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Behavior Med I Exam 2 > Health Disparities & Cultural Competency > Flashcards

Health Disparities & Cultural Competency Flashcards

1
Q

What did Alicia Mercado have a difficult time complying with diabetes treatment?

A

Depression, cultural home remedies, home taken away. When she gained her hope back, by the return of her home, she began complying again.

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2
Q

What is cultural competency?

A

“…the knowledge and interpersonal skills that allow providers to understand, appreciate, and work with individuals from cultures other than their own. It involves an awareness and acceptance of cultural differences, self-awareness, knowledge of the patient’s culture, and adaptation of skills.”

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3
Q

What region of foreign born citizens is most common?

A

Latin American followed by asia

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4
Q

What is ethnicity?

A

Quality or affiliation of a sizable group of people sharing a common and distinctive racial, national, religious, linguistic, or cultural heritage

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5
Q

What is race?

A

A local geographic or global human population distinguished as a more or less distinct group by genetically transmitted physical characteristics

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6
Q

What is culture?

A

The totality of socially transmitted behavior patterns, arts, beliefs, institutions, and all other products of human work and thought.

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7
Q

What is social location?

A 
One’s position in society relative to others, based on:
Race and Ethnicity
Gender
Age
Immigration Status
Language
Neighborhood of Residence
Number of Generations in US
Education
Income
Occupation 
Religion
Sexual Orientation
Prior experiences with racism
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8
Q

What sociological and psychological affects do recent immigrants to the US face?

A
  • Alterations in social status
  • Changes in occupation
  • Changes in daily routines
  • Isolation/lack of social support
  • Change of family hierarchy (younger adapt quicker)
  • Sense of purposelessness
  • Lack of feeling of belonging
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9
Q

What percentage of VA population are immigrants?

A

12%

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10
Q

Where is poverty the highest in VA: rural or urban settings?

A

Rural 17.8%

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11
Q

Ability to interview and assess patients based on a psychological, social, biological, cultural, political, and spiritual model. Is an trait of a ______ ________ _________.

A

Culturally competent provider

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12
Q

Ability to communicate effectively and use interpreters, is a tactic used by what type of providers?

A

Culturally competent

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13
Q

Ability to diagnose with an understanding of cultural differences in pathology, avoiding under-diagnosis and over-diagnosis. Is an trait of a ______ ________ _________.

A

Culturally competent provider

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14
Q

Ability to formulate treatment plans that are culturally sensitive to the patient and the family’s concept of health and illnesses. is a tactic used by what type of providers?

A

Culturally competent

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15
Q

What are the four characteristics that culturally competent providers share?

A

Conduct holistic nterview

Communicate effectively and use interpreters

Diagnose with an understanding of cultural differences in pathology, avoiding under-diagnosis and over-diagnosis.

Culturally sensitive treatment plans

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16
Q

What are the 8 cultural forces of the cultural assessment guide?

A
  1. communication style
  2. education/language
  3. time orientation
  4. nutrition
  5. family & community relationships
  6. health beliefs
  7. religion
  8. ethnicity - population disease prevalence
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17
Q

What are areas of communication style that should be considered during cultural assessment guide?

A
  • oral vs. written
  • eye contact
  • facial expressiveness
  • direct vs. indirect
  • questioning vs. accepting
  • touch practices
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18
Q

What are areas of education/language that should be considered during cultural assessment guide?

A
  • formal
  • informal
  • literacy level
  • language(s) spoken
19
Q

What are areas of time orientation that should be considered during cultural assessment guide?

A
  • present focused
  • future focused
  • perception of time
20
Q

What are areas of nutrition that should be considered during cultural assessment guide?

A
  • role of food in health and illness
  • perception of body size and health
  • availability of traditional foods
  • food practices and intolerances
21
Q

What are areas of family & community relationships that should be considered during cultural assessment guide?

A
  • traditional family units
  • marks of childhood, adolescence, adulthood, and old age
  • gender differences/role, dominance patterns
  • child rearing processes
  • values
22
Q

What are areas of health beliefs that should be considered during cultural assessment guide?

A
  • causation of wellness and illness
  • level of self-determination
  • Western medicine
  • complementary and alternative medicine
  • priority of health care
  • acute vs. chronic disease practices
  • pain reactions
23
Q

What are areas of religion that should be considered during cultural assessment guide?

A
  • interface between religion and health
  • role of religious community in health provision
  • Fatalism vs. personal control/power
24
Q

What are areas of ethnicity, population disease prevalence, that should be considered during cultural assessment guide?

A
  • considerations for diagnosis/treatment
25
Q

What three questions should you ask to elicit patient’s explanatory model of illness?

A
  • what do you think you havE?
  • what do you think caused it?
  • what have you done to treat it?
26
Q

What are the steps culturally competent PA’s use to address patients?

A
  • elicit patient’s explanatory model of illness
27
Q

What is the acronym used to remember guidelines for cross-cultural communication?

A

LEARN

28
Q

Listening with empathy to patient’s perspective of problem (from their sociocultural context), is a step of what guidelines?

A

Guidelines for cross-cultural communication

29
Q

What does LEARN stand for?

A

Guideline for cross-cultural communication;

Listen with empathy to patient’s perspective of problem (from their sociocultural context)

Explain your perception and concerns.

Acknowledge and discuss differences and similarities

Recommend treatment and course of action (Pharmacological, psychological, social, spiritual, educational)

Negotiate treatment plan (collaboration with patient and other health care team members)

30
Q

“…racial or ethnic differences in the quality of healthcare that are not due to access-related factors or clinical needs, preferences, and appropriateness of intervention.”

AND

“…differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups in the United States.”

Are definitions of _____ ______.

A

Health disparities

31
Q

“Despite continued advances in health care and technology, racial and ethnic minorities continue to have higher rates of _____, ______, and _____ ______ than non-minorities”

Fill in the blanks.

A

disease, disability and premature death

32
Q

African Americans, Hispanics/Latinos, American Indians and Alaska Natives, Asian Americans, Native Hawaiians and Pacific Islanders have higher rates of what 6 diseases/health disparities?

A

infant mortality, cardiovascular disease, diabetes, HIV infection/AIDS, cancer,

33
Q

African Americans, Hispanics/Latinos, American Indians and Alaska Natives, Asian Americans, Native Hawaiians and Pacific Islanders have lower rates of _____ and ______.

A

immunizations and cancer screenings

34
Q

Three questions to ask when eliciting pt explanatory model of illness?

A
  • what do you think you have
  • what do you think caused it
  • what have you done to treat it
35
Q

5 causes of inadequate access to care for minorities?

A

Barriers to care can result from economic, geographic, linguistic, cultural and health care financing issues.

36
Q

Even when minorities have similar levels of ____, ____, & ____ the quality and intensity of health care they receive are often poor.

A

access to care
health insurance
education

37
Q

Causes of substandard quality of care for minorities?

A
  • patient provider miscommunication
  • provider discrimination
  • stereotyping
  • prejudice
38
Q

how is quality of care measured (4)?

A
  • effectiveness
  • patient safety
  • timeliness
  • patient centered
39
Q

US census majority and minorities?

A

caucasian - 62%
latino - 17%
african american - 13%

40
Q

VA census majority and minorities?

A

caucasian - 63%
african american - 20%
latino - 9%
asian - 6%

41
Q

four major goals of healthy people 2020

A
  1. increase quality and years of healthy life
  2. eliminate health disparities
  3. create social/physical environments that promote good health
  4. promote quality of life across life span
42
Q

what does CLAS stand for?

A

culturally and linguistically appropriate services

43
Q

purpose of national standards defined by CLAS?

A

“…to advance health equity, improve quality, and help eliminate health care disparities by providing a blueprint …to implement culturally and linguistically appropriate services.”

44
Q

describe the national standards created by CLAS?

A

15 standards organized by 4 themes

  1. principle standard (1)
  2. governance, leadership, & workforce (3)
  3. communication and language assistance (4)
  4. engagement, continuous improvement, accountability (7)

Behavior Med I Exam 2 (3 decks)

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