Cultural Competency Curriculum for Serving Refugee Groups

Cultural Competency Curriculum for Serving Refugee Groups

Bibliography Review

Frances G. Saad, MSW School of Social Work

School of Family Medicine

StateUniversity of New York at Buffalo

Leader- Kim Griswold, MD, MPH

John Brewer, MD

Richard Pretorius, MD

School of Family Medicine

StateUniversity of New York at Buffalo

Family Medicine Liaison- John Taylor

School of Family Medicine

StateUniversity of New York at Buffalo

Key Words: Cultural diversity, curriculum, education, medical, cultural awareness, immigrant health, refugee health, qualitative evaluation, health disparities,

Sally Speed, Director

NYS Medicaid Training Institute- HLTC05

Award: 31177

Project: 1037113

Task: 2

Appointment Period: September 20, 2004 to December 31, 2004

1.Ackerman LK. Health problems of refugees. J Am Board Fam Pract. Sep-Oct 1997;10(5):337-348.

2.Adams KM, Gardiner LD, Assefi N. Healthcare challenges from the developing world: Post-immigration refugee medicine. BMJ: British Medical Journal. Jun 2004;328(7455):1548-1552.

3.Anderson LM, Scrimshaw SC, FulliloveMT, Fielding JE, Normand J. Culturally competent healthcare systems. A systematic review. Am J Prev Med. Apr 2003;24(3 Suppl):68-79.

4.Andrulis DP. Access to care is the centerpiece in the elimination of socioeconomic disparities in health. Ann Intern Med. Sep 1 1998;129(5):412-416.

5.Arroyo SM. The cultural awareness program for immigrant Hispanic women, Arroyo, Sandra Monica: Carlos Albizu U., US; 2001.

6.Barnes DM, Harrison C, Heneghan R. Health Risk and Promotion Behaviors in Refugee Populations. Journal of Health Care for the Poor & Underserved. Aug 2004;15(3):347-356.

7.Betancourt JR, GreenAR, Carrillo JE. The challenges of cross-cultural healthcare--diversity, ethics, and the medical encounter. Bioethics Forum. Fall 2000;16(3):27-32.

8.Betancourt JR, Jacobs EA. Language barriers to informed consent and confidentiality: the impact on women's health. J Am Med Womens Assoc. Fall 2000;55(5):294-295.

9.Betancourt JR, Green AR, Carrillo JE, Ananeh-Firempong O, 2nd. Defining cultural competence: a practical framework for addressing racial/ethnic disparities in health and health care. Public Health Rep. Jul-Aug 2003;118(4):293-302.

10.Betancourt JR. Cross-cultural medical education: conceptual approaches and frameworks for evaluation. Acad Med. Jun 2003;78(6):560-569.

11.Betancourt JR, Green AR, Carrillo JE, Park ER. Cultural competence and health care disparities: key perspectives and trends. Health Aff (Millwood). Mar-Apr 2005;24(2):499-505.

12.Burke MC. Service provision for today's immigrants and refugees. PsycCRITIQUES Vol 49 (Suppl 9), 2004. 2004.

13.Campinha-Bacote J. Cultural competence in psychiatric mental health nursing. A conceptual model. Nurs Clin North Am. Mar 1994;29(1):1-8.

14.Campinha-Bacote J. A model of practice to address cultural competence in rehabilitation nursing. Rehabil Nurs. Jan-Feb 2001;26(1):8-11.

15.Campinha-Bacote J. The Process of Cultural Competence in the Delivery of Healthcare Services: a model of care. J Transcult Nurs. Jul 2002;13(3):181-184; discussion 200-181.

16.Carlson ED, Chamberlain RM. The Black-White perception gap and health disparities research. Public Health Nursing. Jul-Aug 2004;21(4):372-379.

17.Carrillo JE, GreenAR, Betancourt JR. Cross-cultural primary care: a patient-based approach. Ann Intern Med. May 18 1999;130(10):829-834.

18.Carrillo JE, GreenAR, Betancourt JR. Cross-cultural primary care: a patient-based approach. Ann Intern Med. May 18 1999;130(10):829-834.

19.Crandall SJ, George G, Marion GS, Davis S. Applying theory to the design of cultural competency training for medical students: a case study. Academic Medicine. Jun 2003;78(6):588-594.

20.Crosson JC, Deng W, Brazeau C, Boyd L, Soto-Greene M. Evaluating the effect of cultural competency training on medical student attitudes. Fam Med. Mar 2004;36(3):199-203.

21.Einbinder LC, Schulman KA. The effect of race on the referral process for invasive cardiac procedures. Medical Care Research & Review. 2000;57 Suppl 1:162-180.

22.Entzel PP, Fleming LE, Trepka MJ, Squicciarini D. The Health Status of Newly Arrived Refugee Children in Miami-Dade County, Florida. American Journal of Public Health. Feb 2003;93(2):286-288.

23.Ferguson WJ, Keller DM, Haley HL, Quirk M. Developing culturally competent community faculty: a model program. Academic Medicine. Dec 2003;78(12):1221-1228.

24.Flores G. Culture and the patient-physician relationship: achieving cultural competency in health care. Journal of Pediatrics. Jan 2000;136(1):14-23.

25.Fuller K. Eradicating essentialism from cultural competency education. Academic Medicine. Mar 2002;77(3):198-201.

26.Gong-Guy E, Cravens RB, Patterson TE. Clinical issues in mental health service delivery to refugees. Am Psychol. Jun 1991;46(6):642-648.

27.Gordon MJ. A review of the validity and accuracy of self-assessments in health professions training. Acad Med. Dec 1991;66(12):762-769.

28.Gordon MJ. Self-assessment programs and their implications for health professions training. Acad Med. Oct 1992;67(10):672-679.

29.Green AR, Betancourt JR, Carrillo JE. Integrating social factors into cross-cultural medical education. Acad Med. Mar 2002;77(3):193-197.

30.Griswold KS. Refugee health and medical student training. Fam Med. Oct 2003;35(9):649-654.

31.Guzder J. Culturally Competent Practice with Immigrant and Refugee Children and Families. Transcultural Psychiatry Vol 42(3) Sep 2005, 512-514. 2005.

32.Hamilton J. Multicultural health care requires adjustments by doctors and patients. Cmaj. Sep 1 1996;155(5):585-587.

33.Hamilton G, Marco CA. Emergency medicine education and health care disparities. Academic Emergency Medicine. Nov 2003;10(11):1189-1192.

34.Hassett P. Taking on racial and ethnic disparities in health care: the experience at Aetna. Health Affairs. Mar-Apr 2005;24(2):417-420.

35.Howard CA, Andrade SJ, Byrd T. The ethical dimensions of cultural competence in border health care settings. Family & Community Health. Jan 2001;23(4):36-49.

36.Kagawa-Singer M, Kassim-Lakha S. A strategy to reduce cross-cultural miscommunication and increase the likelihood of improving health outcomes. Acad Med. Jun 2003;78(6):577-587.

37.Kaiser MM, Barry TL, Kaiser KL. Using focus groups to evaluate and strengthen public health nursing population-focused interventions. Journal of Transcultural Nursing Vol 13(4) Oct 2002, 303-310. 2002.

38.Kim YJ, Snyder BO, Lai-Bitker AY, eds. Culturally responsive psychiatric case management with Southeast Asians; 1996.

39.Kleinman A, Eisenberg L, Good B. Culture, illness, and care: clinical lessons from anthropologic and cross-cultural research. Ann Intern Med. Feb 1978;88(2):251-258.

40.Lachance KR, Santos AB. Modifying the PACT model: preserving critical elements. Psychiatr Serv. Jun 1995;46(6):601-604.

41.Lesky LG, Hershman WY. Practical approaches to a major educational challenge. Training students in the ambulatory setting. Arch Intern Med. May 8 1995;155(9):897-904.

42.Loudon RF, Anderson PM, Gill PS, Greenfield SM. Educating medical students for work in culturally diverse societies. Jama. Sep 1 1999;282(9):875-880.

43.Loue S, ed. Handbook of immigrant health. New York, NY: Plenum Press.; 1998.

44.Luna I. Diversity issues in the delivery of healthcare. Lippincott's Case Management. Jul-Aug 2002;7(4):138-143; quiz 144-135.

45.Lynch MA. Providing health care for refugee children and unaccompanied minors. Med Confl Surviv. Apr-Jun 2001;17(2):125-130.

46.Meadows LM, Thurston WE, Melton C. Immigrant women's health. Soc Sci Med. May 2001;52(9):1451-1458.

47.Mouradian WE, Berg JH, Somerman MJ. Addressing disparities through dental-medical collaborations, part 1. The role of cultural competency in health disparities: training of primary care medical practitioners in children's oral health. Journal of Dental Education. Aug 2003;67(8):860-868.

48.Muecke MA. New paradigms for refugee health problems. Social Science & Medicine. Aug 1992;35(4):515-523.

49.Musser-Granski J, Carrillo DF. The use of bilingual, bicultural paraprofessionals in mental health services: issues for hiring, training, and supervision. Community Ment Health J. Feb 1997;33(1):51-60.

50.Napoles-Springer AM, Santoyo J, Houston K, Perez-Stable EJ, Stewart AL. Patients' perceptions of cultural factors affecting the quality of their medical encounters. Health Expect. Mar 2005;8(1):4-17.

51.Narayan MC. The national standards for culturally and linguistically appropriate services in health care. Care Manag J. Winter 2001;3(2):77-83.

52.Nunez AE. Transforming cultural competence into cross-cultural efficacy in women's health education. Academic Medicine. Nov 2000;75(11):1071-1080.

53.Olness KN. Refugee health. In: Loue S, ed. Handbook of immigrant health. New York, NY: Plenum Press; 1998:227-241.

54.Palafox NA, Buenconsejo-Lum L, Ka'ano'i M, Yamada S. Cultural competence: a proposal for physicians reaching out to Native Hawaiian patients. Pacific Health Dialog. Sep 2001;8(2):388-392.

55.Palinkas LA, Pickwell SM, Brandstein K, et al. The journey to wellness: Stages of refugee health promotion and disease prevention. Journal of Immigrant Health. Jan 2003;5(1):19-28.

56.Pena Dolhun E, Munoz C, Grumbach K. Cross-cultural education in U.S. medical schools: development of an assessment tool. Academic Medicine. Jun 2003;78(6):615-622.

57.Poss JE, Rangel R. Working effectively with interpreters in the primary care setting. Nurse Pract. Dec 1995;20(12):43-47.

58.Reimann JO, Talavera GA, Salmon M, Nunez JA, Velasquez RJ. Cultural competence among physicians treating Mexican Americans who have diabetes: a structural model. Soc Sci Med. Dec 2004;59(11):2195-2205.

59.Russell MN, White B. Practice with immigrants and refugees: Social worker and client perspectives. Journal of Ethnic & Cultural Diversity in Social Work. 2001;9(3-4):73-92.

60.Schreiber S. Migration, traumatic bereavement and transcultural aspects of psychological healing: Loss and grief of a refugee woman from BegamederCounty in Ethiopia. British Journal of Medical Psychology. Jun 1995;68(2):135-142.

61.Shaw-Taylor Y. Culturally and linguistically appropriate health care for racial or ethnic minorities: analysis of the US Office of Minority Health's recommended standards. Health Policy. Nov 2002;62(2):211-221.

62.Stork E, Scholle S, Greeno C, Copeland VC, Kelleher K. Monitoring and enforcing cultural competence in medicaid managed behavioral health care. Mental Health Services Research. Sep 2001;3(3):169-177.

63.Suarez-Orozco C, Suarez-Orozco M, eds. Migration: Generational discontinuities and the making of Latino identities. Romanucci-Ross, Lola (Ed); De Vos, George A (Ed). (1995). Ethnic identity: Creation, conflict, and accommodation; 1995.

64.Suh EE. The model of cultural competence through an evolutionary concept analysis. J Transcult Nurs. Apr 2004;15(2):93-102.

65.Tang TS, Bozynski ME, Mitchell JM, Haftel HM, Vanston SA, AndersonRM. Are residents more comfortable than faculty members when addressing sociocultural diversity in medicine? Academic Medicine. Jun 2003;78(6):629-633.

66.Taylor SL, Lurie N. The role of culturally competent communication in reducing ethnic and racial healthcare disparities. American Journal of Managed Care. Sep 2004;10 Spec No:SP1-4.

67.Vergara AE, Miller JM, Martin DR, Cookson ST. A survey of refugee health assessments in the United States. Journal of Immigrant Health. Apr 2003;5(2):67-73.

68.Wear D. Insurgent multiculturalism: rethinking how and why we teach culture in medical education. Academic Medicine. Jun 2003;78(6):549-554.

69.Weinstein HM, Dansky L, Iacopino V. Torture and war trauma survivors in primary care practice. West J Med. Sep 1996;165(3):112-118.

70.Weissman JS, Witzburg R, Linov P, Campbell EG. Termination from Medicaid: how does it affect access, continuity of care, and willingness to purchase insurance? J Health Care Poor Underserved. Feb 1999;10(1):122-137.

71.Wells MI. Beyond cultural competence: a model for individual and institutional cultural development. J Community Health Nurs. Winter 2000;17(4):189-199.

72.Westermeyer J. Working with an interpreter in psychiatric assessment and treatment. J Nerv Ment Dis. Dec 1990;178(12):745-749.

73.Westermeyer J, Uecker J. Predictors of hostility in a group of relocated refugees. Cult Divers Ment Health. 1997;3(1):53-60.

74.Whelan JS, Dvorkin L. HolisticKids.org--evolution of information resources in pediatric complementary and alternative medicine projects: from monographs to Web learning. Journal of the Medical Library Association. Oct 2003;91(4):411-417.

75.Zenner WP, ed. Common ethnicity and separate identities: Interaction between Jewish immigrant groups. Kim, Young Yun (Ed); Gudykunst, William B (Ed). (1988). Cross-cultural adaptation: Current approaches.; 1988.

ABSTRACT

We are evaluating the effectiveness of a Cultural Awareness Training Program on the cultural competence of preclinical medical students. A self-assessment instrument was administered at the beginning and at the end of the training program. The Cultural Awareness Self-Assessment Questionnaire was used to assess cultural competency levels pre and post training program. Our goal is to increase cultural sensitivity and competency among medical students and residents while improving access to preventive and primary services for refugees in the Western New York region.

Evidence of racial and ethnic disparities in healthcare is remarkably consistent across a range of illnesses and health care services. These disparities are associated with a number of factors, including socioeconomic differences, cultural isolation, and minority status. Taken as a whole, the literature suggests that cross-cultural education in the health professions is less than optimal. Published studies suggest that a majority of cultural competence curricula are focused on content, with limited evidence on instructional models that are experiential (learning by doing) approaches. The purpose of the literature review is to offer an overview of significant literature published in the area of cultural competency within the medical education and health care systems. Additionally, the literature searches have been useful to provide information on curricular development for cultural competency within the health care system.

As the diversity of the populations that we serve continue to grow, the importance of cultural competency or "cultural and linguistic appropriateness" in the effective delivery of health and social services is undeniable. We believe that participants in our trainings need to examine their own cultural values and evaluate their interpersonal strengths and weaknesses. They also need to recognize that differences in language, age, culture, socio economic status, political and religious beliefs, sexual orientation, and life experience add challenging dimensions to the dynamics of cross cultural interactions. Therefore, the need for culturally competent services is on the rise with the growing diversity of the American population. Individuals need to understand the concept of culture as they apply to the medical care in culturally diverse populations.