History and Program Development HAS 3190

Why this class? More accurate diagnosis Time savings Greater patient retention Greater satisfaction Increased patient compliance

Why this class? Better patient outcomes High quality Reduced malpractice A thriving practice Tune up communications

Health Ed vs Patient Ed Individuals Active process Individual assessment Patient understanding Rapport Emotional support

Health Ed vs Patient Ed Cooperation Knowledge and skills Participation Evaluation Dynamic

History Earliest … patient-provider Next…target population Diabetes (1960s and 70s) Published in 1970s Hospital-wide support

Target Populations Inpatient Diabetes Preoperative ed Heart attack Cardiac rehab Nutrition

Target Populations Outpatient Diabetes Nutrition Prenatal ed Cardiac rehab Heart attack

Health & Illness How do you define Health?

Health Dark Ages WHO Textbook

How is good health expressed?

HEALTH (Physical, Mental, Spiritual) Maintenance Protection Restoration

Determinants of health… Overweight/obesity Tobacco use Substance abuse Responsible sexual behavior Mental health

Determinants of health… Injury and violence Environmental quality Immunization Access to health care

Stages of Illness Experience 1. Symptom Experience Stage 2. Assumption of the Sick Role Stage 3. Medical Care Contact Stage 4. Dependent-Patient Role Stage 5. Recovery or Rehab Stage

Sick Role 1. Sick person is exempt from the performance of certain normal social obligations 2. Sick person is exempt from a certain type of responsibility for ones own state (seeks health care, not immediate cure) 3. Legitimization of the sick role is partial 4. Being sick, except in the mildest of cases, is being in need of help

Illness How do you define illness?

Health Care Philosophies Allopathic Homeopathic Integrative

Homeopathic Schools Homeopathic Medicine Osteopathic Medicine Chiropractic

CULTURE

Local Demographics (Weber Co.) Median age = 29.3 White = 87.7% Black or African American = 1.4% American Indian/Alaska Native = 0.8% Asian = 1.3% Hispanic or Latino = 12.6% Mexican = 8.9%

Local Demographics (Weber Co.) Median income = $44,014 (household) Per capita = $18,246 Persons below poverty = 9.3% Foreign born = 6.4% Language other than English spoken at home, pct age 5+ = 12.6%

Culture Care Culturally Competent Culturally Appropriate Culturally Sensitive

Terminology Culture Ethnicity Race Dominant group Minority group Assimilation Acculturation

Barriers to Cultural Sensitivity Ethnocentrism Stereotyping Cultural blindness Cultural shock Lack of qualified interpreters (speakers & translators--writers) No cultural training

Providing Cultural Care Know own beliefs, attitudes, and biases Use inclusive language, no slang No assumptions other than we are human, are born, and die Walk in shoes - observe and listen Know the history of the people Be patient, flexible, open to change

The Health Care Provider’s Culture in USA Beliefs Practices Habits Likes Dislikes Customs