Cultural Barriers to Care: Inverting the Problem

Abstract

In Brief In working with diverse populations, health practitioners often view patients’ culture as a barrier to care. Inverting this problem by viewing the barriers as arising from the culture of biomedicine provides greater direction for practice. Integral to the delivery of culturally appropriate diabetes care are practitioner competencies in specific areas of cultural knowledge, as well as specific skills in intercultural communication, tripartite cultural assessment, selecting among levels of intensity of cultural interventions (neutral, sensitive, innovative, or transformative), adapting patient education, and developing community partnerships.

Food, Identity, and African-American Women With Type 2 Diabetes: An Anthropological Perspective

“…[14][15][16] Clinicians, diabetes educators, and others who counsel African-American women with type 2 diabetes must recognize that dietary practices are tied to ideologies about African-American womanhood, intimate and community relationships, and ethnic identity. Dietary counseling within this context assumes a stance different from the norm, i.e., it must go beyond the transfer of knowledge and skills.…”

Use of Social Marketing to Develop Culturally Innovative Diabetes Interventions

“…In developing health interventions, Tripp-Reimer et al 5 suggest that program planners use a cultural assessment focused on analysis of beliefs, values, and practices. This assessment can be complemented and enhanced by social marketing phases 2-4: audience analysis, channel analysis, and market analysis, which are collectively referred to as "formative research.…”

“…A recent article by Tripp-Reimer et al 5 suggested that diabetes interventions must be developed that address cultural variations within ethnic communities. Specifically, the authors outlined four phases of cultural assessment (general assessment, problem-or situation-specific cultural information, detailed cultural factors, and patient and family views) that could guide the program development process for ethnic clients and communities.…”

“…This approach, which uses cultural elements to create programs, is referred to as "culturally innovative." 5 This article will describe how the social marketing process can facilitate the development of culturally innovative diabetes interventions.…”

A technological framework based on automatic messaging for improving adherence of diabetic patients

“…It was concluded that communication in the language of the client is crucial for effective care. This barrier can raise issues like selecting a direct versus an indirect approach and a confrontational versus a collaborative style (Tripp-Reimer 2001). Personal barriers are emphasised in many papers as important factor in diabetes care.…”