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Culturally Responsive Health Care: How to Meet the Challenge

Culturally Responsive Health Care: How to Meet the Challenge. Jeffrey Ring, Ph.D. Director of Behavioral Sciences and Cultural Medicine White Memorial Med. Ctr. Family Medicine Los Angeles, California. Presenter Disclosure Information.

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Culturally Responsive Health Care: How to Meet the Challenge

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  1. Culturally Responsive Health Care: How to Meet the Challenge Jeffrey Ring, Ph.D. Director of Behavioral Sciences and Cultural Medicine White Memorial Med. Ctr. Family Medicine Los Angeles, California

  2. Presenter Disclosure Information In compliance with the accrediting board policies, theAmerican Diabetes Association requires the following disclosureto the participants: • Speaker’s Bureau: Merck & Co., Inc. (not product division) • Other: Author of a book for Radcliffe Oxford Publishing Name of Presenter: Jeffrey Ring, Ph.D.

  3. Objectives By the conclusion of this presentation, participants will: • Be able to articulate a strong rationale for providing culturally responsive care • Deepen their capacity for self-reflection • Enhance their understanding of health disparities

  4. Culturally Responsive Care Patient-centered care with an attention to the patient’s culture, beliefs, health behaviors and world view.

  5. Why provide culturally responsive care?

  6. Exploring Similarities and Differences

  7. Imagery Exercise

  8. Exploring Health Inequities

  9. U.S.Diabetes Mortality Rates (2007) • White Non-Hispanic • African American • Latino/a • Am. Indian/Alaska Native • Asian/Pacific Islander

  10. U.S.Diabetes Mortality Rates* (2007) • White Non-Hispanic 22.3/100,000 • African American 48 • Latino/a 32.1 • Am. Indian/Alaska Native 43.7 • Asian/Pacific Islander 16.6 * Age adjusted www/cdc/gov/nchs/data/hus07.pdf

  11. Sources of Health Inequities • Patient Factors • Health Care System Factors • Society Factors • Practitioner Factors

  12. Culturally Responsive Communication Strategies • Q2 (A. Kleinman) • How do you believe you got sick? • What do you believe will help you heal? • LEARN (Berlin and Fowkes, 1983) • Listen with empathy and understanding • Explain your perception of the problem • Acknowledge and discuss similarities/differences • Recommend treatment • Negotiate agreement (Getting to Yes, Fisher and Ury, 1983)

  13. Motivational Interviewing(Miller and Rollnick, 2002) • Patient-Centered Model • Identify and Resolve Ambivalence/Barriers • Diagnose the Patient’s State of Mind/Change • Precontemplation • Contemplation • Action • Maintenance (Relapse) • Resist the Righting Reflex

  14. QUICK CASE • Patient with high sugars is obese, depressed, does no exercise… • Advice? “…people almost never change without first feeling understood.” (Stone, 1999)

  15. QUICK CASE • Patient with high sugars is obese, depressed, does no exercise… • Motivational Interviewing Questions? • What are the benefits of not exercising? • If your heart was failing, might you change then? • Have you thought about what exercise you might try? • What are the sources of strength and support in your life?

  16. Commitment to Act List two commitments/covenants to further your capacity to provide culturally-responsive care, based on today’s discussions

  17. Resources • Ring, Nyquist et al. (2008) Curriculum for Culturally Responsive Health Care, Radcliffe • www.vimeo.com/15822032 Addressing Culture and Language for Medical Assistants • www.diversityrx.org • http://minorityhealth.hhs.gov/ • Medscape.com (Health Diversity Resource Center) • Jeffrey Ring, Ph.D. ring@usc.edu

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