Cultural Competency Exam #1
In delivery of cultural competency it is important to...
-respond to demographic changes - eliminate longstanding disparities in the health status of people based on racial, ethnic, and cultural backgrounds - improve the quality of services and health outcomes - meet legislative, regulatory, and accreditation mandates - make sure that resources are equally distributed
The need for cultural and linguistic competency
-the aim is to provide multicultural training and experiences that expand the health professional 's world in any health setting. Higher cultural competence is perceived when programs or services are culturally responsive, cultural differences are acknowledged and reframed.
CAM and health education
-the practice of health education is based on a holistic understanding of human life and the multidimensional nature of health -health care professionals should also educate the public about the use of CAM and how to choose a CAM practitioner -selecting an appropriate CAM practitioner will protect consumers and increase the likelihood of the success of the treatment
Health educators should NOT:
-use general characteristics to create stereotypes from any group (country of origin, age, race/ethnicity, disability, etc.) -stereotypes create myths that can influence how health educators view and think about certain racial and ethnic groups -- avoid this by opening lines of communication to that individual and have conversation about what they would like to be referred to as
avoid stereotyping
1. learn the characteristics of the different racial and ethnic groups 2. become aware of how they ask questions of the individual when addressing his or her needs - some ethnicities take offense when provider asks certain questions 3. educate others on how stereotypes affect the process of health education 4. create a safe environment in which individuals feel free to discuss any health issue or concern without judgement 5. reflect on other ways not only in health education but in life
Evaluate capacity and define goals
1. resources should be identified each year and analyzed over time 2. priorities should be clearly defined: - raising awareness of cultural and linguistic competence - increasing understanding related to the delivery of health care services - developing skill sets that apply knowledge of cultural and linguistic competence to health disparities, health care access and utilization, patient and provider satisfaction, and participatory research -involve members of clinical practice, community members/partners to be a a part of school setting
environmental quality in healthy people 2020
1/4 of global disease burden comes from this and its factors that are often modifiable
The lead federal entity supporting scientific research in CAM areas, the NCCAM, was created in what year?
1998
Estimates are that by 2050, the Hispanic population will account for what percent of the total population?
30%
Native Hawaiian or Other Pacific Islander
50 percent resided in california and hawaii
the largest projected age group in the future
65 years and older -The four major racial and ethnic groups— white, black, American Indian and Alaska Native, and Asian and Pacific Islander and in the Hispanic-origin population are expected to increase substantially during the first half of this century. -demographers estimate that the number of individuals in this age category will more than double by the middle of this century
Healthy People 2020
A set of disease prevention and health promotion objectives for Americans to meet during the second decade of the new millennium. "a renewed focus on identifying, measuring, tracking and reducing health disparities through determinants of health approach" *by 2030 social determinants of health will be expanded upon
What would NOT be an ideal step in improving cultural competency?
A) Moving away from the belief that one's way of life is more desirable and superior to others B) Take time to learn about a patient's culture, language, experience, and history C) Treating all patients the same, regardless of cultural beliefs D) Demonstrate respect for the patient by integrating personal preferences into assessment and treatment Correct Answer: C
Which of the following is TRUE regarding data from the U.S. Census Bureau?
A) The fastest growing age group is those 45 64 years. B) The majority of the foreign-born population came from Europe. C) The majority of the population will be concentrated in urban areas. D) The population will become less diverse. Answer: C
Which of the following is TRUE regarding developing cultural competency?
A) Understanding ones own culture is the first step in developing cultural competence B) Interactions with individuals from various cultures do little to expand knowledge of cultural competency. C) Developing cultural competency is a simple process. D) Learning cultural competency is a one-time process. Correct answer: A
which of the following would be considered a natural product?
Acupuncture Massage therapy Light therapy Probiotics- correct
The second largest racial group in the United States
African Americans 55% reside in southern states with New York having highest numbers of AA's
What population has the highest life expectancy of any other racial or ethnic group in the United States?
Asian Women
Which population places a high significance on extended family, where the oldest male in the family is often the decision maker and spokesperson?
Asians/Pacific Islanders
monotheism
Belief in one God
Which state has the largest percentage of residents who speak a language at home other than English?
California
What is the second leading cause of death in the US?
Cancer
the tendency of members of a racial group to behave in congruence with the values, beliefs, and attitudes of their own culture to which they have been exclusively exposed.
Conformity
In the conceptual model for dissemination of standards into clinical practice, which behavioral theory is used within the framework?
Diffusion of Innovation
What is the leading cause of death among the White population?
Heart Disease
Atkins Diet
High protein, low carbs
What is the largest ethnic minority group, and one of the fastest-growing population groups, in the United States?
Hispanics
What is necessary when considering the financial constraints of the organization in developing a culturally-competent practice?
Incorporate financial resources for translators into the annual budget
What agency provides a comprehensive health delivery system for American Indians and Alaska Natives?
Indian Health Service
What strategy would be appropriate when delivering services to marginalized populations?
Make sure medical intake forms are inclusive, with gender-neutral language
Which state has the largest African American population in the United States?
New York
Clinicians have a responsibility to advocate on behalf of families and communities at risk for health disparities. What is an example of advocacy specific to cultural competency?
Provide appropriate and culturally relevant consumer information and marketing materials
REACH
Racial and Ethnic Approaches to Community Health
The individual or organization's receptiveness to change refers to which component of the conceptual model?
System Readiness
Use a trained interpreter
When instructions are given to a non-English speaking patient, it is best to: have these because speaking to the family might not work also important for interpreter to have knowledge of medical terminology
What would be the ideal health promotion setting for the 26-64 age group?
Workplace
diversity
a dynamic philosophy of inclusion based on respect for cultures, beliefs, values and individual differences
Health equality
a persons ability to attain his or her full health potential without interference from his or her social position or ethnic/racial background
Acculturation
a process of cultural contact and exchange through which a person or group comes to adopt certain values and practices of a culture that is not originally their own, to a greater or lesser extent
According to the National Health Interview Survey (2007), the highest percentage of adults used CAM therapies for what musculo-skeletal condition?
back pain
Adult use of CAM was used to treat these types of musculoskeletal diseases
back pain neck pain joint pain arthritis, gout, lupus, and fibromyalgia
What modality of CAM as defined for the 2007 NHIS uses simple electronic devices to teach clients how to consciously regulate bodily functions?
biofeedback
Catastrophic Illnesses and Religion
can be a positive coping strategy for dealing with physical illnesses, including cancer (prayer or meditation helps with trials) the role of spirituality has been shown to have a stronger role on quality-of-life measures among cancer patients some individuals may attribute their illnesses to God's will as some form of test. south asian population thought that epilepsy was result of fate, will of God, or past life sins
The need for research
closes gap and improves quality - helps clinicians, nurses, and patients change behavior and make more informed decisions - helps to coordinate care among patient's health care team - strengthens the patient-provider relationship (if respect there, they are more likely to adhere to treatment regiment)
integrative medicine
combination of conventional practices and CAM therapies ex: adding yoga to a conventional medicine prescribed by a doctor
CAM stands for
complementary and alternative medicine -the medical and health care practices, systems, and products that are not included yet in the conventional medicine delivery system
What is the most important thing a person can do to consider the influence of one's own biases and beliefs and the impact it may have on service delivery?
complete a self-assessment
building a culturally-competent practice
create a shared vision by defining the concept of cultural and linguistic competence and its achievement goals can be developed by inviting local families, advocacy groups, or other vested parties to participate in the discussions 4 suggestions: 1. be informed by looking at charts or demographics 2. beware of stereotyping 3. respect your patients 4. enlist community support
What point along the cultural competence continuum is characterized by the belief that helping approaches traditionally used by the dominant culture are universally applicable?
cultural blindness
In the cultural competence continuum, what level of competence is on the most negative end (or the far left side of the continuum) ?
cultural destructiveness
concept of time
cyclical or event or clock based other cultures think that they will get there when they get there patient shows up 1hr. late based off of cultural norms
percentage of Americans who self-identified as Christians
declined 86%-76% from 1990-2008
suggestions for working with a diverse group
differentiate among culture, race, and ethnicity be cognizant of language preferences be cognizant of what you do not know be clear about your objectives remember family dynamics create strong coalitions develop trust select communication methods carefully
despite recent progress in overall national health, disparities _______in the incidence of illness and death among African Americans, Latino/Hispanic Americans, Native Americans, Asian Americans, Alaska Natives, and Pacific Islanders, as compared with the US population as a whole
disparities
Across all ethnic/minority groups, which category of CAM was used the least?
energy medicine
In the values framework, the area of difference based on cognitive process or affective domain is called:
epistemology
'Competence' implies having the capacity to:
function effectively as an individual and an organization within the context of the cultural beliefs, behaviors, and needs presented by consumers and their communities
African Americans are only about ______as likely as whites to participate in HIV clinical trials or to get experimental medicines
half
mental health and religion
having more purpose in life and personal growth less likely to report having been diagnosed with depression less likley to report the daily negative emotions of stress, worry, sadness, and anger greater optimism and coping mechanisms social cohesiveness and support adherence to religious beliefs has also been results of negative mental health outcomes - for example doing some wrong in the eyes of God
What modality of traditional and folk modalities of CAM used in the 2007 NHIS uses a traditional health or practitioner with knowledge of the medicinal qualities of plants?
hierbero
Deism
higher power but no personal god
largest minority group and fastest-growing population group in the US
hispanics -Over 50 percent of the Hispanic population lived in three states: California, Florida, and Texas.
cultural proficiency
holding culture in high esteem- adding to the knowledge base of culturally competent practice by conducting research, influencing approaches to care, and improving relations between cultures. promotes self-determination institutional based setting
What is the first stage of adjustment that newcomers experience when they enter into a new culture
honeymoon/euphoria stage
educational attainment
huge predictor of health status and socioeconomic status and income
An orthopedic clinic created a committee to review evidence-based practices regarding the actual use of CLAS in patient care and was asked to provide recommendations on their possible use in the clinic. This would be an example of what in the conceptual model?
implementation
Did the use of CAMS increase or decrease from the year 2000?
increased 2.3%
Cultural competence 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 services; thereby producing better outcomes
Cultural destructiveness
intentional attitudes, policies, and practices that are destructive to cultures and consequently to individuals within the culture
Axiology
interpersonal values examples include communication with body language if its direct or indirect and if you stare into peoples eyes in whom you are talking to
when examining cultural groups
it is important to determine whether an individual is a migrant, first-generation immigrant, or refugee *common for refugee to be placed in camp for 10 years before finding home
cultural incapacity
lack of capacity to help minority clients or communities due to extremely biased beliefs and paternal attitude to those not of a mainstream culture
achieving spiritual competence
lack of training does not allow professionals to provide effective services to those from diverse religious backgrounds -when health worker and speaking with patient some religions are very sensitive, be sure not to pry too much spiritual competence is a dynamic process characterized by three interrelated dimensions: 1) an awareness of one's personal worldview (social worker, health educator/provider 2) an understanding of the clients spiritual worldview 3) the ability to design and implement intervention strategies that are appropriate, relevant, and sensitive to the client's spiritual worldview
whites
largest racial group in the United States -The white population is older than the other racial and ethnic groups, with a median age of 39.2 years.
being competent in cross-cultural functioning means _______________and effectively applying them in the appropriate settings
learning new patterns of behavior
who has the least frequent church attendance?
males with 39% followed by: -not married with 36% -18-29 yrs old 35% -Asian 31%
The Ulysses Syndrome forms a gateway between mental health and _________.
mental disorder
In the US, __________ ___________ are considered one of the most marginalized and underserved populations.
migrant workers
According to the 2007 NHIS, what was the highest use of CAM therapies among the African-American population?
mind-body therapies
most common used CAM practices by adults
nonvitamins and nonmineral natural products
agonostic
not sure/unknown whether there is a god or presence
implications for health educators
numerous settings: -schools -workplaces -religious institutions -universities -clinics -hospitals -insurance companies
implement changes
offer services at flexible times be mindful of religious holidays make sure medical intake forms are inclusive using gender neutral language have a well-defined procedure for identifying staff that may need more training in cultural competency (You may have staff that knows what they are doing, but you may not) include policies, procedures, and fiscal planning to ensure the provision of translation and interpretation services (those places that provide medicaid and medicare have to provide language translators)
what is NOT an appropriate practice in respecting the rights of patients?
persuading the patient to follow your treatment recommendations
ethnicity
pertaining to a group of people who share a common and distinctive culture, religion, or language
ethnicity
pertaining to a group sharing a common and distinctive culture, religion, language, or etc. can be used interchangeably with race
mormons
prohibit tobacco, alcohol, conservatism and is one of the healthiest populations and more likely to engage in physical activity
improved patient outcomes
reducing errors due to language and culture and health disparities and improved patient experiences with care collect the data and compare pre and post anytime that you want to implement something they will want to see the data
Health problems that migrants experience
sadness nervousness irritability migraines insomnia fatigue mental health issues They will go back and forth through these stages at different time intervals
Possible Settings
schools, workplace, community, hospitals, private sector
conduct an initial assessment
similar to individuals taking a self-assessment -assess the different groups the practice may come into contact with - collect patient information to determine communication needs (make sure to have language interpreters) - involve patients in the process of developing communications strategies -be aware that patients will have different levels of health literacy -assess patient satisfaction - evaluate communication performance over time
trust
single-most important thing because patients will be less honest and less likely to follow treatment prescribed and also less likely to come back for services
ontology
spiritual or objective underlying forces when dealing with health or scientific evidence
demographic shifts
statistical changes in the socioeconomic characteristics of a population or consumer group based off of gender, religion, or age
Obesity in healthy people 2020
still increasing in US globally
chelation therapy
substances used to bond molecules such as metal or minerals held tight so they can be removed from the body
health inequality
synonymous to a health disparity
cultural and language standards in health organizations
system antecedents, system readiness, adoption, implementation, improved patient outcomes
cultural blindness
the belief that service or helping approaches traditionally used by dominant culture are universally applicable regardless of race or culture - These services ignore cultural strengths and encourage assimilation
race
the categorization of parts of a population based on physical appearance
cultural pre competence
the desire to deliver quality services and a commitment to diversity indicated by hiring minority staff, initiating training and recruiting minority members for agency leadership, but lacking information on how to maximize these capacities. This level of competence can lead to tokenism
What is health promotion?
the process of enabling people to increase control over, and to improve, their health -addresses and prevents the root cause of ill health
In the conceptual model approach for dissemination of the presentation of innovations related to cultural competency, which of the following would NOT be a system antecedent?
the reduction of errors others that would be a system antecedent: - human resources - performance measurement system - administrative leadership
tobacco use
the single most preventable thing an individual can control to reduce the risk of disease the most costly issue inflicted in the US today
folk medicine
the treatment of illnesses through remedies and therapies that are based on experience and knowledge of transmitted throughout generations live by experience and not through structural processes
CLAS
there is a lack of implementation of these services within the work community many barriers still exist: - quality measures were not stratified by race/ethnicity, primary language, education or insurance status - human resource policies did not address the cultural competency or staff - ongoing training to physicians not provided - did not recognize patient safety issues related to patients culture
Diffusion of Innovation Theory
to enhance the uptake of public health policy people adopt different things at varying rates some are accepting of change, some people need to see evidence of change
HHS Disparities Action Plan
to reduce racial and ethnic health disparities and was launched to stress the importance of workforce diversity and the reduction of racial and ethnic disparities (looks more holistically at an individual) 5 major goals: 1. transforming healthcare 2. strengthening infrastructure and workforce 3. advancing the health, safety, and well-being of American people 4. Advancing scientific knowledge and innovation 5. increasing efficiency, transparency, and accountability
what affects children in the US more than any other chronic infectious disease? tooth decay
tooth decay
CAM practices among Hispanic/Latino populations are highly influenced by religious beliefs.
true
We are moving away from organized religion and going towards spirituality more
true
although formalized religious affiliation has declined among Americans, faith-based organizations have remained a central focus
true
when individuals 1st thought about cultural competency it was only based race and ethnicity
true
Once immigrants have lived within a place for one year, it is not uncommon for them to relocate to other areas in the US
true * they also consider that living in the country for 1 year is now their home country
Immunizations
whites more likely to have immunizations children from low income households less likely to have
additional social determinants
-access to care -insurance coverage -employment -education -access to resources -income -housing -transportation
demographic characteristics in the textbook:
-race and ethnicity -foreign born and immigrant -language -the elderly -gender -sexual orientation -people with disabilities
infant mortality
-the number of infant deaths per 1k births within the first year of life: based on the race of the mother and not the infant -increase in African American mothers vs. white mothers as well as Asians -higher rate in the US vs other high income countries
what percent of population uses CAM therapies?
38.3% adults and 12% of children
polytheism
Belief in many gods
the process of cultural intermingling
Cultural Diffusion
Oral health in healthy people 2020
a lot of US citizens do not have access to this specific type of healthcare and it is also paired with others severe decay
The number one reason why CAM was used for musculoskeletal diseases was to treat...
back pain
The use of CAM therapies is lesser for children whose parents have used CAM therapies.
false
What is a method that a dominant culture may use to consolidate their power?
fear, money, force
Other diseases that CAMS were used for
head or chest cold (highest use) anxiety/depression stomach or intestinal illness cholesterol (this category was the only one that saw an increase from 2002-2007)
commonly used CAM therapies
natural products, deep-breathing exercises, meditation, chiropractic care, yoga, message, and diet-based therapies
system readiness
readiness to adopt change organizational and front end user buy-in
Office of Minority Health (OMH), says culture and language may influence:
- health, healing and wellness belief systems - how illness, disease and their causes are perceived by the patient/ cusomter -the behaviors of patients who are seeking health care and their attitudes toward health care providers -the delivery of services by the provider who looks at the world through their own set of limited values, which can compromise access for patients from other cultures
Ulysses Syndrome
-A series of symptoms that affects migrants confronted with multiple and chronic levels of stress *forms a gateway between mental health and mental disorder -health educators need to advocate for a sociocultural approach using culturally -sensitive health educators to help newly arrived migrants who are experiencing this syndrome includes: -stress -anxiety -depression --health professionals need to intervene before the person ends up with medical disorder
legal requirements for culturally competent care
-EMTALA: The Emergency Medical Treatment and Labor Act, requires hospitals that participate in medicare program and that have emergency departments to treat all patients (including women in labor) in an emergency without regard to their ability to pay. -Hill-burton act: enacted by Congress in 1946, encouraged the modernization of public and nonprofit community hospitals and health centers. In return for receiving funds, recipients agreed to comply with "community service obligations," one of which is a general principle of non‐discrimination in the delivery of services. The Office of Civil Rights has consistently interpreted this as an obligation to provide language assistance to those in need of such services. -Title VI of the Civil Rights Act of 1964: "no person in the United States shall, on ground of race, color or national origin, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance."
National Center for Complementary and Integrative Health (NCCIH)
-Federal Government's lead agency for scientific research on the diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine
A lack of cultural competency may result in which of the following?
-Lack of adherence to treatment plan -Liability/Malpractice claim -Miscommunication between provider and patient -All of the answers are correct. Correct Answer: D
What is NOT a way that health educators can avoid stereotyping?
-Make a judgement about a client prior to meeting with them
Alexander Technique
-Method for improving ease & freedom of movement, balance, support, and coordination -Corrects unconscious habits of posture & movement (precursors to injuries)
demographic shift predictions
-The U.S. Census Bureau projects that the nation will become more diverse and the majority of the people will be concentrated in urban areas -continuing diversity based on race and ethnicity (The only disparity that is able to be gathered correctly is the one between white and black people) -Demographic shifts are impacted by: immigration, emigration, births, deaths -policies such as the travel ban, removal of protected status, and the proposed wall between Mexico and US
findings from gap analysis by the joint commission
-The analysis revealed consistency between the standards for CLAS but recognized that the accreditation standards were less prescriptive and therefore inadequate for evaluating hospital compliance with the CLAS.
religious and spirituality trends
-approx 82.5% of americans reported a religious identity (2012) -steady decline in mainline church attendance among Americans, with an upward shift to a non-denominational identity -catholics increased to over 173 million members due to immigration, primarily from Latin American countries -beliefs of individuals arent a homogeneous reflection -immigration has small but significant impact on religious groups in the US
cultural universals
-certain behavioral traits and patterns -all cultures classify relations based on blood relations and marriage -differentiate between good and bad -art, jewelry, and the classification of people according to gender and age
edbergs seven facets
-classic -symbolic -ideologic -materialistic -linguistic -mental/cognative: emphasizes "culture as not so much about what people do, but about what they think and how that determines what they do" -cultural/biocultural
Community-based participatory research model
-community based orgs often lack academic skills so CBPR was created to form partnerships. -CBPR is intended to build strong long-term commitments between community based and academic partners in which the stakeholders equally and collaboratively address health disparities at the community level.
social determinants of health: 5 domains
-economic stability -education and access to quality -health care access and quality -neighborhood and built environment -social and community context
Cultural competence requires that organizations:
-have a defined set of values and principles, and demonstrate behaviors, attitudes, policies, and structures that enable them to work effectively cross-culturally. - have the capacity to (1) value diversity, (2) conduct self-assessment, (3) manage the dynamics of difference, (4) acquire and institutionalize cultural knowledge and (5) adapt to diversity and the cultural contexts of the communities they serve. -incorporate the above in all aspects of policy making, administration, practice, service delivery, and involve systematically consumers, key stakeholders, and communities.
what demographic changes can lead to
-health disparities -six priority areas have been identified by the CDC that need immediate attention -health education and prevention programs should be designed to reach diverse groups
Ethos
-independent or dependent -high regard for self/family living in harmony or is it controlling?
Focus areas of Healthy People 2020
-infant mortality -cancer screening and management -diabetes -HIV infection and AIDS -immunizations
NCCAM
-integrative medicine -ex: massage therapy and medication
CAM 4 categories
-natural products -mind and body medicine -manipulative and body based practices -other (movement therapy, magnet therapy etc.)
dominant culture
-often dictates the accepted values when there is a difference in basic values within cultures -use a variety of methods to consolidate their power, including fear, money, and force (may lead to miscommunication and conflict between cultures -white males continue to establish the mainstream culture even though they are no longer the majority examples: -high regard for achievement versus family obligation -competition vs tranquility -material acquisition vs enjoyment for life
Developing Cultural Competence
-ongoing and complex process: always changing due to demographic -self-assessment is needed: how might your personal biases interfere with your interaction with a patient? -after self-assessment determine where you fall on the continuum of cultural competence
cultural practices and their impact on a patient
-persons cultural background provides the foundation for his or hers health beliefs and practices -certain elements are universal others aren't --do NOT assume 2 families share all of the same practices -influenced by acculturation level which could be with clothing, music, food, language, or etc.
social determinants of health
-predict the greatest proportion of health status variance among individuals worldwide -almost 40% of determinants are predicting greatest proportion of health status variance -look at the root of the problem and help reduce health disparities more so than treating individual after they have already succumbed to the disease
What characteristic is true about Native Hawaiians and Other Pacific Islanders?
This population has higher rates of smoking, alcohol consumption, and obesity than other racial and ethnic groups do.
Who should be involved in developing a culturally-competent practice?
advocacy groups, patients and family members
immigrants and migrants
all experience different things when coming over seas especially refugees who did to save their own lives
race
categorization of parts of a population based on physical appearance due to a particular historical social and political forces skin color
healthy people 2020- morbidity indicators
-environmental quality -mental health -nutrition, physical activity and obesity -oral health -tobacco use
What is the leading cause of death for individuals 25 to 44 years of age in the U.S?
HIV
diversity and health education
-grew dramatically from 20% to 58% between 1980-2010 -understanding the health promotion needs of these populations is necessary to design appropriate interventions- and will reduce barriers -our future depends on our ability to embrace and value diversity and remove all forms of ethnic oppression and discrimination
asian population
-has grown more than four times faster than the US population as a whole since 2000 -specifically Filipinos
True or False: Those who share an ethnicity automatically share a language.
False; they do not automatically share a language
pantheism
God is everywhere and in everything. He is not a being but more so a presence
Biofeedback
a system for electronically recording, amplifying, and feeding back information regarding a subtle physiological state, such as blood pressure or muscle tension
Ayurveda
a system of traditional medicine, understood as a teaching transmitted from the sages, clense body
African American women
increased infant mortality and increased incidences of breast cancer within this racial group diabetes 2X as prevalent in any African American
why is spiritual competence necessary?
increases religious diversity negotiates potential value conflicts enhances insight into clients challenges accesses spiritual strengths - meditating more when going through depression
impact on Health and Well-being
very religious and moderately religious Americans were more likely to practice healthy behaviors compared to non-religious Americans very religious and moderately religious Americans were non smokers compered to non-religious Americans Very religious and moderately religious Americans reported having 5 or more servings of fruits and vegetables compared to non-religious
What would NOT be considered a factor in culture and cultural diversity?
veteran status language annual salary gender identity correct answer: annual salary
Office of the National Center on Minority Health
was established to create a strategic plan to address the poor health status of minorities, low-income individuals, and those living in rural areas
epistemology
ways of learning
system antecedents
whether or not your leadership is supportive - capacity to collect all the data and performance measures - anything attributable to the hospital that may support increases the adoption or may be a barrier to the adoption core management and clinical structures and process (including barriers and facilitators for CLAS)
Strategies for developing spiritual competence
-self-assesment: identifying ones values and beliefs -consultation: consult with informed experts (collegues, members of clergy) -religious norms: expand knowledge (resources, clients, patients) -epistemological humility: many ways of knowing exists (cultural humility)
3 key elements of health promotion
1) good governance for health 2) health literacy 3) healthy cities
stages of adjustment to the new country
1)honeymoon/euphoria stage 2) conformity stage 3) dissonance stage 4) resistance and immersion stage 4) introspection stage 5) integrative awareness stage
Latino Paradox
AKA- Hispanic paradox -refers to the epidemiological finding that hispanic and latino americans tend to have health outcomes that are comparable to or in some cases better than those of their US non- hispanic white counterparts even though hispanics have lower average income and education -the longer that they stay in the US, the worse their health becomes
Activities such as drumming and chanting, dancing, use of herbs, and acupressure would be common CAM practices among what racial/ethnic group?
American Indian and Alaska Natives
The highest spanish speaking state is...
California
acupuncture
Chinese medical practice of inserting needles into certain areas of the body
What is the most commonly cited religious affiliation?
Christianity
what does the acronym CLAS stand for?
Culturally and Linguistically Appropriate Services
What is NOT one of the three key elements in health promotion?
Health equity Healthy cities Health literacy Good governance for health Correct Answer: A.
the largest foreign-born, minority, and fastest growing population within the United States
Latin Americans
What are the 2 factors that cause a lot of collateral damage in culture?
Socioeconomic status and education
mental health in healthy people 2020
US is suffering because 1 in 4 adults have this and 1 in 5 children have this most common is ADHD
cultural competence
acceptance and respect for difference continuing self assessment, careful attention to the dynamics of difference, continuous expansion of knowledge and resources and adaptation of services to better meet the needs of diverse populations
implementation
actual use of the standards in healthcare organizations prioritizing what needs to happen first and can happen in waves and not all at one time
CLAS standards
advance health equity, improve quality, and help eliminate health care disparities by establishing a blueprint for health and health care organizations
conventional medicines
allopathic care or biomedicine- the body of scientific knowledge practiced by doctors of medicine, doctors of osteopathic medicine, and allied health professionals
type II diabetes
american Indians under the age of 20 have the highest prevalence of this
culture
an integrative pattern of human behavior that includes languages, rituals, and customs
adoption
an organizational decision to adopt the CLAS standards
worldview
focused on individual inner subjectivity in relation to an external world. It strives to identify the meaning and value of the universe and human life. a broader conceptual framework for religious and spirituality expression can be subjective, but can be viewed on continuum of idealogies such as: - monotheism - polytheism - pantheism - deism - agonostic - antheism
community health worker
individual who lives within the community and have had no formal education in public health /promotion but are viewed as somebody in a position of authority and well respected some individuals more likely to listen to that person more so than outsiders
atheism
no belief in any god or anything
Healthy People Initiatives
reduce disparities in healthcare. 1. promoting healthy behaviors 2.promoting healthy and safe communities 3.improving systems for personal and public health. 4. preventing and reducing diseases and disorders
Name one specific positive patient outcome that may result from implementing the CLAS standards and culturally-competent care.
reduced misdiagnosis reduced medication errors reduce emergency department use follow treatment plan
health disparities
the differences in the incidence and prevalence of health conditions and health status between groups based on race/ethnicity, socioeconomic status, gender, disability status, or a combination of these factors
spirituality
the emotional or experiential expression of "feelings or experiences of awe, wonder, harmony, peace, or connectedness with the universe or a higher power.
Asian health
the oldest family member makes decisions for other family members
religion
the practice of participation in culturally based activities, including prayer and meditation, attendance at services, reading religious texts, and performance or rituals
cultural competence
understanding and appropriately responding to the unique combination of cultural variables and the full range of dimensions of diversity that the professional and client/patient/family bring to interactions - not limited to racial or ethnic differences, but also includes those with disabilities, the aging population, gender identity, country of origin, and veteran status - cultural knowledge is needed in developing health interventions for a targeted population and treating patients based on religious, cultural, and spiritual beliefs and customs
Use of CAM in children
use of CAMs greater in those children whose parents use them most use of CAM therapies is by adolescents (12-17) compared to younger children the most common CAM therapy used by children is the use of natural products CAM use is higher in white children compared to Hispanic and Black children
Even though they no longer represent a majority of U.S. society, what population continues to establish the mainstream culture? white men
white men