1. Presenters: Ariel Cochrane-Brown and Erica Wallace Source: http://www.dmu.edu/magazine/spring-2013/the-criticality-of-cultural- competency/

2. 1.Introduction of presenters 2.Conversation about culture 3.Cultural awareness of self 4.Cultural knowledge of others 5.Inclusive language 6.Case studies Source: http://www.speakingandpresenting.com/presentation-ideas- agendas.html

3. Ariel Cochrane-Brown ● B.A., Journalism and Mass Communication, University of North Carolina at Chapel Hill ● M.Ed., Counselor Education, Clemson University ● PhD student, Educational Research and Policy Analysis, North Carolina State University Erica Wallace ● B.A., Sociology, Davidson College ● M.Ed, Counselor Education, Clemson University ● Coordinator for Peer Mentoring & Engagement, University of North Carolina at Chapel Hill

4. Source: http://www.juliaferguson.com/shock.html

5. Culture is learned from birth through group socialization and language acquisition. Culture is adapted to specific conditions. Culture is dynamic and ever-changing. Culture is shared by most, if not all, of the members of that particular group.

6. Cultural sensitivity as it relates to health care consists of: ˃the awareness and acceptance of cultural differences in patients. ˃the ability to conduct an honest self-assessment of one's own cultural values and beliefs regarding health and illness. ˃the recognition that people of different cultures have different verbal and nonverbal ways of communicating ˃the ability to gather and analyze knowledge of other cultures ˃recognize that cultural beliefs about health and illness impact a patient’s interactions with healthcare professionals, self-treatment practices, health care outcomes and adherence to medications. Cultural competency encompasses cultural sensitivity, but goes a step further. It also is the ability to adapt your practice to meet the cultural needs of the patient community in which you serve. Being competent also means that patient care may have to be adapted or negotiated to be compatible with that patient’s culture. More specifically cultural competence is having the ability to provide care to patients with diverse values, beliefs and behaviors and to tailor that care to patients’ social, cultural, and linguistic needs.

7. 1.Cultural awareness is the self-understanding of one’s own cultural and professional background. 2.Cultural knowledge is the process of seeking and obtaining an educational foundation about different cultural and ethnic groups. 3.Cultural skill is described as the ability to collect relevant cultural data about the patient’s problem as well as perform a culturally based physical assessment. 4.Cultural encounter involves the health professional engaging in cross-cultural interactions with individuals from diverse backgrounds. This interaction is almost impossible when the patient and health provider speak different languages, the patient has a limited English proficiency, the patient is speaking from a different perspective, or the provider has a limited proficiency in the patient’s language. Occasionally, cultural tradition may preclude a patient speaking directly to a provider. For these reasons, an interpreter is sometimes needed. 5.Cultural desire is the motivation of the health care provider to engage in the process of culturally responsive care. A culturally competent pharmacist will consciously adapt care for the patient in a way that is consistent with the patient’s need from the context of a cultural framework. Source: http://www.rcn.org.uk/development/learning/transcultural_health/foundation/sectionthreeSource: http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofC ontents/Volume82003/No1Jan2003/AddressingDiversityinHealthCare.aspxThank

8. Source: http://ptcrn.com/post/cultural-awareness

9. In her book, Cultural Diversity in Health and Illness, R. Spector lists some questions to consider to better understand one’s cultural heritage and its effects on health care perceptions. The questions below include many from Spector’s work, as well as some more general cultural background questions. 1. What is your cultural heritage? 2. Where did your parents/grandparents/great grandparents come from? 3. What were/are some foods, celebrations, rituals, clothing, etc that were meaningful to your family and symbolized your cultural background? 4. How do you define health? 5. How do you keep yourself healthy? 6. How do you define illness? What causes illness? 7. What would you define as a minor, or non-serious medical problem? 8. How do you know when a given health problem does not need medical attention? 9. What health problems do you self-diagnose? 10. Who do you seek for help with minor health problems? Major health problems? 11. Do you use over the counter medications? Which ones and when?” 12. Who makes health care decisions in your family? 13. What expectations are there for who is to care for an elderly relative?

10. Source: http://www.oliviahdzp.com/2013/08/07/what-is-cultural-knowledge-and-how-can-we-use-it

11. Demographics of PC Pharmacy Students 1.Current enrollment: 311 2.% Minority by class a.P1 (first year) 25% b.P2 21% c.P3 23% d.P4 21% 3.% Female by class a.P1 60% b.P2 64% c.P3 73% d.P4 70%

12. Consider the many social identities individuals possess that are connected to different cultures. » Gender » Sexual Orientation » Race » Ethnicity Source: http://alexanderstreet.com/products/health-sciences/counseling-and- therapy/counseling-and-therapy-alexander-street-press

13. ● Bias: a tendency to believe that some people, ideas, etc., are better than others that usually results in treating some people unfairly When you hear a narrative, you fill in the blanks with what you know…..that’s your bias

14. Source: http://studentlife.umich.edu/article/inclusive-language-campaign

15. Inclusive Language Definition: Inclusive language is language that does not belittle, exclude, stereotype or trivialize people on the basis of their identity including but not limited to race, gender, sexual orientation and ability. (UNC-CH) Inclusive language does not mean cumbersome, dull or vague language; it simply means language that has been carefully constructed in ways that treat all people with respect and impartiality. (Guidelines for Inclusive Language, 2012, p. 2)

16. When using inclusive language, it is useful to keep the following generic questions in mind: 1.Is it necessary to refer to personal characteristics such as sex, religion, racial group, disability or age at all? 2.Are the references to group characteristics couched in inclusive terms? 3.Do the references to people reflect the diversity of the intended audience? 4.Is the use of jargon and acronyms excluding people who may not have specialized knowledge of a particular subject? (Guidelines for Inclusive Language, 2012, p. 3-4)

17. Try to avoid being gender specific. Use words like “partner” instead of “husband”, and “they” instead of “he” or “she.” Use language which carries the fewest connotations about the person you are talking to. Instead of saying, “Who is your next-of-kin?” say, “Is there anyone you would like to give as an (emergency) contact name and telephone number?” Don’t force people into categories or disclosure. Instead of saying, “Are you straight, gay or bisexual?” or “Are you male or female?” say, “How do you describe your sexual orientation?” or, “How do you describe your gender?” (Inclusive Language in the NHS, p. 3-4)

18. Use terms that are inclusive such as “first name” and “family name”, instead of “Christian name” and ‘surname” Avoid “racial or ethnic invisibility” like using umbrella terms such as “Asians” that ignores multiple ethnicities within Asia. Instead, refer to people from Indonesia, Thailand, etc. Avoid undue emphasis on racial and ethnic differences. Only refer to the ethnic or racial background of a person or group if it is relevant to the discussion Avoid stereotyping. Do not make positive/negative generalizations about members of a particular racial, ethnic or national group in ways that detract from people’s fundamental humanity and individuality (Guidelines for Inclusive Language, 2012, p. 4)

19. Source: http://www.theclinegroup.com/the-clients/case-studies/

21. Mr. Eduardo Montanez is a 68-year-old Latin American man originally from Matamoros, Mexico. He moved to San Antonio, Texas, 5 years ago because his son, daughter-in-law, and their five children wanted to take care of him. He has limited English skills but is able to navigate his way reasonably well. His son is a schoolteacher and has excellent health benefits. Mr. Montanez is a dependent; therefore, he is eligible to receive the full benefit of his son’s health insurance plan. All of his life, Mr. Montanez has been a deeply religious person. He was raised in the Catholic Church and went to a Catholic school in Mexico. His mother raised him to believe in the church as a spiritual basis for everything in his life. He also has traditional Mexican beliefs about the spiritual nature of illness. Mr. Montanez believes that any illness he develops is related to a failing or wrongdoing on his part. He was raised with folk medicines administered by his mother and spiritual healers.

22. Huong is an 8-year-old Vietnamese boy who arrived in the United States 4 years ago with his mother and father. He speaks English well; however, his mother and father are quite limited in their command of the language. Huong attends public school in Omaha, Nebraska. He is doing very well with all of his subjects. His schoolteacher and a friend in his neighborhood help him to learn his lessons because his parents are not able to correctly interpret the assignments in English. Huong interprets for his parents when they do life chores, such as purchasing items at the hardware or grocery store. He is their “window” to the English-speaking world. His parents frequent a shop that sells Chinese medicines.

23. Mr. Samuel Robinson is a 76-year-old African American male who has resided in Biloxi, Mississippi, since he was 12 years old. He and his wife, Georgia, were married for 40 years. Georgia died 1 year ago. He is having a difficult time keeping his life in order now that he lives alone. He has always been a self-sufficient man. However, Mr. Robinson had a deep love and interdependency with Georgia, as did she with him. She would prepare remedies when he did not feel well, exchanging and discussing several of the traditional comfort remedies with her friends. These remedies were not written down anywhere, and Mr. Robinson cannot help himself with it. He finds this discomforting. Georgia frequented a pharmacist in town regularly. She took care of her husband’s needs with the pharmacist as far as he was concerned. Now he is forgetful and often distracted. Mr. Robinson attended a Baptist church with his wife. He has only gone to church twice since she died—at her funeral and at the 6-month anniversary of her death. Mr. Robinson is on Medicare, his only form of health insurance coverage. He retired from being a farm worker 9 years ago with a very small pension and no supplementary health coverage.

24. Questions

25. » Rogowski, A.C. The pharmacy technician’s guide to understanding cultural diversity. https://www.cedrugstorenews.com/userapp/lessons/page_view_ui.cfm?lessonuid=&pageid=1B04088130882D5944B21736 06285525 https://www.cedrugstorenews.com/userapp/lessons/page_view_ui.cfm?lessonuid=&pageid=1B04088130882D5944B21736 06285525 » Zweber, A. (2002). Cultural competence in pharmacy practice. American Journal of Pharmaceutical Education, 66(2), 172- 176. http://pharmacy304.pbworks.com/f/Cultural+Competence+in+Pharmacy+Practice.pdfhttp://pharmacy304.pbworks.com/f/Cultural+Competence+in+Pharmacy+Practice.pdf » American Society of Health-System Pharmacists. Chapter 1: The patient. http://www.ashp.org/DocLibrary/Bookstore/P2524/Chapter-1.aspx http://www.ashp.org/DocLibrary/Bookstore/P2524/Chapter-1.aspx » Clark, K. J. Achieving cultural competency and its role in pharmacy. http://www.scrx.org/assets/journalce/culturalcompetencynoanswersnocomments.pdf http://www.scrx.org/assets/journalce/culturalcompetencynoanswersnocomments.pdf » American Pharmacists Association. Cross-cultural communication. http://www.pharmacist.com/sites/default/files/files/Chapter19InstructionalMaterials--Halbur.ppt http://www.pharmacist.com/sites/default/files/files/Chapter19InstructionalMaterials--Halbur.ppt

26. » Social identity wheel https://awnastas.expressions.syr.edu/wp-content/uploads/2011/12/Social-Identity-Wheel.pdf https://awnastas.expressions.syr.edu/wp-content/uploads/2011/12/Social-Identity-Wheel.pdf » Cultural Competence Health Practitioner Assessment (CCHPA) http://nccc.georgetown.edu/features/CCHPA.html http://nccc.georgetown.edu/features/CCHPA.html » Quality of Culture Quiz http://academicdepartments.musc.edu/gme/pdfs/Quality%20and%20Culture%20Quiz.pdf http://academicdepartments.musc.edu/gme/pdfs/Quality%20and%20Culture%20Quiz.pdf » Cultural Assessment Mnemonic Tools http://www.geneticcounselingtoolkit.com/pdf_files/Cultural%20and%20Spiritual%20Mnemonic%20Tools %2011.06.09.pdf http://www.geneticcounselingtoolkit.com/pdf_files/Cultural%20and%20Spiritual%20Mnemonic%20Tools %2011.06.09.pdf » Fadiman, A. (1997). The spirit catches you and you fall down: A Hmong child, her American doctors, and the collision of two cultures. Macmillan. » Spector, R. E., & Spector, R. E. (2004). Cultural diversity in health and illness(pp. 256-268). Upper Saddle River, NJ: Pearson Prentice Hall.

27. Ariel Cochrane-Brown, M.Ed. PhD Student, Educational Research & Policy Analysis Graduate Assistant, Office of Graduate Student Support Services Department of Leadership, Policy, and Adult and Higher Education North Carolina State University aecochr2@ncsu.edu Erica Wallace, M.Ed. Coordinator for Peer Mentoring & Engagement Center for Student Success and Academic Counseling University of North Carolina at Chapel Hill werica@email.unc.edu Source: https://www.knowthegoodshepherd.org/contact