The primary aims of this study are two-fold: (a) to understand what role the racial identity of African American graduate students plays in how they perceive the multicultural competence of their faculty mentor; (b) to understand how both the racial identity of African American graduate students and their perception of their faculty mentors’ multicultural competence play in their overall satisfaction in the mentoring relationship. African American participants who are in cross-racial faculty mentoring relationships—will be recruited from programs in rehabilitation counseling, counseling psychology, clinical psychology, and counselor education. The instruments for the study will include the Cross Racial Identity Scale (CRIS), the Alliant Intercultural Competence Scale (ACIS), and the Relationship Assessment Scale (RAS). It is hoped that this study will begin to address current gaps in the literature concerning what constitutes a culturally competent mentor and satisfaction from the protégé’s perspective.

There has been a limited amount of research concerning culture and online education. Although human beings have the ability to transcend past and current environments, helping professions are recognizing the influence of cultural epistemologies on themselves and those they intend to serve. The purpose of this study was to explore the nature of additional challenges and concerns present when designing online instruction in a cross-cultural context. The data collected in this study stands as preliminary work to creating a substantive theory regarding the importance of cultural influences in the thinking, practice and lived experience of instructional designers, specifically those who have been creating cross-cultural online instruction. Twelve participants were chosen through a snowball sampling method, and case studies were constructing mainly through in-depth interviews. All of these participants were aware of cultural differences, although they recognized theirs was a limited awareness. Some of the many cultural differences these participants noticed in learner characteristics and expectations can be loosely separated into the following four categories: (a) technological infrastructure and familiarity, (b) general cultural and social expectations, (c) teaching and learning expectations, and (d) differences in the use of language and symbols. These participants became aware of cultural issues through both informal (unintentional) and formal (intentional) means. These participants felt a tension, however, between their desire to be more responsive to cultural differences, and the situations in which they were working. Three barriers to their ability to be as responsive to cultural differences were identified: (a) an over-focus on content development, (b) a relative lack of evaluation in real-world practice, and (c) the less than ideal roles instructional designers assume in the larger organizational structures involved. From this research, I present a bridge-building metaphor as a description of how an increased sensitivity to cultural differences influences can change the practice of instructional designers. Additional efforts are needed to educate and get buy-in from other stakeholders to engage in more learner analysis and evaluation. And additional models need to be used which put evaluation and learner feedback as a more integral part of the entire instructional design process.

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Cultural competence in health care provision has been broadly identified as the need for providers to acknowledge, address, or incorporate an understanding of the cultural and social context of patients' lives into the process of treating and managing patient's illnesses. However, how cultural competence can be incorporated has been the subject of debates in biomedicine and anthropology, and has often been met with difficulties in physician practice. These challenges arise from differing perspectives about how cultural competence is understood and institutional neglect of culturally relevant education. While the need for cultural competence integration into health care practitioner training during medical school education has been discussed for over six decades, effective incorporation of cultural competence into medical curriculum remains a multifaceted topic of interdisciplinary debate and a challenging task. The purpose of this project is to evaluate cultural competence integration in Southeastern medical school curriculum. Theoretically, this research utilizes critical medical anthropology as developed by anthropologists Arthur Kleinman, Janelle Taylor and Nancy Sheper-Hughes as a theoretical lens through which cultural competency implementation in Southeastern medical school curricula can be examined curricula Southeastern. This research also fills an interdisciplinary gap in both anthropological and medical scholarly knowledge bases. Methodologically, multiple project parameters have been explored utilizing qualitative data collection methods of cultural competence background and evaluation. This research combines primary data collection and secondary data analysis. Primary data collection involved interviewing individuals from Florida medical institutions concerning their experience and personal views of the benefit of cultural competence integration. The analysis of secondary data explored the integration of cultural competence into medical school curricula. These analyses include an examination of the content, format, and language of Southeastern medical school curricula, demographic trends as related to cultural competence in health care, federal grant allocation as related to cultural competence in health care, and institutional perspectives on incorporating social science concepts in medical education. This thesis makes three distinct but interrelated claims: (1) I argue that based on the provided descriptions of medical institution curriculum guides, there is a substantial discrepancy between the cultural competency incorporation claims made by the schools and what is actually integrated into their curriculum; (2) I argue that cultural competence integration must be delivered vertically across disciplines and horizontally across the entire four year span of medical education, and (3) Available ethnographic guides are presented with too narrow of a focus to apply to all medical school curricula. Understanding the shortcomings of medical school curricula in incorporating cultural competence training is significant because it draws attention to the need to develop more effective and systematic ways to train future health care providers to address the needs of an increasingly diverse patient population.

Purpose: The threefold purpose of this research is to identify the essential antecedents of cultural competence as identified by international nurse researchers, to compare the content of the extant cultural competence instruments to these antecedents and to potentially identify gaps in their conceptualization. A secondary aim of this research is to initiate validation of Harper's model of ethical multiculturalism. Conceptual Basis: The model of ethical multiculturalism depicts the attributes of ethical multiculturalism as the fulcrum of a balance between two ethical philosophies of fundamentalism and relativism. The attributes of moral reasoning, beneficence/nonmaleficence, respect for persons and communities, and cultural competence form the pyramidal fulcrum. The antecedents form the base of the pyramid and include cultural awareness, culture knowledge, cultural sensitivity, cultural encounters, cultural skill and understanding of ethical principles. Methodology: An on-line Delphi method was conducted with 35 international nurse researchers identified through published research, university directories, and professional organizations. Consensus was reached after two rounds. Following the Delphi rounds, sixteen members of the expert panel participated in an on-line focus group to validate results of the Delphi and discuss cultural competence in the international arena. Findings: Eighty antecedents of cultural competence were identified. Focus group discussion validated findings of the Delphi. Consensual thematic analysis of the focus group transcripts resulted in six themes: chimerical, contact, contextual, collaboration, connections, and considering impact. The Transcultural Self-Efficacy Tool (TSET) contained the most antecedents identified by the expert panel. Conclusions: Cultural competence is a process, not an outcome, and must be considered from the perspective of the recipient of care or research participant. Nurses must strive to deliver culturally acceptable care. The model of ethical multiculturalism is revised to include cultural desire as an antecedent. Nurses must understand the impact of globalization on individual health and care delivery. Implications for Nursing: Further testing of cultural competence instruments is needed to determine the correlation of self-efficacy with behavior, self-assessment with client assessment, and cultural competence with client outcomes. In education, research is needed to determine the most effective methods of teaching cultural competence. Increased recruitment of minorities into nursing programs is warranted. In practice, nurses must be prepared to provide language assistance as needed, recruitment and hiring of minorities must be increased, and minority thresholds must be used to determine cultural knowledge content for organizations.

Nursing theory has contributed significantly to discussions of so-called culturally competent biomedical healthcare delivery. This study explores how Labor and Delivery nurses at a large, urban teaching hospital negotiate the care of a hyper-diverse patient population and construct working understandings of competence. Archival research, semi-structured interviews and participant observation demonstrate that cultural competence is not a distinct concept, but rather functions as an ambiguous symbol used to discuss a variety of challenges with advocating for patients and delivering care in communities faced with issues of racism, immigration, low socioeconomic status, and multiple comorbidities.

It is well documented that Human Immunodeficiency Virus / Acquired Immune Deficiency Syndrome (HIV/AIDS) disproportionately affects Hispanics and Latinos in the United States (US). While Hispanics represented 17% of the US population in 2014, they accounted for nearly one-fourth (23%) of all new estimated HIV diagnoses. Furthermore, Hispanics/Latinos made up nearly one-fifth (21%) of all persons living with HIV infection in the United States (and six dependent areas). Hispanic/Latino populations face numerous barriers that negatively impact their outcomes along several steps of the HIV care continuum. This paper will discuss the HIV care continuum, particularly focusing on disparities that Hispanic and Latino populations may face progressing through several steps of the continuum. Furthermore, a focus on defining barriers that this population may face accessing and maintaining regular HIV care will be used to explore ways that providers can deliver culturally tailored, appropriate HIV care to this population. An emphasis on the social determinants of health on the HIV outcomes of Hispanics/Latinos will be crucial in addressing the disproportionate share of the HIV burden that this population encounters.

This PhD by published work consists of: • two single authored articles in refereed journals; • four jointly authored articles in refereed journals; • one jointly authored editorial; • one jointly authored book, including four single authored chapters; They were published in the period 2003-2013. Philip Gilligan submitted the jointly written publications as part of his submission for the award of Degree of Doctor of Philosophy by Published Work in 2013. This thesis identifies substantive findings, theoretical insights, new questions and practice/policy implications arising from the published work. The body of work has and continues to stimulate debate about the need to recognise and appreciate the significance and relevance of religion and related belief in the lives of people accessing health and social care services in the UK. It outlines the general relevance and impact of religion and related belief and explores questions and research concerned with the extent to which social work takes these matters into account in its practices, polices and professional training. It prompts practitioners to reflect on their own and others’ religious beliefs by providing a framework of nine related principles to assist them in their professional practice. One key finding is the need for service providers and policy makers to develop new services that are more responsive to the diverse needs of people living in the UK today by recognising and adopting some of the diverse helping strategies employed and imported by different communities. / The full text of the published articles submitted with this PhD thesis are not available in full text in Bradford Scholars due to copyright restrictions.

This thesis aims to provide insight into how academic institutions teach health care professionals about cultural influences on mental health and clinical encounters, as well as how health care providers implement these ideas in their work. Fifteen semi-structured interviews were conducted with mental health care providers in Hamilton. Providers varied significantly in their definition and experience of cultural competence. Few providers had received training in cultural competence, and the experiences of those who had received such training were generally not congruent with what is described in the literature. While the literature describes a shift towards a skills-based paradigm, health care education appears to continue to focus on knowledge and attitudes. Many providers are more familiar with other frameworks for addressing cultural issues; however, these have important implications for quality and access to care for migrant and newcomer individuals. / Thesis / Master of Science (MSc)

No description available.