A Culturally Relevant Care Model to Reduce Health Disparities Among Medicaid Recipients

Health disparities among Hispanics are associated with poorer health status across multiple health conditions, greater use of high-acuity services, and lower use of care continuity and preventive services. A new integrated delivery organization (IDO) designed around culturally responsive care aims to reduce health disparities and improve health outcomes among the Hispanic community by deploying a multifeatured approach. The IDO combines the universal administration of a culturally sensitive health risk screening tool, the delivery of culturally appropriate medical, behavioral and spiritual health, and creative support of provider practices with training and informational resources, financial incentives, actionable data, technology, and cultural sensitivity training for providers and staff. The IDO further distinguishes its unique approach by partnering with a university informatics program to establish a local learning health care system destined to enrich the evidence base for culturally appropriate interventions that reduce health disparities. Longitudinal research is currently underway that focuses on the impact of culturally motivated interventions on resource utilization, retention, and quality.

Improving Respect and Dignity of Older Lesbian Adults: Interprofessional Approaches for Specialized Care

Interprofessional research pertaining to LGBTQ older adult cultural sensitivity training for social workers and nurses is often missing in the empirical literature. Members of the LGBTQ communities become increasingly vulnerable to health disparities as they age and treating clients with respect and dignity is at the forefront of this study. Students and faculty engaged in an interprofessional simulation project with older members of the LGBTQ community to learn health knowledge and applied assessment and brief intervention skills. Quantitative findings (N=58; 23 social work; 35 nursing) indicated increased student health knowledge. Reflection and qualitative findings are included with four primary themes: (a) bias of health care providers, (b) access to quality care, (c) specific health care needs, and (d) health risks of LGBTQ older adults. Specific emphasis is given to reflection and insight of the older lesbian participants about access to care, recognition of significant relationships, and marriage equality.

A Framework to Ensure Patient Partners Have Equal and Contributing Voices Throughout the Research Program Evaluation Process

Purpose of program: Traditionally, peer review was a closed process conducted only by individuals working in the research field. To establish a more integrated and patient-centered approach, one of Canada’s largest kidney research networks (Can-SOLVE CKD) has created a Research Operations Committee (ROC) that includes patients as key members. The ROC represents one way for achieving meaningful patient-oriented research (POR). Source of information: Can-SOLVE CKD, a network created as part of the Canadian Institutes of Health Research (CIHR) Strategy for Patient-Oriented Research (SPOR). Methods: The ROC consists of patients, physicians, scientists, Indigenous partners, experts in research methodology, and a member of Can-SOLVE CKD’s operational team. On an annual basis, Can-SOLVE CKD’s research teams provide the ROC with a review package, which incorporates information from patient engagement check-in calls and surveys, the project’s knowledge translation plan and products, and a progress report written by the project team. The ROC evaluates the review package and provides feedback and recommendations accordingly. Key findings: The transparent nature of the process, regular feedback and review, along with an overt accountability and scoring system, has been embraced by both patients and researchers. As a result of the ROC process, the number of patient leads for each project has grown over a 3-year period and more researchers have received POR and cultural sensitivity training. Limitations: While anecdotal evidence suggests this approach is beneficial for achieving POR, formal mechanisms of evaluation are currently lacking. Implications: This ROC framework ensures patients are active contributors throughout the research process and could be adopted by other organizations to achieve a more patient-centered approach to research.

Absence of Cultural Awareness Training in International Non-Governmental Organizations

Introduction:Cultural awareness can be defined as an understanding of the differences that exist between cultures. This understanding is a crucial first step towards the development of cultural sensitivity, a willingness to accept those differences as having equal merit, and becoming operationally effective when working within different cultures. The benefits of cultural awareness have become apparent in recent decades, including within governments, militaries, and corporations. Many organizations have developed cultural awareness training for their staffs to improve cross-cultural cooperation. However, there has not been a large movement toward cultural sensitivity training among non-governmental organizations (NGOs) who provide aid globally, across a number of countries and cultures. Cultural awareness can be a useful tool which enables an NGO to better serve the populations with which they engage.Problem:The goal of this study was to evaluate the presence of cultural awareness training for employees and volunteers working within international NGOs.Methods:Ten of the largest international NGOs were identified. Their websites were evaluated for any mention of training in cultural awareness available to their employees and volunteers. All ten were then contacted via their public email addresses to find out if they provide any form of cultural awareness training.Results:Of the ten NGOs identified, none had any publicly available cultural awareness training on their websites. One NGO dealt with cultural awareness by only hiring local staff, who were already a part of the prevalent culture of the area. None of the others who responded provided any cultural awareness training.Conclusion:Cultural awareness is a vital tool when working internationally. Large NGOs, which operate in a wide-range of cultures, have an obligation to act in a culturally aware and accepting manner. Most large NGOs currently lack a systematic, robust cultural awareness training for their employees and volunteers.

Absence of Cultural Awareness Training in International Non-Governmental Organizations

Introduction:Cultural awareness is the understanding of differences in cultures, and openness to these differences. It is a vital step in the development of cultural sensitivity and becoming operationally effective when working within different cultures. The benefits of Cultural Awareness have become apparent in recent decades, including within governments, militaries, and corporations. Many organizations have developed Cultural Awareness training for their staff to improve cross-cultural cooperation. However, there has not been a large movement toward cultural sensitivity training among Non-Governmental Organizations (NGOs) who provide aid across a number of countries and cultures. Cultural Awareness can be a useful tool which enables an NGO to better serve the populations with which they engage.Aim:To evaluate the presence within International NGOs of Cultural Awareness Training to employees and volunteers.Methods:Ten of the largest international NGOs were identified. Their websites were evaluated for any mention of training in Cultural Awareness available to their employees and volunteers. All 10 were then contacted via their public email addresses to find out if they provide any form of Cultural Awareness training.Results:Of the ten NGOs identified, none have any publicly available Cultural Awareness training on their websites. One NGO deals with cultural awareness by only hiring local staff, who are already a part of the prevalent culture of the area. None of the others who responded have any cultural awareness training which they provide.Discussion:Cultural awareness is a vital tool when acting internationally. Large NGOs, which operate in a wide range of cultures, have an obligation to act in a culturally aware and accepting manner. Most large NGOs currently lack cultural awareness training for their employees and volunteers. It is time for these NGOs to develop, and begin to employ, cultural awareness training to better prepare their staff to serve international populations.

Factors influencing public satisfaction with the local police: a study in Saskatoon, Canada

Purpose – The purpose of this paper is to explore determining factors that account for variation in public satisfaction with the local police in Saskatoon, Saskatchewan, Canada. Design/methodology/approach – An integrated method was used to gather the data for this study, including official survey data conducted by Insightrix, and interviews with citizens in Saskatoon. Findings – This research found that demographic factors including age, race (in this study, Aboriginal status in particular), education, and income, perception of neighborhood safety, citizen-police interaction, and learning about crime from news media all have impact on public attitudes toward the police, to different degrees. The gap or distance between the police and the Aboriginal community was highlighted as a major factor. Research limitations/implications – Further research should be done to compare statistical patterns in other same-level cities in Canada. Practical implications – This paper indicates that Saskatoon Police Service in the future should provide a more structured avenue for citizen participation in establishing safe neighborhoods, more structured cultural sensitivity training, and create a wider channel through which community residents with various social backgrounds can demand some measure of accountability for police work in their area. Originality/value – The paper is of value to law enforcement policy-makers and academic researchers with interest in policing and police-community relationship.

The refugee experience of acquiring a family doctor

Purpose – The purpose of this paper is to explore refugees’ experiences of the barriers and facilitators involved in finding a regular family doctor. Design/methodology/approach – Hermeneutic phenomenology was used to produce an integrated description sensitive to the lifeworlds of refugees who came from multiple cultural perspectives. Participants consisted of refugees from Iran, Afghanistan, Myanmar, Vietnam, and Latin America who arrived in Canada between 2005 and 2007. Texts for analysis came from first language focus group discussions and interviews with the interpreters for those groups. Findings – The principal themes that emerged from the experience of barriers were “futility,” “dependence,” and “relevance.” Themes related to the experience of facilitators were “inclusion,” “congruence,” and “benefit to family.” These themes provide key messages about sources of patient decisions to seek or not seek care, not comply, attend irregularly, and not disclose symptoms, which can be used by doctors and other health providers to enhance care planning. Practical implications – The factors that facilitate refugees’ access to a regular family doctor have implications for the development of culturally appropriate healthcare information, policies that support adequate interpreter services, and cultural sensitivity training for physicians. Originality/value – Previous research documents barriers such as lack of language access, differences in health beliefs, and lack of knowledge about western healthcare systems. However, little is known about how refugees experience these barriers, nor how they overcome them. This study contributes a rich and deeper understanding of how refugees experience these barriers and elucidates factors that facilitate their process of obtaining a regular family doctor.