MRNY’s CHW Training Program Cultural Humility

Guiding Questions for today What is culture? What is cultural competence? What is cultural humility? How do our identities and experiences of discrimination impact our experiences in general and potentially in the workplace as CHWs?

Culture is the shared values, traditions, norms, customs, religion, arts, history, folklore, language and/or institutions of a specific people. Someone with cultural competence learns about others and acts in ways that show an understanding of and respect for cultural differences.

Cultural Humility “cultural humility incorporates a lifelong commitment to self-evaluation and critique, to redressing the power imbalances in the physican-patient dynamic, and to developing mutually beneficial and non- paternalistic partnerships with communities on behalf of individuals and defined populations.” (Melanie Tervalon and Jane Murray-Garcia)

More about culture In order to understand others, we must first understand our own culture. Cultures are neither better nor worse, simply different. Every human being is bound by his or her culture. Behind the differences among people, there are basic similarities, such as love, family, loyalty, friendship, joy… -Judith Carmen Nine Curt (1984)

Differences in values between different cultures Question: What do you think are some examples of differences between values you see in Western cultures and values you see in traditional Asian, African, or Latin American cultures? (What are Western cultures? What are values, etc.?) Look at: “Core Value Differences between Cultures” handout

Building Cultural Self Awareness- ‘quiz’ Notes from class discussion after our quizzes:

Our cultural identity is about more than where we’re from…. Gender Economic class Race Ethnicity Immigration status Employment status Age sexual orientation Health national origin others?

More on Cutural Humility What’s it look like in practice? (p. 145 in text) How does it differ from the idea of cultural ‘competence’? (see p. 144– A word of Caution)

More on becoming culturally humble Read and explain these sections: Recognize the Transference of Power The explanatory model

Understanding Health beliefs What are the health beliefs in your family or culture? Where did you family go to receive health care? What were the home remedies for illnesses? How were they used? What do you still practice today? Were there health issues or topics considered taboo?

Two models to understand clients’ health beliefs (p. 148-49) “Tool to elicit Health Beliefs”- Explanatory model What do you call your problem? What do you think caused your problem? Why do you think it started when it did? What does your sickness do to you? How does it work? How severe is it? Will it have a short or long course? What do you fear most about your sickness? What are the chief problems that your sickness has caused for you? What kind of treatment do you think you should receive? What are the most important results you hope for from treatment?

The LEARN model for Cross cultural work L: listen with sympathy and understanding to the client’s perception of the problem E: explain your perceptions of the problem A: acknowledge and discuss the differences and similaries between the perceptions of the client and the CHW R: recommend resources N: negotiate agreement

Read client scenarios on p. 147-48 Answer the following questions: Have you ever been offended by assumptions that a health care or social services provider made about you or a family member? What else could you do to demonstrate cultural humility in working with the clients described on pp. 147-48? If you were going to give advice to CHWs working with your culture or community what advice would you give them to help them avoid cultural communication?