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Valuing Cultural Competence

Public health experts now recognize that certain racial, ethnic, and cultural groups face disparities in availability of health care and access to health education. As a result, health care providers have become increasingly aware of the need to consider culture in the context of their work with patients and their families. Thus, cultural competence has become an important area of skill building for health care providers, and some believe it is an ethical imperative.23

Learn about diseases or health concerns that are common among the ethnic groups you serve.
  • For example, Black/African American adults have high rates of hypertension, diabetes, and heart failure and may be taking medications for these illnesses, creating the potential for drug interactions. Lactose intolerance is common among most racial/ethnic minorities. These situations may need to be taken into account when making suggestions for foods to eat that make medications more palatable or easier on the stomach.
Assess youth and families' cultural perspectives on medications.
  • Providers approach medication and treatment from a scientific, empirical viewpoint, whereas patients and their families may take an intuitive approach. Get to know what they think about the treatment regimen you are proposing. Do they have fears or hesitations? Do they believe the treatment plan will work? Are they willing to try? Have regular conversations about perceptions of treatment and its effectiveness. Encourage youth and their families to let you know when they feel a plan is not working.
Talk with youth and families regarding their involvement with traditional healers.
  • Many ethnic groups, including Blacks/African Americans, American Indians/Alaska Natives (AI/ANs), Asian Americans/Pacific Islanders (AA/PIs), and Latinos hold culturally specific spiritual beliefs and individuals may seek advice and intervention from ministers, Yoruba priests, spiritual readers, herbalists, voodoo priests, shamans, or others known for their healing abilities. Determine whether your patients are using herbal or other therapies that may interact with ARV medications or negatively influence treatment adherence.

References

  1. Ridley CR. Imperatives for ethnic and cultural relevance in psychology training programs. Prof Psychol Res Pr. 1985;16(5):611-622.
  2. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Smedley BD, Stith AY, Nelson AR, eds. Washington: National Academies Press; 2003.