Beyond the List of Traits: Addressing and Assessing Cultural Needs of Patients in Health Care Settings

in Kinesiology Review
Restricted access

Purchase article

USD  $24.95

Student 1 year subscription

USD  $41.00

1 year subscription

USD  $54.00

Student 2 year subscription

USD  $77.00

2 year subscription

USD  $101.00

Historically, cultural competence included providing a list of traits or characteristics germane to ethnic and racial groups. Although it is important to understand cultural groups broadly rather than merely reducing information to a cultural list, health care professionals need to know how individual patients experience their illness or injury. The purposes of this paper are to provide health care professionals an example of how to elicit cultural information from the patient’s perspective using the outline for cultural formulation and cultural formulation interview, to discuss the need to be aware of the social determinants of health in order to help patients or clients beyond cultural needs, and to suggest advocacy through a social-justice lens.

The author is with the School of Rehabilitation and Medical Sciences, Central Michigan University, Mt. Pleasant, MI.

Address correspondence to shing1rr@cmich.edu.
  • Aggarwal, N.K., DeSilva, R., Nicasio, A.V., Boiler, M., & Lewis-Fernández, R. (2015). Does the Cultural Formulation Interview (CFI) for the fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) affect medical communication? A qualitative exploratory study from the New York site. Ethnic Health, 20(1), 1–28. doi:10.1080/13557858.2013.857762

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Aggarwal, N.K., Nicasio, A.V., DeSilva, R., Boiler, M., & Lewis-Fernández, R. (2013). Barriers to implementing the DSM-5 cultural formulation interview: A qualitative study. Cultural Medical Psychiatry, 37(3), 505–533. doi:10.1007/s11013-013-9325-z

    • Crossref
    • Search Google Scholar
    • Export Citation
  • American Psychiatric Association. (2013, May). Outline for cultural formulation. In Diagnostic and statistical manual of mental disorders (5th ed., pp. 778–783). Arlington, VA: Author. Retrieved from https://dsm-psychiatryonline-org.cmich.idm.oclc.org/doi/full/10.1176/appi.books.9780890425596.CulturalFormulation

    • Search Google Scholar
    • Export Citation
  • Association of American Medical Colleges. (2017). Diversity in medical education: Facts & figures 2014. Retrieved from http://aamcdiversityfactsandfigures.org/section-ii-current-status-of-us-physician-workforce/#fig1

    • Export Citation
  • Bell, L.A. (2016). Theoretical foundations for social justice education. In M. Adams, L.A. Bell, D.J. Goodman, & K.Y. Joshi (Eds.), Teaching for diversity and social justice (3rd ed., pp. 3–26). New York, NY: Routledge.

    • Search Google Scholar
    • Export Citation
  • Betancourt, J.R., Green, A.R., Carrillo, J.E., & Park, E.R. (2005). Cultural competence and health care disparities. Key Perspectives and Trends Health Affairs, 24(2), 499–505. PubMed doi:10.1377/hlthaff.24.2.499

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Biddington, C. (2007). Teaching diversity awareness. Academic Exchange Quarterly, 11(4), 71–75.

  • Brach, C., & Fraserirector, I. (2000). Can cultural competency reduce racial and ethnic health disparities? Medical Care Research and Review, 57(1), 181–217. doi:10.1177/1077558700057001S09

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Brunett, M., & Shingles, R.R. (2017). Does having a culturally competent healthcare provider affect the patients’ experience or satisfaction? A critically-appraised topic. Journal of Sport Rehabilitation. Advance online publication. doi:10.1123/jsr.2016-0123

    • Search Google Scholar
    • Export Citation
  • Cartwright, L.A., & Shingles, R.R. (2011). Cultural competence in sports medicine. Champaign, IL: Human Kinetics.

  • Center for Medicare and Medicaid Services, and Center for Medicare and Medicaid Innovation. (2017). The Accountable Health Communities Health-Related Social Needs screening tool. Retrieved from https://innovation.cms.gov/Files/worksheets/ahcm-screeningtool.pdf

    • Export Citation
  • Clingerman, E. (2011). Social justice: A framework for culturally competent care. Journal of Transcultural Nursing, 22(4), 334–341. PubMed doi:10.1177/1043659611414185

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Cohn, D., & Caumont, A. (2016, March 31). 10 demographic trends that are shaping the U.S. and the world. Pew Research Center, Fact Tank: News in numbers [online]. Retrieved from http://www.pewresearch.org/fact-tank/2016/03/31/10-demographic-trends-that-are-shaping-the-u-s-and-the-world/

    • Export Citation
  • Commission on Accreditation of Athletic Training Education. (2018). 2020 standards for accreditation of professional athletic training programs. Retrieved from https://caate.net/wp-content/uploads/2018/02/2020-Standards-for-Professional-Programs-copyedited-clean.pdf

    • Export Citation
  • Díaz, E., Añez, L.M., Silva, M., Paris, M., & Davidson, L. (2017). Using the Cultural Formulation Interview to build culturally sensitive services. Psychiatric Services, 68(2), 112–114. doi:10.1176/appi.ps.201600440

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Farrer, L., Marinetti, C., Cavaco, Y.K., & Costongs, C. (2015). Advocacy for health equity: A synthesis review. The Milbank Quarterly, 93(2), 392–437. PubMed doi:10.1111/1468-0009.12112

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Garg, A., Toy, S., Tripodis, Y., Silverstein, M., & Freeman, E. (2015). Addressing social determinants of health at well child care visits: A cluster RCT. Pediatrics, 135(2), 296–304. PubMed doi:10.1542/peds.2014-2888

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Geisler, P.R. (2003). Multiculturalism and athletic training education: Implications for educational and professional progress. Journal of Athletic Training, 38(2), 141–151. PubMed

    • Search Google Scholar
    • Export Citation
  • Gerson, W.T. (2016). Commentary: Health disparities, social justice and the practice of pediatrics. Current Problems in Pediatric Adolescent Health Care, 46(9), 313–314. PubMed doi:10.1016/j.cppeds.2016.08.002

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Grant-Ford, M. (2003). Working toward cultural competence in athletic training. International Journal of Athletic Therapy and Training, 8, 60–66. doi:10.1123/att.8.3.60

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Health Leads. (2016). Social needs screening toolkit. Retrieved from https://healthleadsusa.org/wp-content/uploads/2016/07/Health-Leads-Screening-Toolkit-July-2016.pdf

    • Export Citation
  • Healthy People 2020. (2018a). Social determinants—Life stages and determinants. Retrieved from https://www.healthypeople.gov/2020/leading-health-indicators/2020-lhi-topics/Social-Determinants/determinants

    • Export Citation
  • Healthy People 2020. (2018b). Social determinants: Overview and impact. Retrieved from https://www.healthypeople.gov/2020/leading-health-indicators/2020-lhi-topics/Social-Determinants

    • Export Citation
  • Jenks, A.C. (2011). From “lists of traits” to “open-mindedness”: Emerging issues in cultural competence education. Cultural Medical Psychiatry, 35, 209–235. doi:10.1007/s11013-011-9212-4

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Marra, J., Covassin, T., Shingles, R.R., Canady, R.B., & Mackowiac, T. (2010). Assessment of certified athletic trainers’ levels of cultural competence in the delivery of health care. Journal of Athletic Training, 45(4), 380–385. PubMed doi:10.4085/1062-6050-45.4.380

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Maurer-Starks, S. (2005). Are athletic training students culturally competent? [Unpublished doctoral dissertation]. Columbia University, New York, NY.

    • Search Google Scholar
    • Export Citation
  • National Association of Community Health Centers, Association of Asian Pacific Community Health Organization, and Oregon Primary Care Association. (2016, August). PRAPARE implementation and action toolkit. Retrieved from http://www.nachc.org/wp-content/uploads/2016/08/PRAPARE_Toolkit_Intro_Table_of_Contents_Sept2016.pdf

    • Export Citation
  • National Athletic Trainers’ Association. (2011). Athletic training educational competencies (5th ed.). Dallas, TX: Author.

    • Export Citation
  • National Athletic Trainers’ Association. (2017, June 5). Ethnicity demographic data. Retrieved from https://www.nata.org/sites/default/files/ethnicity-report.pdf

    • Export Citation
  • National Prevention Council. (2011). National prevention strategy. Washington, DC: Office of Disease Prevention and Health Promotion. Retrieved from https://www.surgeongeneral.gov/priorities/prevention/strategy/report.pdf

    • Search Google Scholar
    • Export Citation
  • Nynas, S.M. (2015). The assessment of athletic training students’ knowledge and behavior to provide culturally competent care. Athletic Training Education Journal, 10(1), 82–90. doi:10.4085/100182

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Oher, M. (2001). I beat the odds: From homelessness, to the blind side, and beyond. New York, NY: Penguin.

  • Perrin, D.H. (2015). Seeking greater relevance for athletic training education within American higher education and the health care professions. Athletic Training Education Journal, 10(4), 323–328. doi:10.4085/1004323

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Spector, R.E. (2009). Cultural diversity in health and illness (7th ed.). Upper Saddle River, NJ: Prentice Hall.

  • U.S. Census Bureau. (2015, October). U.S. Census Bureau, 2009–2013 American Community Survey: Table 1. Detailed languages spoken at home and ability to speak English for the population 5 years and over for United States: 2009–2013 [Data file]. Retrieved from https://www.census.gov/data/tables/2013/demo/2009-2013-lang-tables.html

    • Export Citation
  • U.S. Census Bureau. (2016). U.S. Census Bureau, 2012–2016 American Community Survey 5-year estimates: ACS demographic and housing estimates [data file].  Retrieved from https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?src=bkmk

    • Export Citation
  • U.S. Department of Health and Human Services, Office of Minority Health. (2018). National culturally and linguistically appropriate services standards. Retrieved from https://www.thinkculturalhealth.hhs.gov/clas/standards

    • Export Citation
  • U.S. Department of Health and Human Services, Office of Minority Health. (2018). What is cultural competence? Retrieved from https://www.cdc.gov/nchhstp/socialdeterminants/docs/what_is_cultural_competency.pdf

    • Export Citation
  • Volberding, J.L. (2013). Perceived cultural competence levels in undergraduate athletic training students. Athletic Training Education Journal, 8(3), 66–70. doi:10.4085/080366

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Volberding, J.L. (2014). Relationship between cultural competence and athletic training students’ confidence in providing culturally competent care. Athletic Training Sports Health Care, 6(1), 31–36.

    • Search Google Scholar
    • Export Citation
  • Volberding, J.L. (2015). Individual, programmatic, and institutional influences on undergraduate athletic training students’ cultural competence. Journal of Cultural Diversity, 22(4), 134–141. PubMed

    • Search Google Scholar
    • Export Citation
  • Wear, D., Zarconi, J., Aultman, J.M., Chyatte, M.R., & Kumagai, A.K. (2017). Remembering Freddie Gray: Medical education for social justice. Academic Medicine, 92(3), 312–317. PubMed doi:10.1097/ACM.0000000000001355

    • Crossref
    • Search Google Scholar
    • Export Citation
  • World Health Organization. (2018). What are social determinants of health? Retrieved from http://www.who.int/social_determinants/en/

    • Export Citation
  • Zong, J., Batalova, J., & Hallock, J. (2018, February 8). Frequently requested statistics on immigrants and immigration in the United States. Migration Information Source. Retrieved from https://www.migrationpolicy.org/article/frequently-requested-statistics-immigrants-and-immigration-united-states#Numbers

    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 33 33 2
Full Text Views 3 3 0
PDF Downloads 1 1 0