Integrating Interprofessional Education and Cultural Competency Training to Address Health Disparities

McElfish, Pearl A.; Moore, Ramey; Buron, Bill; Hudson, Jonell; Long, Christopher R.; Purvis, Rachel S.; Schulz, Thomas; Rowland, Brett; Warmack, T. Scott

doi:10.1080/10401334.2017.1365717

Cited by 46 publications

(75 citation statements)

References 31 publications

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“…Residents in our study reported a preference for cultural competency training and experiential learning to help them identify and address health disparities. While evidence regarding the effectiveness of cultural competency training for improving patient outcomes is mixed [27], research suggests that when combined with experiential learning, cultural competency training can help increase clinicians' awareness of their own biases and the needs of underserved and minority patients [28,29]. Academic medical centers can incorporate disparities-focused experiential learning using methods such as community-based teaching [30], simulations and community tours [31].…”

Section: Discussionmentioning

confidence: 99%

Awareness of Racial Disparities in Diabetes Among Primary Care Residents and Preparedness to Discuss Disparities with Patients

Taylor

Davis

Mohanan

et al. 2018

J. Racial and Ethnic Health Disparities

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Many healthcare providers lack the awareness of health disparities among their patients that precedes action to improve outcomes. Limited health disparities training is a probable contributor. We assessed primary care residents' awareness of racial and ethnic disparities in diabetes, their perceived preparedness to discuss health disparities with patients, and their preferences for training and resources to improve their preparedness. Primary care residents (n = 98) affiliated with two teaching hospitals in North Carolina were invited to complete a 20-question health disparities survey. Fifty-two residents completed the survey (response rate = 53%). Most were non-Hispanic White (54%) and had ≤ 50% African American patients in their panel (65%). Although 83% were aware of higher diabetes prevalence among African Americans, only 31% felt prepared to discuss diabetes health disparities with patients. Their primary concerns included not having information for the discussion (58%) and being unsure how to share information in a way that is easy for patients to understand (48%). Perceived preparedness to discuss health disparities did not differ significantly by primary care resident race or percentage of African American patients in their panel. Residents indicated that having information regarding how to discuss and address health disparities would make them feel more prepared. Cultural competency training and experiential learning were the most preferred methods to learn how to identify and address health disparities. Future health disparities training should focus on improving residents' preparedness to address health disparities in their clinical practice using culturally relevant communication tools and experiential learning opportunities.

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Section: Discussionmentioning

confidence: 99%

Awareness of Racial Disparities in Diabetes Among Primary Care Residents and Preparedness to Discuss Disparities with Patients

Taylor

Davis

Mohanan

et al. 2018

J. Racial and Ethnic Health Disparities

View full text Add to dashboard Cite

show abstract

“…Cultural safety includes, "the delivery of quality care through changes in thinking about power relationships and patients' rights" [252]. To this end, several programs exist that educate medical students about Indigenous health using collaborative and decolonizing methods [253][254][255][256], result-ing in improved Indigenous health knowledge [257], improved knowledge about Indigenous perspectives, commitment to rural and underserved areas [255], and improved cultural responsiveness within healthcare settings [254].…”

Section: Reducing Trauma and Discriminationmentioning

confidence: 99%

Stress and Cardiometabolic Disease Risk for Indigenous Populations throughout the Lifespan

Lewis

Volpert‐Esmond

Deen

et al. 2021

IJERPH

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Background: Indigenous people experience the greatest cardiometabolic disease disparity in the Unites States, yet high cardiometabolic disease risk factors do not fully explain the extent of the cardiometabolic disease disparity for Indigenous people. Stress, trauma, and racism occur at high rates within Indigenous communities and have not been well explored as significant contributors to cardiometabolic disease disparities despite emerging literature, and therefore will be described here. Methods: This descriptive study explores the relationship between cardiometabolic disease risks and Indigenous-specific stressors (e.g., early childhood stress and trauma, adulthood stress and trauma, and historical and intergenerational trauma) using current literature. Indigenous-specific protective factors against cardiometabolic disease are also reviewed. Results. Increasing research indicates that there is a relationship between Indigenous-specific stressful and traumatic life experiences and increased cardiometabolic disease risk. Mental health and psychophysiology play an important role in this relationship. Effective interventions to reduce cardiometabolic disease risk in Indigenous communities focus on ameliorating the negative effects of these stressors through the use of culturally specific health behaviors and activities. Conclusions: There is increasing evidence that cultural connection and enculturation are protective factors for cardiometabolic disease, and may be galvanized through Indigenous-led training, research, and policy change.

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“…This situation is gradually changing, as some medical and nursing schools have become increasingly informed about safe, culturally congruent, and evidence-based alternative, complementary, and integrative approaches to health care delivery. 3,4,5,6,7,8,9,10 Patient challenges. TM/H is critical to the identity and culture of tribal nations and the ways that they relate to the world around them.…”

Section: Practice Challengesmentioning

confidence: 99%

How Should Allopathic Physicians Respond to Native American Patients Hesitant About Allopathic Medicine?

Esposito

Kahn-John

2020

AMA Journal of Ethics

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American Indian (AI) and Indigenous peoples utilize traditional medicine/healing (TM/H) for health and well-being. Allopathic health care practitioners (HCPs) receive minimal training and education on TM/H and its application and integration into health care settings. Lack of knowledge and practice guidelines on how to navigate these 2 health care perspectives (allopathic and traditional) creates uncertainties in the treatment of AI and Indigenous peoples. Such conflicts can undermine patient autonomy and result in culturally incongruent practice. This article presents a case study showcasing suggestions for how HCPs can direct clinical decision making when working with AI/Indigenous patients who utilize TM/H. The article argues that health professions education institutions and HCPs must dedicate effort to expanding awareness of and education about TM/H to enhance the delivery of evidence-based and integrated clinical treatment for AI/Indigenous patients. Case Ms Q is a 72-year-old Navajo woman seeing Dr S, a new physician at an Indian Health Service (IHS) unit in New Mexico. Ms Q reports 5 months of weight loss, fatigue, epigastric pain, and jaundice. She lives in a remote community on the Navajo Nation, and her granddaughter drove 2 hours to bring her to the IHS clinic, insisting that Ms Q's symptoms should be evaluated by an allopathic physician. Traditional Navajo healing practices and customs are important aspects of Ms Q's life. Although she does not routinely visit the IHS clinic, Ms Q is open to being evaluated by Dr S. In a follow-up visit, Dr S discusses test results with Ms Q. Based on laboratory evidence of obstructive jaundice and a computed tomography scan revealing a solid mass in the head of Ms Q's pancreas, Dr S suspects that Ms Q has pancreatic cancer and recommends endoscopic retrograde cholangiopancreatography (ERCP), a procedure that enables examination of the liver and pancreas ducts, with endoscopic ultrasound (EUS) to confirm the diagnosis. Ms Q feels hesitant to pursue ERCP with EUS and the required travel and requests to see her medicine man to discuss her symptoms and Dr S's recommendations. Unfamiliar with traditional Navajo healing, Dr S wonders how to respond.

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Integrating Interprofessional Education and Cultural Competency Training to Address Health Disparities

Cited by 46 publications

References 31 publications

Awareness of Racial Disparities in Diabetes Among Primary Care Residents and Preparedness to Discuss Disparities with Patients

Awareness of Racial Disparities in Diabetes Among Primary Care Residents and Preparedness to Discuss Disparities with Patients

Stress and Cardiometabolic Disease Risk for Indigenous Populations throughout the Lifespan

How Should Allopathic Physicians Respond to Native American Patients Hesitant About Allopathic Medicine?

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