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• Cultural Competency in Healthcare: Translating Differences Into Improved Quality and Access
• Advancing Health Literacy: A Framework for Understanding and Action

A provider-patient language barrier can undermine the quality and accessibility of healthcare for that patient. But cultural misunderstandings can have more subtle consequences.

This special report, "Cultural Competency in Healthcare: Translating Differences Into Improved Quality and Access," details educational and communication strategies for leveraging cultural differences to improve the quality and accessibility of healthcare. Representatives from two healthcare organizations detail how their diversity programs are addressing the needs of culturally diverse populations. Also included are first-hand experiences from some of the respondents to HIN’s recent online survey of cultural diversity efforts in the healthcare industry.

You'll hear from Elsa Batica, cross-cultural health development and training manager, Children's Hospital and Clinic (Minneapolis) and Loretta Estes, coordinator, cultural and linguistics services, Passport Health Plan on the development and implementation of the cultural diversity programs at their organizations.

This 33-page report is based on the May 18, 2005 audio conference "Cultural Diversity in Healthcare: Addressing Differences to Overcome Barriers" during which Batica and Estes provided in-depth details on their respective programs.

You'll get details on:

• Building an organizational cultural competence environment;
• Creating orientation and ongoing training for staff members on cultural sensitivity; and
• Addressing the challenges of a multicultural society.

Table of Contents

• Building Organizational Cultural Competence
  • Developing Relationships with Community Organizations
  • Top Management Makes Diversity a Priority
  • Identifying Culturally Competent Knowledge, Skills and Attitudes
  • Culturally Responsive Employees from Day One
  • Addressing Language Barriers
• Assessing Cultural Competency
  • Cultural and Linguistic Competency in Healthcare
  • Job Description: Cultural and Linguistic Services Coordinator
  • Provider Education and Support
  • Translating Educational Materials
  • Passport Health Plan’s Associate Training
  • Internet-based Staff Training
  • Cultural and Linguistic Services for Members
  • Technology and Cultural Competency Tools
• Addressing the Challenges of a Multicultural Society
  • Striving for Diversity
  • Looking Ahead
  • Advice from the Field
• Q&A: Ask the Experts
  • Merits of Monthly Celebrations
  • Recommended Reading Levels for Translated Materials
  • Population Participation in Program Development
  • Interpreter Reimbursement and Information
  • Coping with Conflict
  • Training, Testing and Toolkits
  • Becoming a Certified Cultural Diversity Trainer
  • Educating Vendors
  • Toolkit Training
  • Combating Cultural Competence Cop-Outs
  • Tools and Tests
• Glossary
• For More Information

Step by step, the authors outline the theory and practice of health literacy from a public health perspective. This comprehensive resource includes the history of health literacy, theoretical foundations of health and language literacy, the role of the media, a series of case studies on important topics including prenatal care, anthrax, HIV/AIDS, genomics, and diabetes.

The book concludes with a series of practical guidelines for the development and assessment of health communications materials. Also included are essential techniques needed to help people make informed decisions, advocate for themselves and their community, mitigate risk, and live healthier lives.

About the Authors

Christina Zarcadoolas, Ph.D., is associate clinical professor in the Department of Community and Preventive Medicine, Mount Sinai School of Medicine, in New York City. She is a sociolinguist who has spent thirty years studying language and literacy of vulnerable populations.

Andrew F. Pleasant, Ph.D., is an assistant professor in the Department of Human Ecology and the Extension Department of Family and Community Health Sciences at Rutgers, the State University of New Jersey in New Brunswick, New Jersey. He previously served as a temporary advisor to the World Health Organization in Geneva, Switzerland, and actively conducts research both in the United States and internationally.

David S. Greer, M.D., is dean of medicine emeritus, and professor of community health emeritus at the Division of Biology and Medicine, School of Medicine, Brown University. Greer has been a family doctor, researcher, medical school leader, community leader, and mentor to countless health professionals for many decades. He was a founding director of International Physicians for the Prevention of Nuclear War, which won the Nobel Peace Prize in 1985.

Table of Contents

• List of Tables, Figures, and Exhibits. Preface.
• The Authors.
  1. Health Literacy: Why Is It a Public Health Issue?
     • Definitions of Key Terms.
     • Medical Information.
     • The Relationship Between Health and Literacy.
     • Characteristics of People as Language Users.
     • Wrapping Up.
     • Exercises.
  2. Advancing Health Literacy: Getting Here from There.
     • Historical Considerations.
     • A Brief History: How Did We Get to Health Literacy?
     • Early Public Health Promotion and Education.
     • Social Movements and Advocacy in the 1960s and 1970s.
     • Informed Consumer Decision Making and Community Collaboration in the 1980s and 1990s.
     • The 21st Century.
     • Wrapping Up.
     • Exercises.
  3. Defining Health Literacy.
     • Literacy: Defining Terms.
     • Reality Bytes.
     • The Evolving Field of Health Literacy.
     • A Multidimensional Model of Health Literacy.
     • Wrapping Up.
     • Exercises.
  4. Literacy at Work.
     • How Language Works.
     • Reading.
     • Spoken Language.
     • Implications for Spoken and Written Health Messages.
     • Wrapping Up.
     • Exercises.
  5. The Traditional Mass Media.
     • Introduction to Mass Media.
     • Media Content: Challenges and Opportunities to Advance Health Literacy.
     • Wrapping Up.
     • Exercises.
  6. Health Literacy and the Internet.
     • Internet Use in Health Care.
     • Potential Disadvantages and Barriers to the Internet for Conveying Health-Related Information.
     • Wrapping Up.
     • Exercises.
  7. Baby Basics: A Prenatal Program Focusing on Developing Health Literacy.
     • Healthy Beginnings: Infant and Maternal Health.
     • The Baby Basics Book and Program.
     • The Baby Basics Program Model.
     • Wrapping Up.
     • Exercises.
  8. Anthrax: A Missed Opportunity to Advance Health Literacy.
     • The American Public Reacts.
     • The U.S. Postal Service Postcard: A Mixed Success.
     • Seeking Anthrax Answers on the Internet.
     • Scientific Uncertainty: A Consistent Challenge.
     • Wrapping Up.
     • Exercises.
  9. Genomics and Health Literacy.
     • Why Genomics?
     • Understanding and Misunderstanding Genomics: A Review.
     • Wrapping Up.
     • Exercises.
  10. Highlighting the Role of Civic Literacy: The Massachusetts Tobacco Control Program.
      • Smoking and Health: The Threat.
      • Smoking and Health Literacy.
      • Massachusetts Tobacco Control Program.
      • Wrapping Up.
      • Exercises.
  11. Highlighting the Role of Cultural Literacy, Part 1: The Changing Face of HIV/AIDS.
      • HIV/AIDS in the United States.
      • The Public Dialogue.
      • The Conflict in Communicating About HIV/AIDS.
      • Community Planning: The San Francisco AIDS Foundation.
      • Wrapping Up.
      • Exercises.
  12. Highlighting the Role of Cultural Literacy, Part 2: Diabetes and Native Americans.
      • How to Be Culturally Relevant.
      • Diabetes and Native Americans: An Epidemic of Culture.
      • The Role of Culture in Diabetes Prevention and Care.
      • The Sioux San Hospital Diabetes Program.
      • Listening to the Community.
      • Wrapping Up.
      • Exercises.
  13. Program Evaluation: World Education’s Breast and Cervical Cancer Project.
      • Adult Basic Education and Health Literacy.
      • Targeting Breast and Cervical Cancer.
      • What Is Evaluation?
      • HEAL:BCC Implementation and Evaluation.
      • Lessons Learned from the Evaluation.
      • Wrapping Up.
      • Exercises.
  14. Guidelines for Advancing Health Literacy.
      • Guideline 1: General.
      • Guideline 2: Vocabulary.
      • Guideline 3: Sentences.
      • Guideline 4: Text Structure.
      • Guideline 5: Giving Instructions.
      • Guideline 6: Field Testing.
      • Guideline 7: Spoken Language.
      • Guideline 8: Language Translation.
      • Guideline 9: Web Design.
      • Guideline 10: Graphics and Layout of Print Materials.
      • Guideline 11: Media.
• References.
• Name Index.
• Subject Index.