate, respectful and relevant interventions

Organizations function at the Macro level by...

developing culturally sensitive laws, policies & regulations

Cultural Competence (stage 5 of the cultural competence continuum)

differences are accepted & respected, self-evaluations are continuous, cultural skills are acquired, and a variety of adaptations are made to better serve culturally diverse populations; situations can be evaluated from multiple frames of reference

Cultural Proficiency (stage 6 of the cultural competence continuum)

engages in activities that add to the knowledge base, conducts research, develops new approaches, published, encourages organizational cultural competence, and works in society to improve cultural relations

Cultural Encounter

involves integrating all the cultural competency components in nutrition, health promotion, and intervention in ways that preserve the participants' cultural values, health beliefs, and health-related practices that maintain their well-being

Cultural Incapacity (stage 2 of the cultural competence continuum)

paternalistic attitude toward the "unfortunates"; no capacity to help

Race

primarily a social classification that relies on physical markers

Dietary acculturation

process that occurs when immigrants adopt the dietary practices and eating patterns/food choices of the host country

Organizations function at the Micro level by...

providing resources and training programs to help professionals develop & utilize cultural competence skills

Diversity (in a cultural context)

refers to differences among groups of people

Forms of diversity that are not visible

sexual orientation, identification, socioeconomic status, & age

Cultural competence

the ability to understand, communicate with, and effectively interact with people across cultures (developing cultural competence is an on-going life process)

Culture

the shared history and patterns of human behavior defined as the... - language - thoughts - communication - actions - customs - beliefs - values - institutions of racial, ethnic, religious, or social groups

Cultural Pre-competence (stage 4 of the cultural competence continuum)

weaknesses in serving culturally diverse populations are realized, and there are some attempts to make accomodations