A Review and Clinical Practice Guideline for Health Professionals Working With Indigenous and Culturally and Linguistically Diverse (CALD) Populations During COVID-19

Background: As the rates of infection and mortality from COVID-19 have been higher in minority groups, the communication of health information in a way that is understood and accepted is of particular importance.Aims: To provide health professionals with a clinical practice guideline for clear and culturally sensitive communication of health information about COVID-19 to people of Indigenous and culturally and linguistically diverse (CALD) backgrounds.Assessment of Guideline Options: The authors conducted a review of the literature on health communication, and the guidelines were developed with particular reference to the SPIKES protocol of “breaking bad news” in oncology and the use of the DSM-5 Cultural Formulation Interview (CFI).Actionable Recommendations: The guideline combines two approaches, the Cultural Formulation Interview, developed for DSM-5, and the SPIKES protocol used for delivering “bad news” in oncology. The combined CFI-SPIKES protocol is a six-step clinical practice guideline that includes the following: (1) Set up (S) the interview; (2) Determine how the patient perceives the problem (P) using the Cultural Formulation Interview (CFI) to elicit the patient's cultural perception of the problem; (3) Obtain an invitation (I) from the patient to receive a diagnosis; (4) Provide the patient knowledge (K) of diagnosis in a non-technical way; (5) Address the patient's emotional reaction (E) to diagnosis; and (6) Provide the patient a summary (S) of healthcare and treatment.Conclusions and Relevance: This article presents guidelines for assessing the cultural dimensions of patients' understanding of COVID-19 and delivering diagnostic and treatment recommendations in ways that are culturally safe and responsive, such as: (a) suspending the clinician's own cultural biases to understand the explanatory models and cultural values of their CALD or Indigenous patients; (b) encouraging the use of interpreters or cultural brokers to ensure that that the message is delivered in a way that the patient can understand; and (c) encouraging CALD or Indigenous patient to take an active part in the solution and treatment adherence, to minimize transmission of COVID-19 in CALD and Indigenous communities.

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The Cultural Formulation Interview since DSM-5: Prospects for training, research, and clinical practice

Transcultural Psychiatry ◽

10.1177/1363461520940481 ◽

2020 ◽

Vol 57 (4) ◽

pp. 496-514 ◽

Cited By ~ 1

Author(s):

Neil Krishan Aggarwal ◽

G. Eric Jarvis ◽

Ana Gómez-Carrillo ◽

Laurence J. Kirmayer ◽

Roberto Lewis-Fernández

Keyword(s):

Clinical Practice ◽

Social Science Research ◽

Science Research ◽

Cultural Dimensions ◽

Cultural Formulation ◽

Simplified Approach ◽

Clinician Training ◽

Dsm 5 ◽

Training Research ◽

Cultural Formulation Interview

While social science research has demonstrated the importance of culture in shaping psychiatric illness, clinical methods for assessing the cultural dimensions of illness have not been adopted as part of routine care. Reasons for limited integration include the impression that attention to culture requires specialized skills, is only relevant to a subset of patients from unfamiliar backgrounds, and takes too much time to be useful. The DSM-5 Cultural Formulation Interview (CFI), published in 2013, was developed to provide a simplified approach to collecting information needed for cultural assessment. It offers a 16-question interview protocol that has been field tested at sites around the world. However, little is known about how CFI implementation has affected training, health services, and clinical outcomes. This article offers a comprehensive narrative review that synthesizes peer-reviewed, published studies on CFI use. A total of 25 studies were identified, with sample sizes ranging from 1 to 460 participants. In all pilot CFI studies 960 unique subjects were enrolled, and in final CFI studies 739 were enrolled. Studies focused on how the CFI affects clinical practice; explored the CFI through research paradigms in medical communication, implementation science, and family psychiatry; and examined clinician training. In most studies, patients and clinicians reported that using the CFI improved clinical rapport. This evidence base offers an opportunity to consider implications for training, research, and clinical practice and to identify crucial areas for further research.

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Engaging target users to appraise and refine clinical practice guidelines in pediatric concussion: An integrated knowledge translation approach

Journal of Concussion ◽

10.1177/20597002211017405 ◽

2021 ◽

Vol 5 ◽

pp. 205970022110174

Author(s):

Melissa Paniccia ◽

Christine Provvidenza ◽

Shauna Kingsnorth ◽

Christina Ippolito ◽

Roger Zemek ◽

...

Keyword(s):

Clinical Practice ◽

Knowledge Translation ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

Clinical Practice Guideline ◽

Practice Guideline ◽

Health Professionals ◽

Agree Ii ◽

Allied Health Professionals ◽

Pediatric Concussion

Background Clinical practice guidelines are systematically developed statements that assist clinicians in making evidence informed decisions regarding patient care. Within pediatric concussion, the Ontario Neurotrauma Foundation released the Guidelines for Diagnosing and Managing Pediatric Concussion in 2014. The purpose of this study was to evaluate the 2014 guidelines using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) evaluation tool, in addition to a brief knowledge translation survey, and to utilize the collected feedback from end users to inform improvements to support an updated version. An integrated knowledge translation approach was employed using clinical experts as guideline appraisers. Methods A purposive sample of researchers, physicians, allied health professionals, policy makers, educators and knowledge translation experts involved in updating the guidelines (N = 31) completed the AGREE II Likert scale survey regarding the 2014 guideline, and provided written justifications for their ratings. Domain and item AGREE II scaled scores were reported stratified by demographic factors, and written justifications were synthesized using content analysis to determine areas of improvement for the 2014 guideline. Results Appraisers scored the editorial independence (88.9%) and scope and purpose (80.8%) domains the highest, indicating high quality. The guidelines scored the lowest in the applicability domain (69.3%). Participants with less than 10 years of experience in their respective disciplines, as well as physicians and allied health professionals consistently provided higher ratings across domains compared to other professions. Conclusions The process of evaluating the 2014 guideline resulted in these important outcomes: (1) identified areas of the guideline that may have affected the lack of previous clinical uptake while abiding by a clinical practice guideline development framework; (2) shared and informed decision making regarding content and format of the revised clinical practice guideline; and (3) targeted content, clinical questions and dissemination strategies, which are key to clinical uptake.

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Building a bridge: A case report on communicating mental-health diagnoses to patients of a culturally and linguistically diverse background

Australasian Psychiatry ◽

10.1177/1039856217726685 ◽

2017 ◽

Vol 25 (5) ◽

pp. 478-480 ◽

Cited By ~ 3

Author(s):

Rony Kayrouz ◽

Christine Irene Senediak ◽

Roy Laube

Keyword(s):

Mental Health ◽

Case Report ◽

Middle Eastern ◽

Linguistically Diverse ◽

Culturally And Linguistically Diverse ◽

Cultural Formulation ◽

Mental Health Diagnosis ◽

Diagnosis Of Cancer ◽

Cultural Formulation Interview ◽

Health Diagnosis

Objective: This paper is based on a case report, describing a protocol to help practitioners communicate mental-health diagnosis to patients from culturally and linguistically diverse (CALD) backgrounds. The protocol was presented by integrating the DSM-5 Cultural Formulation Interview (CFI) and the SPIKES protocol for communicating the diagnosis of cancer, yielding a modified CFI-SPIKES protocol (i.e. S, Support; P, Perception using CFI; I, Invitation; K, Knowledge; E, Emotions). The protocol was demonstrated using a case report with a patient of a Middle-Eastern background experiencing generalised anxiety disorder. Conclusions: The CFI-SPIKES protocol for communicating mental-health diagnosis allows for a collaborative process, whereby the CALD patient and practitioner can address the stigma associated with communicating a mental-health diagnosis, ensuring patient engagement and informed shared decision making.

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