Cultural Competency Quizzes
In the year BLANK Congress called for the establishment of BLANK. What is their role?
2000, National Center on Minority health and Health Disparities-within the NIH R ole is to make stretigic plan to adress poor health statuses of minorities, low incomes, and rural dwellers
The leading cause for AA men ages BLANK to BLANK is AIDS
35-44
What is the difference between acculturation and assimlastion
Acculturation is the aquistion of a new culutral idenity without ridding oneself of the elements of the first culutre Assimilation-occurs when the new culutre is incoprated and the first one is lost or given up
What is the National Quality Forum?
Advocated for CLAS by endorsing 45 practices that align with the national standards of CLAS
What is the Liaison Committee on Medical Education Requirements?
All medical schools must teach students about diversity
What are the 2012 funding prioroites
Allevieating chronic pain synromes Reducing inflamatiory process Maximize health and wellness imprive quality of life
Why does faith help in health outcomes?
Allows for individual to cope
Saint Johns Wort interacts with what?
Anti-depressants
Mind-body Biofeedback meditation- guide imagery- progressive relaxation- deep breathing hyponisis yoga- tai chi- qu gong
Biofeedback-uses breathing and electronic device to reduce stress and eliminate headaches, recondition injured muscles, astma meditation-person learns to focus attention and suspend the stream of thoughts that occupy the mind guide imagery-relaxation technquie followed by visualization of detailed images. imagine body free from certain condtion progressive relaxation- deep breathing hyponisis-altred state of conciousnes yoga- tai chi-Orginally china martial art. Body moves slowly while breathing depply and meditating qu gong-Chinese displine use gentle physical movement, mental focus, and deep breahting directed toward specific part of body. done 2-3 times a week 30 min @ time
What CAM modalities were studies in 2007 NHIS
Biologically based therapies Chelation nonvitamin, nonmineral products diet based Mind-body Biofeedback meditation, guide imagery progressive relaxation deep breathing hyponisis yoga tai chi qu gong Alternative medicine systems Acupuncture Ayireveda Homeopathic treatment naturopathny tradiional healters Manipulative and body-based Chriopracic massage movement therapies
Which type of Hispanic attends church more?
Black Hispanics
What is implemntation and dessimastion research rooted in?
Business and organizational change, marketing, evidence-based research
What is difference b/w CC and Cultural sensitivity/awareness?
CC emphasizes the idea of effectively operating in different cultural contexts, and altering practices to reach different Cultural groups Knowledge, sensitivity, and awareness do not do this
Who are the connectors between health care consumers and providers to promote health among groups that traditionally lack access to adequate care.
CHW's
What state has highest number of Spanish speaking households?
California
Is unauthorized foreign born immigrants increasing or decreasing since 2007?
Decreasing
What therapies showed a significant increase in 2007?
Deep breathing, meditatio, massage, yoga
what is Ethos
Dependence vs interdependence. High regard for self, family, control vs harmony
What is the Multi-Ethinic Study of Atherosclerosis looking at?
Detect CVD symtoms noninvasvley before produced clinical signs and symtoms in AA, Whites, Hispanics, Asians
In order to decrease health disparities and promote health equity health educators should...
Develop interventions that address multiple determinants of health
What is the Hill-Burton Act
Enacted in 1946-Modernization/construction of non-profit community/public hospitals. In return for funds they had community service obligations
men are more likely then women to...
Have high blood pressure, heart disease, and have a heart attack Be uninsured
Children from low income families are more likley to...
Have less than basic reading level
What considers health disprites to be a high prority area?
Healthy People 2020
What is the largest ethnic minority group, and one of the fastest-growing population groups, in the United States? Native Hawaiians/Pacific Islander Hispanics American Indians and Alaska Natives Asians
Hispanics
How is Healthy People 2020 working to eliminate the HIV dispairties?
Impove acess to prevention and health care services for all Americans Increasing the proportion of HIV diagnosed AA and Latinx with undetectable viral load by 20 %
Why does Ulyesse synrdome pose a pwoerful challnege to dominant appraches?
It is nonclinical and comprehensive assesiment for immigrants who suffer chronic and multiple stresses
What does the foregin born category include?
Legal permanent residents (immigrants), temporary migrants (students), humanitiarian migrants (regugees), naturalized citizens, persons illegeally in US
What is macro/micro culture?
Macro- our common values and beliefs form living in the same country Micro-Culutre that specific group members share Goal is to function successfully in both cultures
What is the Emergency Medical Treatment and Active Labor Act?
Must treat Pt. in ER regardless of ability to pay
Who is more likley to have visited the dentist in the past year?
NHW's higher income Higher education
What is the objective intervention for Ulysses syndrome?
Not to worsen the condiion so that they do not suffer standarrd mental disorder
Who could serve as amn example on important of establishing formal education on CAM?
Nursing proffesion- have AHNA
What is Medicare
Reimburses hospitals for the coat of an intrpreter
What is medicaid?
Requires anyone who offers services to provde CALC.
What is ontology
Spiritual or objective
The individual or organization's receptiveness to change refers to which component of the conceptual model? Implementation Adoption System Antecedents System Readines
System Readines
T/F children living below poverty rate had lower immunization coverage
T
What is CC?
a set of congruent behaviors, attitudes, and policies that come together in a system or among professionals, enabling effective work to be done in cross-cultural situations
What are the 5 essential elements of cultural proficiency .
assessing culture, claiming the differences and valuing diversity, reframing the differences or managing the dynamics of difference, adapting to the differences and diversity, changing practices for differences
What was reasons children used CAM?
back pain, cold, anxiety, muskoskletal, ADHD, imsomina
How does society assign people to a racial category?
based on opionon and social expirence
differences in language among cultures is referred to as:
linguistic diversity
What do Anmericna Indians and Alslaka Natives use in CAM?
smuding, sweat lodges, drumming and chanting, dancing, acupressure, use of herbes, consultations with medicine man and women
What are demographic shifts?
statistical changes in the socioeconomic characteristics of a population or consumer group
T/F there is a growing segment of Non/Atheitest/Agnostic category, reporting a belief in no god?
t
What is CAM
types of treatment that are not included in conventional Western meidince but are in the process of being studied under rigorous scientific inquiry
What were the 15 racial categories with the option to idenityfy as multiracial on the US census?
white, black or African American, Native American or Native Alaskan, Asian Indian, Korean, Chinese,Japanese, Vietnamese, Filipino, Native Hawaiian, Samoan, Guamanian, other Pacific Islander, other Asian, and other races.
what was the highest use of CAM therapies among the African-American population? - manipulative and body-based therapies - mind-body therapies - biologically-based therapies - energy-healing therapies
- mind-body therapies
What are the three ethnocentric stages? I
1. Denial of diffrences 2. Defense with negative sterotyping 3. Minimizlation of diffrences
How many children/adults are obese
1/3 adults and 1/6 children
In comparison to non-hispanic whites median income in Asians
13, 000 HIGHER, but 12% Asians lived below poverty level compared to 11 percent of NHW
What was mean age in 2010
37
How many individals idenity as biraical?
9 million
In terms of cervical and breast cancer who is affected disproportionately?
AA due to not recoveing regular mamorgams and pap smears
Over 50% of Native Hawaiian and Other Pacific Islanders live in the 2 states
California, Hawaii
What is the Office of Minority Health?
Division of the US HHS. Published set of CLAS standards
What governmental agency provides health and educational assistance to federally recognized tribes?
Indian Health Service
In comparison to non-hispanic whites in marriage status American Indians and Alaska Natives are.
Less likely to be married
Can you address SDOH only focusing on health care
No requires many different areas
Is it enough to have a consulter who is the religion you are consulting on?
No- they should have an understanding of its value system
Are varations in health status between race/ethnicity due to biological diffrences?
No-primairly a result from variations in exposure, vultrability to behaviroal, psychosocial, material and environmental risk factors and resources
Do all ethnic groups share a linguistic or religious trait?
No-some share common group history
What is multiracial?
a person who identifies as belonging to two or more races
What is folk medicine
remadies and therapies transmitted throughout generations...apprenticeship model
Is identifying as multi/bi racial a personal choice?
yes
which state has the largest percentage of residents who speak a language at home other than english? - california - florida - texas - new mexico
- california
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 -Move forward with culturally-competent care regardless of resources -Resources needed for building a culturally-competent practice should be analyzed on an "as needed" basis -Implement culturally-competent practices on funding rather than priorities
What is Axiology?
Interpersonal values-personal space,
Why do low-income minorities spend more time traveling to work then low-income whites?
They have fewer private vehicles so they have to use public transportation and car pools
What characteristic is true about Native Hawaiians and Other Pacific Islanders? Over 50 percent of this population reside in Hawaii and Arizona. A higher percentage of this population is married compared to non-Hispanic whites. In 2010, the median age for this group was 6 years less than the median age of non-Hispanic whites. This population has higher rates of smoking, alcohol consumption, and obesity than other racial and ethnic groups do.
This population has higher rates of smoking, alcohol consumption, and obesity than other racial and ethnic groups do.
Over 30,000 LGBTQ die every year from
Tobaco related diesase
very religious/moderately religious vs non-religious
Very religious/moderatey religious more likely to practice health behaviors More fruit/veggies Exercise Non-smokers
What is epistemology
Ways of learning
What are Asians at higher risk for then any other group?
cancer, heart disease, stroke, unintentional injuries, diabetes, chronic pulmonary disease, hepatitis B, HIV/AIDS, smoking, tuberculosis, and liver diseases
Native Hawaiian and Other Pacific Islanders die more from
cancer, heart disease, unintentional injuries (accidents), stroke, diabetes, hepatitis B, HIV/AIDS, and tuberculosis
What do American Indians and Alska Natives use the most from CAM?
Bilogically based therapires and mind body therapies both very popular
What modality of CAM as defined for the 2007 NHIS uses simple electronic devices to teach clients how to consciously regulate bodily functions? Alexander technique Chelation therapy Hypnosis Biofeedback
Biofeedback
What is race?
"biological variation including phenotypical differences in stature, skin color, hair color, facial shape and other inherited characteristics that may or may not be mutually exclusive in each individual"
What is most spoken language in US?
English, followed by Spanish
Who are Native Native Hawaiian and Other Pacific Islanders
People who are natives of Hawaii and other Pacific Islands, including Polynesian, Micronesian, Melanesian
his conference acknowledged disparities and urged member states to explore ways to address health disparities in social determinants of health
International Conference on Primary Health Care
If a health educator wants to incorporate CAM what might be the best way?
Introduce complementary because it shows values for both types of med
What was diffrent in the 2000 Census
Introduced larger pool of options, allowed people to selct more then one race/ethnicity
What is epistemological humility?
Involves recognizing the many ways of knowing, exist. Such as those that prioritize non-empircal, spiritual adventures of knowledge
Where do the majority of American Indians and Alaska Natives live-on/off reservations?
Off
T/F Cubans are taught herbal therapies, acupuncture, massage, and mind body modalities and hypothesis?
T
T/F a persons cultural background provides the foundation for his health beliefs and practices?
T
Asian/Pacific Islander use CAM...
Tai Chi, Ayurveda, Massage, Acupuncure, moxibusion, cupping, chineese medicince
When using an interpreter should you talk to the Pt or interpreter
Talk directly to the Pt
Which pop had lowest tobaco use?
Asianas
Who is most likley to attend church?
NH Blacks
What most often causes conflict or confusion?
when people of different cultures interact with no awareness of the difference between their cultures.
the lead federal entity supporting scientific research in CAM areas, the NCCAM, was created in what year? - 1978 - 2008 - 1978 - 1998
- 1998
estimates are that by 2050, the hispanic population will account for what percent of the total population? - 50% - 30% - 40% - 20%
- 30%
what is a method that a dominant culture may use to consolidate their power? - force - money - fear - all of the answers are correct
- all of the answers are correct
what modality of CAM as defined for the 2007 NHIS uses simple electronic devices to teach clients how to consciously regulate bodily functions? - hypnosis - alexander technique - chelation therapy - biofeedback
- biofeedback
Describe elderly population chracterisics.
1. More females then males, 2. will become more racially ethnically diverse-four major racial groups white, black, American Indian and Alaska Native, API and Hispanic during first half of century
What are the 3 characteristic of spiritual competence?
1. an awareness of one's personal value-informed worldview 2. An empathic, strengths based understanding of client's spiritual worldview 3. Ability to design and implement intervention strategies that are appropriate,
AA postal codes have BLANK as many chain supermarkets then white areas. Latinx?
1/2 in AA 2/3 less in Latnix
What is integrative medicince?
A combo of conventional and CAM therapies. Promote equal importance and scientific value
Which is the second largest racial group in the US?
AA
What was fastest growing age group?
Age 65 and older-more then double by middle of century
What was most/least popular among Himspanic CAM users
Biologically based therapies least was energy
What was most/least used CAM for whites?
Biologically based therapies least was energy
Biologically based therapies Chelation- nonvitamin, nonmineral products diet based
Chelation-substance used to bind molecules such as metals or minerals nonvitamin, nonmineral products-Products taken by mouth that contain dietary ingredints inteded to supplement the dier other than vitamins or minerasl-herbs, flac, soy, enzymes, etc diet based
What was the largest tribal grouping amongst American Indians and Alaska Natives
Cherokee
What is the most common cited religion in US? Most popular?
Christiantiy Protestant/other christian, catholic, mormon, Jewish, Muslim,
What barriers do American Indians and Alaska Natives face in healthcare?
Cultural barriers, geographical, inadequate sweage disposal, low incomes that prevent high-quality midecal care
What are the CLAS standards? Who wrote them? Are we required to follow them?
Culturally and Linguistically Appropriate Services, made ny Office of Minority Health (HHS) Not required except for 4-7if you receive federal funds like medicaid, medicare
English speaking immigrants were more likely to identity as what religion? Vs Spanish speaking immigrants
English- Baptist or mainline religious Spanish-Catholic especially Mexican immigrant and Latin American Immigrants
What is traditional medicine?
Group of practices that incorporates knowledge and skills that are culturally rooted in the teriores, beliefs of indigenous groups.
What is Think Cultural Health?
HHS Office of Minorty Health Developed this program as a resource that provides CEU's for healthcare providers on CC
Which religions had high educational attainment? Which religions had a decline in educatial attainment?
Jewish and Eastern religions Muslims and non-Christain traditions
Who reported less frequnet church attednance
Males, non married ages 18-29 Asians
Where are the majority of white people employed?
Management, business, sciences, arts, sales, office occupations
What is a shaman? Who may use them?
Medicine woman/man Native Americans
What does it mean to create strong coalition?
Members of target group are deeply involved in planning and implementation
Top ten states with AA?
NY, FL, TX, GA, CA, NC, IL, ML, VA, OH
Who differentaited the diffrent words to descibe CAM?
National Center for Complementary and Alternative Medicine
What is the NCCAM and what does it do?
National Center for Complementary and Alternative Medicine federal entity supporing scientific research on CAM
Where has CAM been documented in a journal database? What did it show?
National Library of Medicine-documents usefulness of acupuncture for osteoarthritis, back pain, knee pain, insomnia, nausea and benefits of massage for back pain.
Who placed a great deal on family and spiritual beliefs. They believe that illness is an imbalance between nature and the ill person?
Native Americans
What is ageism
Negative stereotypes and discrimination based on age
What is the single most substantial source of health disparity in the US? How is operationalized?
Poverty- SES
What are NCCAM priorites?
Scientific research Accurate and timley information Support rgrious clinical trials Build eveidence for CAM uses
What do standard diagnoses fail at when mislabeling immigrants with depression?
The knowledge, attitudes, practices, values, and beliefs of those from other cultural groups
What is place?
The relashionship between physical, social, and emotional environment that contrbute to health dispairetes by affecting the SDOH
T/F Puerto Ricans and Mexican Americans were more likely than Mexican adults to use biologically based CAM therapies or manipulative and body-based therapies
True
T/F healthcare organizations continue to struggle to implement CLAS?
True-dissemination and implementation science may be able to help
Do most European Americans value Western medicine or holistic mind body
Western medicine
What was the most used CAM prodcut for children?
What was the most used CAM prodcut for children? ecchnacea
What are beliefs that lead to lack of CC
believe all people have acess to knowledge, skill, and attitudes in the same manner and quality Everyone related to the instructor the way the instructior did when they were learning It doesn't matter is students are members of historically entiltled propulation It doesn't matter whether the students are successful in this society or less so The instructor has tremendous poer and equal poteintal for infulence over all the learned in the envionrment regardless of the students background or expirences
What does the current dominant culture in the US value?
individualism and privacy; informality in interaction with others; an emphasis on the future, time, and punctuality; a high regard for achievement, work, and material acquisition; and competition.
What factors impact Asian healthcare?
infrequent medical visits, and language barriers
What do White people use in terms of CAM
naturopathy, diet-based therapies, biofeedback, chiropractic, meditation, and home remedies such as peppermint and cinnamon teas, castor oil, onion poultices, and honey.
Which hospitals were more likley to adopt CLAS?
non-profit serving diverse population and those in more competitive and affluent market
What is ethnicity?
refers to people, their religion, language, traditions, and heritage
In comparison to non-hispanic whites age for Asians-by how many years
Younger on average-median age of 35.6. 7 years younger
In comparison to non-hispanic whites in age American Indians and Alaska Natives are...
Younger-median age of 30.2
diversity
a dynamic philosophy of inclusion based on respect for cultures, beliefs, values, and individual differences of all kinds
In comparison to non-hispanic whites death rate for AA
Heart disease, stroke, cancer, asthma, influenze, pneumonia, diabetes, HIV/AIDS, homicide
In comparison to non-hispanic whites education in Asians
Higher rates of HS/College grads
culture
an integrated pattern of human behavior that includes thoughts, communications, languages, practices, beliefs, values, customs, courtesies, rituals, manners of interacting and roles, relationships and expected behaviors of a racial, ethnic, religious, or social group
race
the categorization of parts of a population based on physical appearance due to particular historical social and political forces
the Ulysses syndrome forms a gateway between mental health and _____ - mental disorder - chronic disease - health inequity - cultural competence
- mental disorder
Who is most likely to identify as having no religion? What are they like?
18-29 year olds More educated Male grew up in a religious home, both parents same religion Accept human evolution
How does race intersect with diability?
18-64- -two or more race effecred more then whites -All races except Asians/Hispanics effected more then whites 65+ -AIAN effected most, --whites second highest
Children living in poverty are BLANK times as likley to suffer tooth decay
2 times as likley
X/3 of Asians are US citizens, however approx. BLANK % are foregin born
2/3, 67%
In April BLANK Joint Comminsion prepeared a cross walk with what?
2014 Joint Commission Hospital Accreditation Standards and CLAS
How many American have a diability?
36 million in the US
Compared to rest US population how many year is AA life expectancy?
4 years shorter
AA infants are BLANK times more likely then NHW's infants to die due to complications from low birth weight
4x
The Asian population has grown X times faster than the US pop. as a whole
4x
What age group used CAM the most?
50-59
How many federally recognized tribes are there?
565
BLANK% of Asians spoke langugae other then English at home
77% (Highest Vietanmeese, Chineese)
HOw many adult and how much was spent on alternative therapies?
83 million adults, 33.9 billion out-of-pocket
What is spiritual competence?
A form of cultural competence that deals with spirituality and religion, specifically clients constructed spiritual worldviews
What is Ulyesses syndome? How is it different then depression?
A group of symtomes migrants face as a result of the chronic stressors they face. They respond positivley if they are given an oppurtunity to decrease the level of stress.
Who is an immigrant? Who is a migrant? A non-national who moves into a country for the purpose of settlement Migrant-moves to a country other than that of their usual residence for a periods of a least one year so that the country of destination becomes their new country of residence-can return home, would get a non-imigrant visa
A non-national who moves into a country for the purpose of settlement Migrant-moves to a country other than that of their usual residence for a periods of a least one year so that the country of destination becomes their new country of residence-can return home, would get a non-imigrant visa
What is health equality?
A person's ability to attain his full health potential without interference from their social position or racial background
What is concept of time
Cyclical, event, or clock based
The use of CAM therapies is lesser for children whose parents have used CAM therapies. T/F
Faulse
Female vs Male religious identification
Female-Formal christian groups like pentocotals, Baptisits, mainline Chirstian Males-none, easter religion, Muslim, New religious movements ( scientology)
What are the most common natural products used?
Fish old, glucoasimine, echinacea, flaxseed oil, ginseng
How can you best provide effective communication?
Get to know Pt. social and cultural perspective Take a cultural history Make an effort to hire diverse staff Have brochures in multiple languages Use interpreter services
When exporing culutral groups and immigration what is it important to determine? What does this do?
If individual is a migrant, first-generation immigrant, or refugee; the length of time he or she has lived in the country; and the reason precipitating the immigration. Helps to determones emtotaional state, and stress levels
Hispanic adults with daibetes believed...
Illness was God's will-78%
Why has Catholicism grown, but overall still dropped in %?
Immigration primarily form Latin American Countries
What is the outcome measure that indcates whether implementing training programs, policies and culutrealy apporpriate standards make a diffrence?
Improved quality of care
Is it enough to understand the cognitive knowledge of a clients beliefs and values for the second step of SC?
No-should work to Develop a deeper psychological understanding and appreciation for clients world veiw and their associated strengths
Are all symptoms of psychopathology the same?
No-they are culturally contingent
What are the most common therapies used by all cultures CAM
Non Mineral and natural products followed by deep breathing exercises
What are the most praciced CAM by adults?
Non-vitamin and nonmineral natural products
What has seen an upward shift in terms of religion
Nondenominational idenity rejection of all organzied forms of religion
Ex-catholics now respond as...
None
Using I statements with Muslims is an example of what?
Not SC-they prefer less direct communication
Who determines the definitions for racial and ethnic groups?
OFfice of Managment and Budget
What does ageism often result in with attidues?
Old people are unproductive, sickly, depressing, cognitively impaired
Open continuum vs closed continuum
Open-God has direct relationship on Earth and in people's lives Closed-Cannot interact because they are spatially separated
What did the research article do to look at psychosocial and pain?
Paint testing and Stress testing using the Trier Social Stress Test and measure of psychosocial background
What are the 6 principle of integrative med?
Partnership both conventional and alternative believs in body's natural healing Looks as both in crtical manner Acknowledges value of science for both types Practitioners are committed to self-development
What are CHW's and Promotoras?
People who live within the community, and may have been immigrants themselves. Allows health appraches to be desimated in hard-to-reach communites
Who are AA?
Person whose lineage includes anyone whose anstors are from any of the black racial groups in Africa. Includes Africa, Barbbean, and south American descent
What is the order of popularity among belif in a personal God, vs atheist (no God) vs agnostic (unsure) vs deistic (they believe in higher power but no god)
Personal God 70% Athiest or agnostic (12%) Deistic (12%)
Who uses Santeros use storytelling and prayers to saints as a mechanism to restore health. Botanicas are small stores where people can purchase herbs, ointments, and incense prescribed by santeros or spiritual healers
Perto Ricans
What does complementary medicine mean?
Practices used simultaneously with conventional medicine
What are health disparites?
Preventable differences in the burden of disease, injury, and violence, or opportunities to achieve optimal health experienced by socially disadvantaged racial, ethnic, and or other population groups and communities
What religions to older people report?
Protestant or Catholic
T/F social workers hold negative sentiments toward the religious tradtion of family origin?
T-can cause countertransferene Less empathetic posture, increased negative appraisals, may pathologize clients values, or convert them to secular values
T/F without systemin and active approaches that enforce accountanbility some innovations like CLAS may never be fully adopted
T-may need things like penalities for failure to lower health care costs, while improving quality outcomes related to diverse populaitons
Who madates that race and hispanic orgin are distinct concepts?
The US Office of Managment and Budget Standards
By 2050 what will happen?
The minority will be the majority
Which CLAS standard has higher implemntation?
The one related to lang. because it is federally mandated
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 Human resources Performance measurement system Administrative leadership
The reduction of errors
What did the research article study?
The role of psychosocial factors in mediating the relationship between race and pain sensitivity. The idea that more stress had led to increase in pain sensitivity when blood pressure rises. It usually is an inverse relationship but with AA it isn't
What are some of the special challenges undomuented immigrants face
Their status makes them easier to expolit, may avoid healthcare workers for fear,
What is worldview?
Theological concept that focuses on indvivalual inner subjectivity in relation to the external worlds Identify meaning and value from the universe and human life
What does it mean when we say culture is like an iceberg?
There are two layers to culutre The visible layer-aspects such as food, language, clothinge, customs The hidden layer-grounded in values, cultural assumptions, non-verbal communication, perceptions, etc
What is significant about 7th Day Adventists?
They eat vegetarian, refrain from negative health habits such as smoking and alcohol California 7th day had higher life expectancy
Why are legilators concrnded to give money toward evidence based care research?
They have failed investments-it takes awhile for it to ever be implemented
Japanese cancer Pts what's significant about religion?
Those with existential distress experienced loss of autonomy, low self-esteem, and hopelessness. More likely to ask to hasten death, and express desire to die Those with post=itive meaning and acceptance demonstrated spiritual well-being
What is the single most preventable cause of disease, disability, and death in the US?
Tobacco use
What effects US children the most then any other chronic infectious diesase?
Tooth decay
What are the 4 fundamental themes of CLAS?
Treat ALL people with respect Workforce development Language assistance Continuous improvement
Who is the dominant culutre here is the US? Are they the majority group?
White men are dominant, but not the majority
Who had the lowest growth in the last decade?
White people
Who is the largest racial group in the US?
White people
Which race of children used CAM the most?
White, hispanic and then black
What did white, black, hispanic, Asians/otherraces report in terms of religion?
White-Catholic or Prtestant Black Baptist or Christian generic Hispanics-Catholics, growing number Christian generic Aisans-Eastern religions , none
Who had highest HS dropout rate?
Who had highest HS dropout rate? Hispanics
Who lives longer women or men?
Women, but their later years have more morbidity
What types of adults use CAM the most?
Womwn and people with higher education
Is race a socially constructed category?
YES
Have health educators embraced the concepts of holisitc health and integrative healing?
Yes
Is age a factor in health disparities?
Yes Fixed income, lack of acess to health info-internet
Do health educators have positive attitudes towards CAM
Yes-most use CAM modaliity
Who are white people?
a person having origins in any of the original people of Europe, Middle East, or North Africa
What is an ethno-relative perspective?
an expectation that one will have significant adjustments to make when living and working with others as well as an ability to understand components of one's own and others' subjective culture"
Roughly how many people had visited the dentist in the past 12 months?
around 45%
What is higher levels of education associated with?
better health, pursuit of healthier lifestyle, income, access to health-related information and resources
How did a faith in God impact AA males with cancer?
cope with perceptions and achieve purposeful acceptance or resignation
What can stereotypes do?
create myths that can influence how health educators view and think about certain racial and ethnic groups based on their religion, gender, occupation, or nationality
What are the parts of the cultrual competence continum?
cultural destructiveness-seeing differences and trying to stomp them out. Assumed one's race/culture is superior cultural incapacity-no time, attention, or resources are devoted to understanding cultural differences. Cultural differences aren't supported but aren't punished. differences are bad cultural blindness- "don't see color" believe that the dominant culutre is universially apicable cultural precompetence-Recoginze the diffrences, but an inadequate response to nonliberating structures and teaching practices occurs. One day CC traning, or one activity during black hisotry month cultural competence-Seeks advice form minority community, activkey invloved in own social justice work, support ongoing educationfor themselves and others. Uses the 5 essential elements of cultural proficiency. cultural proficiency-the sucesfully redress nonliberating structures in all areas
What religions to younger American report?
younger Americans were more likely to report Eastern religions, Muslim, and unaffiliated religious traditions.
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 pre-competence - cultural blindness - advanced cultural competence - cultural incapacity
- 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 incapacity - cultural pre-competence - cultural destructiveness - cultural blindness
- cultural destructiveness
across all ethnic/minority groups, which category of CAM was used the least? - manipulative and body-based practices - energy medicine - mind-body medicine - biologically-based practices
- energy medicine
in the values framework, the area of difference based on cognitive process or affective domain is called: - axiology - concepts of self - ontology - epistemology
- epistemology
the use of CAM therapies is lesser for children whose parents have used CAM therapies - true - false
- false
what is the leading cause of death among the white population? - unintentional injuries - stroke - heart disease - cancer
- heart disease
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 - curandero - botanica - espiritista
- hierbero
what is the first stage of adjustment that to some extent, all newcomers experience when they try to integrate into a new culture? - conformity stage - dissonance stage - honeymoon/euphoria stage - introspection stage
- honeymoon/euphoria stage
what agency provides a comprehensive health delivery system for American indians and alaska natives? - office of minority health - indian health service - centers for disease control and prevention - centers for medicaid and medicare services
- indian health service
what is NOT a way that health educators can avoid stereotyping? - become aware of how they ask questions of the individual - learn the characteristics of the different racial and ethnic groups - make a judgement about a client prior to meeting with them - educate others on how stereotypes affect the process of health education
- make a judgement about a client prior to meeting with them
which state has the largest african american population in the U.S.? - texas - maryland - illinois - new york
- new york
which of the following would be considered a natural product? - acupuncture - light therapy - probiotics - massage therapy
- probiotics
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 - leave cultural competence to public health practitioners only - work in isolation in clinical practice to treat patients - pay little attention the impact of state and federal legislation on service delivery
- provide appropriate and culturally relevant consumer information and marketing materials
which of the following is TRUE regarding data from the U.S. Census Bureau? - the fastest growing age group is those 45-64 years - the majority of the population will be concentrated in urban areas - the population will become less diverse - the majority of the foreign-born population came from Europe
- the majority of the population will be concentrated in urban areas
what characteristic is true about native hawaiians and other pacific islanders? - over 50% of this population reside in hawaii and arizona - a higher % of this population is married compared to non-hispanic whites - this population has higher rates of smoking, alcohol consumption, and obesity than other racial and ethnic groups do - in 2010, the median age for this group was 6 years less than the median age of non-hispanic whites
- this population has higher rates of smoking, alcohol consumption, and obesity than other racial and ethnic groups do
what would NOT be an ideal step in improving cultural competency? - demonstrate respect for the patient by integrating personal preferences into the assessment and treatment - take time to learn about a patient's culture, language, experience, and history - treating all patients the same, regardless of cultural beliefs - moving away from the belief that one's way of life is more desirable and superior to others
- treating all patients the same, regardless of cultural beliefs
CAM practices among hispanic/latino populations are highly influenced by religious beliefs - true - false
- true
Where do over half of AA reside?
In the south
In comparison to non-hispanic whites AA unempoyment
Twice as high
Where will the majority of the pop. be found?
Urban areas
In comparison to non-hispanic white median income for Native Hawaiian and Other Pacific Islanders
Was similar, but had higher level living below poverty line
T/F health outcomes have been shown to be impacted by spirituality
T
T/F the gap b/w race and ethnicites and white populations has narrowed for Immunizations
T
What is ethnocentrism?
When a person belueves that his culutre if superior to all other culutres
Hispanics
Which group is highly influeced by religious belifs and theories such as hot and cold orgin of ailments?
a lack of cultural competency may result in which of the following? - miscommunication between provider and patient - lack of adherence to treatment plan - liability/malpractice claim - all of the answers are correct
- all of the answers are correct
activities such as drumming, chanting, dancing, use of herbs, and acupressure would be common CAM practices among what racial/ethnic group? - american indiana and alaska natives - african americans - latinos/hispanics - asiana and pacific islanders
- american indian and alaska natives
what would NOT be considered a factor in culture and cultural diversity? - annual salary - veteran status - gender identity - language
- annual salary
what population has the highest life expectancy of any other racial or ethnic group in the U.S.? - hispanic men - asian women - african american women - non-hispanic men
- 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? - american indians/ alaskan natives - hispanics - whites - asians/pacific islanders
- asians/pacifica islanders
the highest percentage of adults used CAM therapies for what musculo-skeletal condition? - arthritis - neck pain - back pain - joint pain
- back pain
what is NOT an example of a cultural dimension that is globally applicable and is reflected in all areas of life? - family life - child-rearing practices - education - community engagement
- community engagement
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? - integrate the patients' traditions, customs, values in service delivery - complete a self-assessment - collaborate with other health care professionals - ask for feedback from your supervisor
- complete a self-assessment
What if the VI of Civil Rights Act of 1964?
No one should be excluded b/c of race or national origin
How many urban organizations does the Indian Helath service fund? How many sites do they operate in? What services do they provide?
-34 orgs. -41 sites. -medical and dental services; community services; alcohol and drug abuse prevention, education, and treatment services; mental health services; nutrition education; and counseling
What were the results of the study on AA and psycosocial stress
-AA reported more psycosocial stress then NHW's Racial diffrences in stress reactivity are elimnated when controlling for racial diffrences in income, occupation, and education There may be genetic influence may be role in pain relationship because adjusting for differences didn't account for differences in pain
What is the Majority/minority/dominant group?
-Majority group-refers to the group with larger percentage of the total population -Minority group-living within the society and is disadvanated in terms of pwoer, control, and wealth -Dominant group-has more power, control and wealth they set the "rules"
What strategy would be appropriate when delivering services to marginalized populations? -Make sure medical intake forms are inclusive, with gender-neutral language --Do not take into consideration religious holidays to avoid showing favoritism -It's not necessary to have policies and procedures in place -Offer services from 8am-5pm to ensure consistency
-Make sure medical intake forms are inclusive, with gender-neutral language
Those who are religious in mental health..
-Report greater happiness and optimism -very religious tend not to experience negative emotions higher levels of religious/spiritual practices had higher mental health outcomes -Also has been shown to have negative mental health outcomes -Christian/Muslim students showed greater obsession and personal guilt for intrusive thoughts
What are the four variations of biracial
-Transcendent identity-consciously denies having any racial identity -Singular identity-idendtifes as either black or white rather then biracial -Border idenity -encompases socially accepted racial categorization of black and white -Protean-multiple identities based on context
Describe how to build a CC practice...
1. Create a shared vision Define what you want it to look like-invlove community and other parties 2. Conduct and initial assessment- use Pt. info to see types of diversity and know what to measure USe metrics like CLAS standards 3. Evaluate capacity/define goals Realize financial and temporal constraints Resources toward CC should be identified each fiscal year and analyzed over time Priorities should be clearly defined 4. Implement changes Services-changing forms, times of services, etc HR and staff development-getting more diverse staff Physical environment-pics, magazines, gender neutral bathrooms etc Data-use self-identification approach The front desk-make sure its CC Elicit regular feedback Offer oppurtunity to lodge anyonmys complains identify CC parameters and track overtimes Implementation and Dissemination Frameworks
What are the goals of the HHS action plan to reduce Racial and Ethnic Disparities?
1. Transform healthcare 2. strengthen infrastructure and workforce of HHS Advance health, safety, and wellbeing of the American People Advance scientific knowledge and innovation Increase the efficiency. transparency and accountability of the HHS programs
Approximately BLANK of global disease burden results from environmental quality
1/4 and 1/3 for children
Approx. Blank afults in US have mental health disorder in last year
1/4 with 1/7 being severe
What agre of children most report CAM use? What agre of children most report CAM use?
12-17
Which pop. is effected disproportionately by infant mortality?
AA
Who places a great deal of importance on the family and chirch? In many cases key family members are consulted and the church is a support system
AA
What is the second largest racial group in the US? What is the largest minority group and fastest growing population group in US
AA Hispanics
Who was more likley to have at least one emergency room visit in past year?
AA People over 65+ Poor people People on Medicaid
Compared to whites who is twice as likley to have diabetes?
AA and hispanics
How does unemplyment compare from AA to White?
AA more likely to be unemployed
Who did whites have a higher income then?
AA, Hispanic, American Indian/Alaskan Native
What did AA, Hispanic, Chinese, white women use the most of in CAM?
AA-Spirtual healing methods Hispanic-nutrtional therpay Chinese-herbal remedies
The most common mental disorder in children is... How many children have a mental disorder?
ADHD 1/5
What is leading cause of death for individuals ages 25-44 in the US?
AIDS/HIV
Alternative medicine systems Acupuncture Ayireveda- Homeopathic treatment naturopathy-
Acupuncture-uses needles on atomical points Ayireveda-clense the body of substanced that can cause disease and therby reestablish harmony and balance Homeopathic treatment-Any substance that can produce symptoms of disease in a healthy person can cure a sick one/ naturopathy-healing power in the body. Does a variety of therpapies
What is the Latino paradox
Also known as the healthy immigrant effect-Hispanics have better healthout comes then NHW's but as they assimilate they end up with worse health outcomes
Traditional medicine practices employed outside of indigenous groups are called...
Alternative/comp. medicine
Who had the highest use of CAM
American Indian and Alaska Natives, follwoed by Native Hawaian and Other Pacific Islander, NHW, Asians, Blacks, Hispainces
What group has spirutaility and natural medicine as core concepts of CAM?
American Indian/Alaska Native
Who has highest prevalence of type 2?
American Indians under the age of 20 have highest prevalence of type 2 Diabetes
Describe the Dissemination/Impeltnations in the article
Antecedents-attributes of hospital including structural and leadership support Structure must be in place for organization to achieve CC Leadership collection system for outcomes HR practices that support diversity etc Presecnse of antecedents can support rediness for change-but does NOT indicate actual adoption or implementation Readiness-Indiviudal or organizations recpetiviness to change Need buy in from individuals May use scales to measure individual's readiness for change Adoption-The decision to implement or incorporate practices Occurs on a continum Does not indicate actual implemntation of standards Implementation-puts actual standards into practice Initial, full, and sustainable implementation all occur Needs to happen at both organizational and individual Nurse leaders play important role in implementing and translating into practice Consequences- result or Pt. outocmes of adoption of CLAS standards In this case related to Pt. outcomes, reduction in disparities, better communication, adherence to treatment, etc.,
What is interculural cometence/cross-culural competence?
Appropriate interactions in a variety of culutral contexts, especially when people are diffrent then you
What are some examples of CAM used by AA?
Asafetida worn around neck, silver bracelts on baby girls to protect ilnnes, sassafras tea for respitory illness
Why has there been an increase in the idenitifcation of easter religions?
Asian Immigrants
Which population uses importance of understanding the yin (representing the female, negative energy) and yang (representing the male, positive energy) in the genesis and management of disease.
Asian/Pacifc islander
Who has extended family, particularly the oldest male in the family acing as the decision maker and spokesperson?
Asian/Pacific Islanders
Which group uses Moxibustion-applicaition of heat from a dried plant?
Asian/Pacific islanders
Who has the lowest church attendance?
Asians
Who values a mintaince of harmony and avoids conflict, which often results in not disagreeing with the recommendations of healthcare professionals, but not following treatment recommendations anyway?
Asians
Who was the worldwide leader in CAM use?
Cubans
According to the National Health Interview Survey (2007), the highest percentage of adults used CAM therapies for what musculo-skeletal condition? Arthritis Back pain Joint pain Neck pain
Back Pain
What is acupuncture used for?
Back pain, imsomnia, smoking cessastion, massage, meditation, depression and anxiety
What does a Health Educator need to do to develop trust with a population?
Be familiar with pop Partcipate in community events be accepted into everyday life in community events Become a familiar face and participate in activities other then the ones they run
The majority of people who reported being black and another race were...
Black and white
traditional healers- Traditional healer- Alternative medicine Botanica Curadero Espiritista- Hierbero- Native American Medicine man Shaman Sobador
Botanica-healer who supplies healing products, sometimes associated with spirtual intervention Curadero-treats illness through the use of supernatural force, herbal remdies, and other natural medicines Espiritista-reccomends herbs, religious amulets in order to imporve this person's health Hierbero-knowledge on the medical quality of plants Native American Medicine man healer who uses information for the spirit world in order to benifet the community-may come for illness or spirtual guidece Shaman-Contact b/w spirtual and physical world. Use information to perform tasks such as divination, influenceing natural events, and healing sick or injured Sobador-Uses massage or run technquies in order to treat pt Traditional healer-based on indienous therories, beliefs, and expirences handed down from one generation to next
CLAS vs NQF?
CLAS are more comprehensive, overarching, and allow more flexibility NQF_targets specific practices and eliminates the option of varying interpretations by different institutions.
Four states with largest white population are
California, texas, Florida, New York
What is The Consortium of Academic Health Centers for Integrative Medicine?
Calls for comprhensive and compassionate health care that offers integrative services and individual and community level
What is the second leading cause of death in the US
Cancer
When trying to make changes to pracice what is best focus on one facet of the org of many?
Change at multiple levels of the organization
What is place
Conditions in the various environments or settings-include material attributes but also sense of security, patterns of social engagement, etc
What are some ways to enhance understanding of CAM in health education setting?
Created standing committees on organizaations add to health education cirriculunm Academic certificate programs international research coopertive agreements
How does Healthy People 2020 adress the SDOH?
Creating social and physical environments that promote health for all
The precentage of Americans who idenitified as Christian has...
Decreased
Describe the second characteristic of spiritual competence . An empathic, strengths based understanding of client's spiritual worldview
Develop a deeper psychological understanding and appreciation for clients world veiw and their associated strengths You do NOT have to agree with the values
Describe the first characteristic of spiritual competence- an awareness of one's personal value-informed worldview
Develop an in-depth awareness of one's personally constructed worldview Know that no one has a completely objective view of reality Develop limitations, biases associated with one's worldview- helps ensure that they do not negatively impact the therapeutic relationship
What is the 7th leading cause of death in the US?
Diabetes
n the conceptual model for dissemination of standards into clinical practice, which behavioral theory is used within the framework? Diffusion of Innovation Social Cognitive Theory Health Belief Model Theory of Planned Behavior
Diffusion of Innovation
What are best way to reverse diabetes trends?
Early Screening and treatment
What are the "place-based" framework determinants that are focused on?
Economic Stability Education Social and Community Context Health and Health Care Neighborhood and Built Environment
Where does food insecurity fall in the place based framework?
Economic stability
What is the most critical element in ensuring safe and effective utilization of CAM?
Education-education should be based on cultural competence and humility
When selecting a CAM practitioner what should be looked for>
Education/training Cost Ask for brief consultation Ask for research Amount of time practioner spend with each peorson hours of appointments
What should health educators with bachelors, masters, or advanced level 2 do?
Entry level-expand body of knowlege on CAM Advanced level 1-engage, implement and evaluate educational programs related to CAM Advanced level 2-enegaeg in research and scintific discovery
What are subculutres?
Ethnic groups that exsist in a larger American culutre
Is Hispanic a race or ethnicity
Ethnicity-you can be Hispanic and any race
Which group practices preventive medicine, yet also suffer from a rise in rates of chronic diseases and diseases related to obesity?
European Americans
What is the Jackson Heart study looking at?
Examining the physiological, envionrment, social, and gentetic facotes related to CVD in AA pop.
T/F our nation CAN reach optimal level while health disparities continue to exist
F
T/F the absence of disease is the same thing as good health?
F!!!!!!!!!!!
What are the determinants of health? What do they include?
Factors that influence individual or population health Include-social factors, policymaking, health services, individual behaviors, biology/genetics
3 key elements to HP ]
Good governance-All about policy development, health is central focus of policy making Health in ALL policies-policy makers-when looking at any policy they should have consideration of health included. Health literacy Individuals have tools, knowledge to pursue health Hard to engage if they don't understand what a behavior is Providing info in a way they can understand, read, verbally communicate, etc. Healthy cities Leadership from city council, mayor, Funds allocated to initiatives to promote health
What is the Promotores de Salud Initiative?
HHS Office of Minority Health promotes the use of CHW's Any volunteer or paid frontline public health worker who are trusted members of the community and/or have unusually close understanding of the community served Shown improved outcomes in underserved, minority communites
As a result of the Unequal Treatment report what came about?
HHS action plan to reduce Racial and Ethnic Disparities
CC requires that orgs...
Have defined set of values and principles that enable them to work effective cross-culturally have capacity to value diversity, conduct self assessment, acquire and institutionalize cultural knowledge and adapt diversity and then cultural contexts of the communities they serve
Where does health literacy fall in the place nased framework?
Health and Health Care access
Health inequality is used interchangeably with what word
Health disparities
What are the Healthy People health indicators?
Health issues that if not addressed will lead to major problems tobacco, health disparities, "overweight/obesity"
People who have liberal religious beliefs compared to fundamentalism
Healthier but less happy
What is the leading cause of death in the US?
Heart disease and stroke-but minorites are disproportionately burdened
What are the top 5 causes of death for White?
Heart disease, chronic lower respiratory disease, stroke, unintentional injuries
What do Dominicans primarily use for CAM>
Herbal medicine
selflessness, detatchment, and dharma may appear like an "underdevloped ego" but if you are SC you know it could just be...
Hindu culutre
More then 1/2 new AIDS cases come from which populations?
Hispanic and AA
Who has a respect for elders, who are often consulted on matters of illness. They tend to believe illness if God's will, or the result of divine intervention? They may prefer the use of home remedies or folk medicine?
Hispanics
What are the stages of adjustment to a new country?
Honeymoon stage-Newcomers enter to new cultural experience and it appears to be everything they freamed of Conformity stage-begin to see cultural differences and begin to adjust to the physiological and psychological changes that occur in them. They attempt to fit into dominant group. begin to feel an increased tension and frustration Resistance and immersion stage-Chracterized by withdrawal or hostility from relationships and interactions. Respond w/ anger to oppression and racism they experience or withdrawal form interaction with dominant group Introspection stage-delopment of a deeper sense of self and support for the minority group. develop concern and empathy toward their own self and others in the same minority group. Integrative awareness stage-releif phase. Accompied by humor and joy. Understand subjective culutreal aspects. Able to interpret and interact from their own culutral perspective and that of the dominant group of the new country
What are reasons people have become unaffilated with church?
Hypocrisy overmphasis of rules not enough on spirtuality too much focus on money and power among leaders of church
What did Healthy people 2020 put a renewed focus on?
Identifying, measuring, tracking, reducing health disparities through the determinants of health approach
Is there a specific region that has more nones?
No-really all have had nones popping up Regions that have been predominently catholic- New England and middle atlantic are moving toward None category
What is necessary when considering the financial constraints of the organization in developing a culturally-competent practice? Move forward with culturally-competent care regardless of resources Resources needed for building a culturally-competent practice should be analyzed on an "as needed" basis Incorporate financial resources for translators into the annual budget Implement culturally-competent practices on funding rather than priorities
Incorporate financial resources for translators into the annual budget
Did deep breathing, therapy, and yoga see an increase or decrease?
Increase
What are the 6 areas the the Department of Health and Human Services selected as racial minorities experience disparities?
Infant motality Cancer screening/managment, cardio diesase, diabetes, HIV, immunizations
What report basically said health disparities are hella complex?
Institute of Medicine-Unequal Treatment report
How does culutre impact our lives?
It determines the most fundemental level of the way in which we preceive the world.
Why is it a mistake to assume that Hispainc is homoeogenous?
It includes 19 countries in South America, 1 in Euroupe
Even though there is less intrest in religion, what happened to spirituality?
It is still an interest
How does the HHS office of Minority Health align with the HHS Disparities Action Plan
It's prioritizing CC training Supporting initiatives that promote diversity in the work-force and promote community based models
Who reported that CLAS and unequal treatment report wern't being uptaken by hopsitals?
Joint Comminsion
What should new immigrants be warned about in order to reduce Ulysses syndrom risk?
Keep strong ties with their langugae and culutre
What region has highest foregin-born population in US?
Latin America
Where were the majory of undomuents immigrants from?
Latin America
Which group of immigrants has faced higher levels of oppression and maginliazation? Why?
Latin America becuase of the anti-immigrant setiment acorss the US
Were those with higher income and education more or less likely to smoke?
Less
What is bad about the words used to descibe CAM?
Limits scope-words like holistic health would allow more invloved
Women are more likely then men to
Live 200% below poverty line been diagnosed with cancer
Who uses traditional healing practices associated with curanderismo for folk illnesses such as mal de ojo (evil eye or bad eye), caida de la mollera (fallen anterior fontanelle), and envidia (envy).
Mexican/ Mexican americans
Who is more likley to belive the bible is inspired by the word of God? Who is more likley to tak ethe bible as literal word?
Middle/higher income, attend weekly, college/post grad Less educated, very religiuous, lower income
What region do White people live in?
Midwest and South
What was highest CAM use in AA?
Mind body therapy, lowest energy healing
According to the 2007 NHIS, what was the highest use of CAM therapies among the African-American population? Energy-healing therapies Mind-body therapies Manipulative and body-based therapies Biologically-based therapies
Mind-body therapies
What are the disparities in HIV?
Minorities are less likely then whites to get experimental testing women and AA with HIVE are less likely to get antiretroviral therapy Drug users are less likely to get antiretroviral therapy then non-drugies
Continuum of religious ideologies
Mono-Belief in one God Poly-Belief in many Gods Pantheism-Belief that god is everywhere and in everything but not an individual being Dieism- A higher power but no personal God Agnostic-Unsure or unknown Atheism-No God
What are the most commonly cited reasons for use of CAM?
More affordable More closely related to Pt. ideology Less paternalistic
How has latino religion changed?
More self report as none
Most used CAM for Asian and Pacific Islanders?
Most-Mind body, least energy
Who is needed in order for uptake of eveidence into practice?
Multidisciplinary team
What are the three ethnorelative stages My culture is one of many equally valid worldviews 1. Acceptance and respect of culutral diffrences Adaption of a framwe of refrenced to other culutral diffrences integration of other wouldview points into one's own
My culture is one of many equally valid worldviews 1. Acceptance and respect of culutral diffrences Adaption of a framework to other cultural differences i ntegration of other wouldview points into one's own
Who reported more frequent church attedance?
NHBlacks Those over 65 black hispanics those who are married females white hispanics
Have any national standards been developed to unify criculum for health educators on CAM?
NO
Is focusing on health education, promotion, and improving access to healthcare by providing health insurance to the uninsured enough to reduce health disparities?
NO
Was the spirtual workbook effective?
NO-but did provide more energy
Should family and friends provide interpreter services?
NO-not unless the Pt asks for it
Is it SC to as American Indians about their spiritual rituals?
NO-some can only be discussed with other tribal members, may find it stressful and terminate
What are the most common CAM practices in children?
Natural products, chiropractic, deep breathing, yoga, homeopathic treatments, tradional healer
What were the most reported CAM uses for adults?
Natural products, deep breathing, meditiation, chiropractic, massage, yoga, diet based therapy, progressive relaxation, guided imagery, homeopathic treatment
What are the four sub-gourps of CAM pracices according to NCCAM?
Natural products-may be known as dietary supplements, vitamins, minerals, probiotics, etc Mind and Body medicince- interactions b/w brain and body and behavior. USe mind to affect physical funciotn. Meditation, yoga, breathing, tai chi, qi gong, etc Manipulative and body based practices-spinal manipulation, massage-physical body Other Movement therapsies-Alexandar technquie, pilates Pracices from tradional healers Manipulation of energy fields-magnet therapy, Reki, healing touch Whole medicince systems-ayurveda, homeopathy chinese medicince, etc
What state has highest % of AA?
New York
What is external reality?
Quantifies time and the sequence of events. Experience this reality through mathematical sequence of predictable events
What is race? What is ethnicity?
RACE=the categorization of parts of a population based on physical appearance due to particular historical social and political forces ETHNICITY= pertaining to a group sharing a common and distinctive culture, religion, language, etc
What is infant mortality rate and what is the trend in the US overall?
Rate at which babies under one die. Used to compare health and well-being of pop. across and within countries Overall it is decreasing
T/F clients who share religion find it easier to make SC interventions?
T
nstitute of medicine" Unequal treatment" report showed disparities exsited
Recommended more diversity in workforce, and more diversity training
What is religion vs spirtuality?
Relgion-practice or participation in culutrally based activities, including prayer, meditation, attednance at services, reading relgious text, performance or rituals Spiruality-Emotional expirences, expression of awe, wonder, harmony, or connectedness
How does the Afordable Care Act support CC?
Requiring pop. surveys and healcare programs collect data related to race, sex, primary lang, etc Provides funding fro educational materials and CC training
What do South Asians believe about epilepsy
Reult of fate, God's will, or punishment for past life sins
Existential scholars ve theologians?
Scholars argue that there can be no act of God as a historic event and religion is a subjective experience Theologians believe the new testament as diving communication of God to man
What are the diffrences between second generations and first generation immigrants?
Second gen, haver higher earning and are less likley to live in poverty, but better health doesn't happen. As they acculturate they lose family connections and cultural connection in favor of American lifestyles. Stress and illness rates increase
What are the ways to build SC?
Self assesment -Internal logic if differing culutral value systems, at a macro level -introspection -Put ones spirtual journey on paper -Considering values that one disagrees with Consultasion -Should use someone who is well versed in SC, especially SC of the religions you typically see -Possibly clergy Develop knowledge of the values of the religious cultures -Knowing that an individual may not hold all the religious values Use Epistemological humility
What are the main components that help male prostate cancer Pts. Is it only elusive to religion?
Sense of meaning and peace-not just by religion
"our genetic predispositions affect the health care we need, and our social circumstances affect the health we receive" describes....
Social determinants of health
What has protective effect in preventing or decreasing the risk of development of illness, especially in second-generation immigrants confronted with acculturation and the impact of oppression and marginalization?
Social support
The use of consultation with holistic healers, the use of herbs and nutritional supplements, as well as prayer, meditation, and massage.
South and Central Americans
Where is church attendance highest in terms of regions?
South, Midwest, East, West
Interventions that resonate with client spirtutality can...
Speed recovery, facilitate wellness, prevent relpase, and used after termination
Which has stronger relation with quality of life religion or spirituality?
Spirituality
T/F confidence in organized religion is at an all time low
T
What is the most diverse nation in terms of religion
USA!!!!!
What is ligunistic competence?
Understanding that many people don't speak English well and healthcare environments may not accommodate their predominant language
What are emerging strategies to address the SDOH?
Use of Health Impact Assessments "health in all policies"
What does alternative medicine mean?
Used instead of conventional medicine
What is the new trend in the lit?
Using CC in a focused or strategic way can be helpful in adjunct to quality improvement process
Is there empirical evidence that supports benefit of religious involvement on health outcomes?
Very Little
What are examples of CAM used in Hispaines?
Visiting shrines, treatment by sobanderoes (massage healers) hueseros (bone settlers), midwifes, use of camonile, spearmint, organge leaves and sweet basil and tea infusions
What is health promotion?
WHO-HP enables people to increase control over their own health. Wide range of interventions that are used. Addresses and prevents the root causes of ill health. Behavior, and SDOH
What does the culutre of the dominant culutre do?
dictate accepted values
What does the new version for diversity need to include?
diversity need to include? not only typical racial/ethnic or gender composition of a pop. but also how different groups perceive and interact with the environment, political and ideological beliefs and equity in access to opportunities and care.
What is diversity?
dynamic philosophy of inclusion based on respect for cultures, beliefs, values, and individual differences of all kinds. It respects and affirms the value in differences in ethnicity and race , gender, age, sexual orientation, socioeconomic status, linguistics, religion, politics, and special needs
What was the Racial and Ethnic Approaches to Health?
engaged neighborhoods and faith based organizations in health promotion strategies to reduce cardiovascular disease and diabetes
What was the recomendation from the Joint Center for Political and Economic Studies and California State University, Fresno's Central Valley Health Policy Institute?
equity in all policies-consider the impacts of zoning and contracting on all postal codes
Describe the third step in SC?A bility to design and implement intervention strategies that are appropriate, relevant, and sensitive to the client's spiritual worldview
evelop interventions that resonate with clients values and implementation flows naturally
Agency for Healthcare Research and Quality sponsors research that.... focuses on how providers and patients can better manage diabetes to improve outcomes
focuses on how providers and patients can better manage diabetes to improve outcomes controlling blood sugar levels to prevent blindness and the importance of routine monitoring and treatment of severe foot infections to prevent amputations
What is health equity? t
he attainment of the highest level of health for all people. Achieving health equity requires valuing everyone equally with focused and ongoing societal efforts to address avoidable inequalities, historical and contemporary injustices, and the elimination of health and health care disparities.
What are the SDOH?
health are conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks
What are American Indians and Alaska Natives disporintley affected by?
heart disease, cancer, unintentional injuries (accidents), diabetes, stroke, mental health issues, suicide, obesity, substance abuse, sudden infant death syndrome, teenage pregnancy, liver disease, and hepatitis
WHat is culture?
learned, shrared and transmitted behaviors including values and beliefs from one generation to the next
What occured in the second half of the 20th century in tems of migration?
migration rate has soared and become largely characterized by the movement of lower-income individuals seeking prosperity or safety to wealthier countries
How can Hispanics be classified further?
nationality-where the person's place of legal birth or citizenship
What was the Ottawa Charter f
or UN to make a commitment to population health and improve health of our communities
Why is it hard to quantify health disparities
people report having more than one race-we can only gather is disparities between blacks and whites from US censu berau
What is poor air quality linked to?
premature death, cancer, long term damage to the respiratory and cardiovascular systems
Most disparities affect groups marginalized because of.... What does this do? socioeconomic status,
race/ethnicity, sexual orientation, gender, disability status , geographic location , or some combination of these factors. Reduces access to determinants that support health
which of the following is TRUE regarding developing cultural competency? - understanding one's own culture is the first step in developing cultural competence - learning cultural competency is a one-time process - developing cultural competency is a simple process - interactions with individuals from various cultures does little to expand knowledge of cultural competency
- understanding one's own culture is the first step in developing cultural competence
even though they no longer represent a majority of the U.S. society, what population continues to establish the mainstream culture? - white men - asian men - white women - hispanic men
- white men
What was the Secretary's report on Black and Minority Health?
-1985 report-first times authoritatively documented health disparities is different US populations -Established basis for Healthy People Inatitive
What are the overaching goals for People 2020?
1. Attain high-quality, longer lives free of preventable disease, disability and premature death 2. Achieve health equality, eliminate dispaitres and imporve health for all groups 3. Create socil and physical environments that promote good health for all 4. Promote quality of life, healthy development and healthy behaviors acorss all life stages
What are most common form of disability
1. Hearing 2. Any physical funciton 3. Vision 4. Walking a quarter mile/unable to do so
The median age for Native Hawaiian and Other Pacific Islanders is BLANK years less then the median age for non-hispanic whites
16 years less 26:42
In comparison to non-hispanic whites median age American Indians and Alaska Natives is...
17,000 less, 30% below poverty line, and 24% uninsured
Over Blank million peope in US are American Indians and Alaska Natives
5 million
Describe sexual orientation
5-10% of pop LGBTQIA Census does not ask for sexual orentaiton-does ask about household makeup
What percent of people in US identified as Asian?
5.6% with Chineses, Asian Indians, and Filipinos making up majority.
In comparison to non-hispanic in age, marriage and household maintenance
AA-younger, less likley to be married, more maintatined by women
What group has a large percentage of grandparents who lived in the house responsible for the care of the children?
American Indians and Alaska Natives
Who are American Indians and Alaska Natives?
Any of the original people of North, Central, South America who maintain tribal affiliation or community attachment
Who are Asians?
Anyone who has orgins in Far East, Southeast Asia, or on Indian subcontinent including Cambodia, China, Philippines, India, Japan, Korea, Malaysia, Pakistan and Vietnam
Who holds the higest life expectancy if comparison to any other racial/ethinic group?
Asian women-specifically Chineese
Which group is described as the highest income, best educated, fastest growing racial group in US?
Asians
Which group makes up the largest share of recent immigrants
Asians
In comparison to non-hispanic whites emplyment in Asians
Asians were more likely to be employed in management, professional, and related occupations than were non-Hispanic whites— 48 versus 40 percent, respectively.
3/4 of the Asian pop. resides in these 10 states
California (5.6 million), New York (1.6 million), Texas (1.1 million), New Jersey (0.8 million), Hawaii (0.8 million), Illinois (0.7 million), Washington (0.6 million), Florida (0.6 million), Virginia (0.5 million), and Pennsylvania
Which state has largest % of residents who speak langugae other then English @ home?
California, NM, Texas
American Indians and Alaska Natives are most likley to live in
California, Oklahoma, Arizona, Texas, New York, New Mexico, Washington, North Carolina, Florida, and Michigan
Why is it difficult to get info for LGBTQIA? What are the results of this?
Census doesn't ask for it, and people are in the closet Hard to develop, implement, and evaluate health education programs for this pop.
In comparison to non-hispanic whites in education
Less likley to have HS/College dipolma 82 HS, 18% college
In comparison to non-hispanic whites AA insurance rate
Lower
In comparison to non-hispanic whites in household income
Lower median family income
Describe gender characteristics
More females (50.8) to males (49.2) More females has HS dipolma (roughly 85% for both genders) More males has Bachelor degree (28:27)
In comparison to non-hispanic whites in marrgige/houeholds Asians...
More likley to be married and live in family household, higher percent maintated by married couple
What are the 3 largest Native Hawaiian and Other Pacific Islanders(NHPI) groups in US?
Native hawaiian, Samoan, Guamanian
Native Hawaiian and Other Pacific Islanders has higher rates of
Smoking, alcohol consumption, unintentional injury
What is second most popular langague in US
Spanish
Majority of Native Hawaiian and Other Pacific Islanders households are
families and married couples
ethnicity
pertaining to or characteristic of a people, especially a group (ethnic group) sharing a common and distinctive culture, religion, language, or the like
