Cultural Competency
Cultural and linguistic competence is the ability to interact effectively with people of different cultures. Culture refers to the integrated patterns of human behavior that include the language, thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups (U.S. Department. of Health and Human Services, Office of Minority Health Affairs).
In terms of Emergency Medical Services for Children (EMSC), providing culturally and linguistically appropriate emergency medical care that is both respectful of and responsive to the cultural and linguistic needs of pediatric patients and their families offers the potential to improve healthcare access, quality, and, ultimately, outcomes.
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HEALTHCARE PROVIDER RESOURCES
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EXAMPLE PRACTICES Utah Emergency Medical Services for Children
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DATABASE SEARCHES
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FAMILY AND CAREGIVER RESOURCES
More details about this and other family and caregiver resources |
HEALTHCARE PROVIDER RESOURCES
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On the Same Team. Funded by the EMSC Program, this CD-ROM was created by the National Association of Emergency Medical Technicians to address issues concerning inclusion of families in the prehospital care setting, including cultural competency. (2001).
American Academy of Pediatrics
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Community Pediatrics: Culturally Effective Pediatric Care. This section of the American Academy of Pediatrics’ (AAP) website articulates the Academy’s position on culturally competent care by stating that “the needs of pediatric population are influenced by factors relating to culture and ethnicity. Pediatricians must acquire the knowledge and practice skills that will allow them to: recognize and address culture and ethnicity, make valid assessments of clinical findings, and provide effective patient management.” (Accessed November 2011).
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Policy Statement: Ensuring Culturally Effective Pediatric Care: Implications for Education and Health Policy. This policy statement defines culturally effective health care and describes its importance for pediatrics and the health of children. The statement also addresses the importance of cultural effectiveness, sensitivity, and competence, especially as related to medical training and education. (Reaffirmed August 2008).
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Culturally Effective Care Toolkit. This is a practical, hands-on resource to help practicing pediatricians and their office staff provide culturally effective care to their patients and families. (2011).
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Presentation – Culturally Effective Pediatric Care in a Community-based Health Program. This presentation provides an overview of culturally effective pediatric care and highlights the AAP’s online Culturally Effective Care Toolkit. A Healthy Tomorrows grantee discusses their experience creating culturally responsive health education materials and training providers how to manage diverse health literacy levels. (April 2011).
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Educational Goals and Objectives for Culturally Effective Pediatric Care for Residents in Pediatrics. AAP Committee on Pediatric Education, 2008 Provides list of goals and objectives in providing culturally effective care for pediatric residents. (2008).
American College of Emergency Physicians
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Policy Statement: Cultural Competence and Emergency Care. This policy statement affirms the American College of Emergency Physician’s support for culturally and linguistically appropriate resource utilization in the emergency department as well as cultural awareness amongst emergency care providers. (Revised April 2008).
American Medical Association, Institute of Ethics
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Communication Climate Assessment Toolkit. The C-CAT is a new organizational performance assessment toolkit from the Ethical Force Program® at the American Medical Association designed to assist your organization in meeting the needs of a diverse patient population. The C-CAT can help organizations improve communication with all patient populations and many of the questions are specifically focused on common communication problems, such as culture, language and health literacy gaps. (2008).
Association of Maternal & Child Health Programs
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Cultural Competency. An online conference call discusses state involvement to develop culturally competent programs that raise awareness about ASD and engage newly diagnosed families from culturally, linguistically, and geographically diverse communities. Populations of specific concern to the State Demonstration Grantees include Hispanic, Native American, and rural families. (May 2009).
Association of State and Territorial Health Officials
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2008 Snapshots: State Activities to Promote Health Equity (Interactive Map). With support from the U.S. Department of Health and Human Services’ Office of Minority Health, the Association of State and Territorial Health Officials surveyed state and territorial health agencies on racial/ethnic minority health and health disparities. This map of the United States portrays each individual state response. (2008).
Champlain Valley Area Health Education Center
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Cultural Competency For Health Care Providers. This manual not only provides a definition of cultural competency, but also helps raise awareness of the increasing diversity in Vermont and offers resources to help providers become better acquainted with different populations. (November 2007).
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Cultural Competency and Quality of Care: Obtaining the Patient's Perspective. This research, conducted with support from the Commonwealth Fund, identifies five domains of culturally competent care that can be best assessed from the patient's perspective, including: (1) patient-provider communication, (2) respect for patient preferences and shared decision making, (3) experiences leading to trust or distrust, (4) experiences of discrimination, and (5) linguistic competency. The report also makes recommendations regarding the implications of cultural competence for healthcare providers and health systems, and identifies areas for further research. (October 2006).
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Racial and Ethnic Disparities in U.S. Health Care: A Chartbook.This chartbook serves as a detailed resource on health care disparities for policy makers, researchers, practitioners, and others, addressing disparities in health status and mortality, healthcare access, health insurance coverage, and quality of care ‐ as well as strategies for closing the gaps. (March 2008).
This online project incorporates a number of links to web resources that are designed to facilitate the provision of culturally competent healthcare to refugees and immigrants worldwide, including:
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Bibliographies by Ethnic Group (Accessed November 2011).
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List of Health and Culture Websites (Accessed November 2011).
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Cross Cultural Training Resources for healthcare providers and the general public. (Accessed November 2011).
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Multilingual Health Materials (Accessed November 2011).
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Universal Symbols in Healthcare: Best Practices for Sign Systems. Developed by Hablamos Juntos – a project designed to improve communications amongst providers and patients with Limited English Proficiency (LEP) support from the Robert Wood Johnson Foundation – this best practices manual provides instructions for implementing culturally and linguistically appropriate health care signage systems to increase healthcare access for patients with limited English language skills. (2005).
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Race, Ethnicity, and Language of Patients: Hospital Practices Regarding Collection of Information to Address Disparities in Health Care. This report addresses the ability of health care organizations to describe their patient populations and assess the size and scope of health care disparities in-house. It focuses on hospitals and their practices concerning the collection of information on patient race and ethnicity. The report also provides information on the extent to which U.S. hospitals currently collect information on the race and ethnicity of their patient populations, as well as how this information is collected, recorded, and used. (January 2006).
National Center for Cultural Competence
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A Guide for Advancing Family-Centered and Culturally and Linguistically Competent Care. This guide is derived from the comments, concerns, and discussions generated from participants of the Family-Centered Care and Cultural Competence Meeting convened by the Maternal and Child Health Bureau (MCHB). The meeting explored ways in which family-centered care and cultural and linguistic competence could be integrated in a more effective manner to support and sustain a community-based system of services that are comprehensive, coordinated, and accessible and that provide the highest quality of care. (2007).
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Cultural Competency Health Practitioner Assessment. This healthcare provider self-assessment was developed for the Health Resources and Services Administration's (HRSA’s) Bureau of Primary Care to encourage cultural and linguistic competence in efforts to support the elimination of health disparities among racial and ethnic groups. (Accessed November 2011).
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And the Journey Continues…Achieving Cultural and Linguistic Competence in Systems Serving Children and Youth with Special Health Care Needs and their Families. Designed to offer insight and lessons learned over a decade, this publication shares the efforts of state and territorial programs in implementing culturally and linguistically competent policies, structures, and practices. (Fall 2007).
National Center for Cultural Competence
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A Guide for Advancing Family-Centered and Culturally and Linguistically Competent Care. This guide is derived from the comments, concerns, and discussions generated from participants of the Family-Centered Care and Cultural Competence Meeting convened by the Maternal and Child Health Bureau (MCHB). The meeting explored ways in which family-centered care and cultural and linguistic competence could be integrated in a more effective manner to support and sustain a community-based system of services that are comprehensive, coordinated, and accessible and that provide the highest quality of care. (2007)
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Cultural Competency Health Practitioner Assessment. This health care provider self-assessment was developed for the Health Resources and Services Administration's Bureau of Primary Care to encourage cultural and linguistic competence in efforts to support the elimination of health disparities among racial and ethnic groups. (Accessed January 2010)
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And the Journey Continues…Achieving Cultural and Linguistic Competence in Systems Serving Children and Youth with Special Health Care Needs and their Families Designed to offer insight and lessons learned over a decade, this publication shares the efforts of state and territorial programs in implementing culturally and linguistically competent policies, structures, and practices. (Fall 2007)
National Initiative for Children's Healthcare Quality
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Improving Cultural Competency in Children’s Healthcare: Expanding Perspectives. With support from The California Endowment, this report from the National Initiative for Children’s Healthcare Quality shares findings from a pilot project looking at racial and ethnic disparities in health care, specifically as they relate to children’s health. (July 2005).
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A Comprehensive Framework and Preferred Policies for Measuring and Reporting Cultural Competency: A Consensus Report. This publication aims to promote culturally competent care, to reduce health disparities, and to make care more patient-centered. It does so by endorsing a comprehensive framework or "road map" for measuring and reporting cultural competency. The report also endorses 45 preferred practices for the provision of culturally competent care. (2009).
University of South Carolina Rural Health Research Center
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Rural Hospitals and Spanish Speaking Patients with Limited English Proficiency. Funded by the U.S. Department of Health and Human Services, Office of Rural Health Policy, this Rural Health Research Center study reviews how rural hospitals are meeting the needs of their LEP patients with regards to the federal government's Culturally and Linguistically Appropriate Services (CLAS) requirements. (October 2005).
U.S. Department of Health and Human Services
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Office of Minority Health (OMH). The OMH website links to a variety of programs and online resources addressing the topics of linguistic and cultural competence. These include the following:
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The Center for Linguistic and Cultural Competence in Health Care. The mission of this congressionally mandated center within OMH is to develop the capacity of health care professionals to address the cultural and linguistic barriers to health care delivery and increase limited English-speaking individuals' access to health care. (April 2007)
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National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health Care. This OMH final report focuses on developing recommendations for national CLAS standards to support a more consistent and integrated approach to cultural competency. (March 2001)
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Agency for Healthcare Research and Quality (AHRQ). AHRQ, whose mission is to improve the quality, safety, efficiency, and effectiveness of health care for all Americans, offers the following online resources:
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Health Literacy and Cultural Competency. This webpage links to relevant AHRQ cultural competency resources, including funding opportunities, articles of interest, consumer and patient resources, assessment tools, and explications of AHRQ activities to reduce racial and ethnic disparities in healthcare. (Accessed November 2011).
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Health Literacy Universal Precautions Toolkit. This toolkit offers primary care practices a way to assess their services for health literacy considerations, raise awareness of the entire staff, and work on specific areas. (April 2010).
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Minority Health Research. This section of the AHRQ website links to program briefs and evidence reports on agency initiatives addressing timely issues in minority health. (Accessed November 2011).
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Centers for Disease Control and Prevention (CDC). CDC includes an Office of Minority Health and Health Disparities dedicated to working with governmental and nonprofit stakeholder groups to improve health status and eliminate disparities among racial and ethnic groups. (Accessed November 2011).
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Minority Health Resources. The webpage of the CDC Office of Minority Health and Health Disparities links to minority health resources, including cooperative agreements, regional and state minority health consultants, and stakeholder groups. (December 2010).
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Health Resources and Services Administration (HRSA). Cultural competency resources available online through the HRSA website include:
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Cultural Competency Resources for Health Care Providers. This page incorporates relevant provider resources from assessment tools and language/culture or disease/condition specific clinical care guides to training curricula and technical assistance information. (Accessed November 2011).
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Quality Health Services for Hispanics: The Cultural Competency Component. TThis primer is designed to help healthcare professionals better understand, and more effectively respond to the growing needs of Hispanics in the United States. It should facilitate greater access to, and utilization of, health and human services for this patient population, as well as provide suggestions for improving one-to-one provider-patient interactions. (2001).
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National Institutes of Health (NIH). The NIH, which houses a National Center on Minority and Health and Health Disparities to promote minority health and efforts to reduce health disparities across NIH Institutes, also provides the following resource through the National Library of Medicine:
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Multi-Cultural Resources for Health Information. This comprehensive compendium includes information on cultural competency dictionaries, glossaries, online translation tools, and health resources in multiple languages from professional societies and organizations, governmental entities, state medical centers and university medical schools, and other stakeholder groups. (April 2011).
Yale Center for Public Health Preparedness
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Cultural and Linguistic Competence in Public Health Preparedness. This publication highlights the importance of incorporating cultural and linguistic competency within the developing fields of public health preparedness and disaster response. (November 2007).)
EXAMPLE PRACTICES
Utah Emergency Medical Services for Children. In 2006, the Utah EMSC Program conducted a needs assessment survey of 668 EMS providers to determine how EMSC could help meet their needs. Survey results were then used to compile the Cultural Competence Needs Assessment Fact Sheet, a document that summarizes the survey results, revealing the need and recommended strategies for the development and integration of culturally and linguistically appropriate resources for EMS healthcare providers. (Revised May 2010).
California Primary Care Association. Founded in 1994, the California Primary Care Association (CPCA), together with the more than 500 community clinics and health centers it represents, has helped to ensure affordable, quality health care to California's uninsured, low-income, and minority communities. CPCA's mission is to promote and facilitate equal access to quality health care for individuals and families through organized primary care clinics and clinic networks that, among other things, seek to maintain cost-effective, affordable medical services, as well as meet the linguistic and cultural needs of California's diverse population.
As part of its efforts to improve language access for LEP patients, CPCA conducted a survey of community clinics and health centers throughout California on policies and procedures for providing care to LEP patients. Based on this information and subsequent surveys and interviews, CPCA produced Providing Health Care to Limited English Proficiency (LEP) Patients: A Manual of Promising Practices. This study report demonstrates how health centers address the needs of their LEP patients and includes detailed profiles of promising practices. (2004).
Southern Ohio Health Services Network. The Southern Ohio Health Services Network – a network founded in 1976 and consisting of 11 primary health care centers in poor Appalachian communities – implemented a “cultural brokering” program designed to integrate mental health services for children into the overall medical system by improving the lines of communication between healthcare providers and local communities. The resultant fact sheet, NHSC Link Appalachian Communities and Care, demonstrates the implementation of successful cultural and linguistic competency strategies in addressing children’s access to mental health care by sharing how and why provider strategies worked in a Southern Ohio Health Services Network. (2003).
FAMILY AND CAREGIVER RESOURCES
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Working with Families to Enhance Emergency Medical Services for Children. Developed by emergency care professionals and families who have experienced emergency care first hand, this guide is intended to help state and local emergency medical services agencies, EMSC grantees, hospitals, and family advocates explore the concept of family-centered care, including culturally competent care, and apply it to pediatric emergency medical services. (2001).
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Non-English Language Resources. Through the Publications and Resources section of its website, the NRC also distributes a number of resources in Spanish and/or English, including the following downloadable documents:
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Common Emergencies for Children with Special Health Care Needs (English) (Spanish) (2007).
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Disaster Preparedness Planning for Children and Youth with Special Healthcare Needs (English) (Spanish) (2007).
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How to Get Help for A Sick or Injured Child (English) (Spanish) (2007).
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¡Urgente! A fact sheet for Spanish speaking parents and caregivers. (2000).
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What to do Until Help Arrives for a Child Medical Emergency (English) (Spanish) (2006).
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Diversity and Cultural Competence. This Family Voices webpage includes a variety of culturally focused resources that address building relationships with community liaisons and cultural brokers to reach families of children and youth with special healthcare needs – particularly those from underserved population groups. (Accessed November 2011).
Institute for Family-Centered Care
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Advancing the Practice of Patient- and Family-Centered Ambulatory Care: How to Get Started. This Institute for Family-Centered Care publication includes checklists that address patient and family-centered care topics, including issues relevant to cultural and linguistic competency. (September 2009).
U.S. Department of Health and Human Services, Office of Minority Health
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National Partnership for Action to End Health Disparities. With a mission to mobilize and connect individuals and organizations across the country to end health disparities, the Office of Minority Health’s National Partnership for Action to End Health Disparities provides opportunities for interested parties to explore a network of relevant tools, programs, and information for consumers, caregivers, and health providers. (October 2011).