Diabetes is a worldwide epidemic, especially as the prevalence of Type 2 diabetes has increased in recent years. Minorities are disproportionately affected by the disease and, at the same time, often have less access to resources including medication and education. The Emory Latino Diabetes Education Program (ELDEP) is a culturally component diabetes education program aimed at promoting increased knowledge about diabetes disease management within the Latino population of metropolitan Atlanta. The program considers cultural competence and acculturation theory in its learning structure. The purpose of this study was to evaluate ELDEP’s effectiveness in increasing knowledge of diabetes, healthy behaviors, and disease management in the study population. The study evaluated changes in knowledge for those participants who attended only the initial intervention and those patients who attended both the initial session and at least one follow-up intervention. Data was collected through a selfreport questionnaire completed by patients at the beginning of each intervention session. The results of this study indicate that specific participant characteristics may be associated with attendance at follow-up sessions. Participant knowledge about certain factors related to diabetes also increased. Based on these results, recommendations will be made to the program staff at ELDEP.

Dissertation (Ph.D.)--The University of North Carolina at Greensboro, 2008. / Title from PDF t.p. (viewed Aug. 14, 2009). Directed by Debra Wallace; submitted to the School of Nursing. Includes bibliographical references (p. 121-135).

Background: In the United States, minorities are numerous and account for 28% of the population. It is well known that some of the cultural elements are related to the patients’ health. Therefore, it is an obligation of healthcare providers to become culturally competent to improve minorities’ overall healthcare. PURPOSE: This study was conducted to assess the cultural attitudes, skills, and knowledge of undergraduate and graduate respiratory therapy (RT) students at an urban university located in the southeastern United States. METHODS: The study used a descriptive exploratory design with a self-reporting survey. The survey instrument used was a short version of the Cultural Competence Self-Assessment “ASK” (Attitude–Skills–Knowledge) Scale. The survey was administered to a convenience sample of first and second-year BSRT and MSRT students attending an accredited RT program. The survey consisted of 24 items on a five-point Likert scale. The collected data were analyzed using descriptive statistics and independent samples t-test. RESULTS: Fifty-three students were surveyed; around two-thirds of the respondents were female. Sixty-eight percent of respondents were BSRT and 22% were MSRT students. First-year students accounted for 56.6% of the respondents and second-year students accounted for 43.4%. The majority of the respondents were under the age of 25. The respondents reported to be ready to practice in the attitude and skills subscale (4.49±.49, 4.20±.62 respectively) but they need practice based on the knowledge subscale (3.80±.86). The statistically significant findings were found between first-year and second-year respondents in the skills subscale, knowledge subscale, and the total scale. However, there were no statistically significant difference between BSRT and MSRT students. CONCLUSION: This study found that respondents made progress throughout the RT program. Also, it found that level of education has no effect on cultural competency. This may be because student’s level of cultural competence improves as they advance in their clinical course work and their educational training. The results may assist RT educators to recognize the students’ needs for more information to improve their cultural competency.

Racial health disparities and social injustices in health care continue in the United States (US) despite decades of research, policies, and programs dedicated to their elimination (Feagin & Bennefield, 2014). Cultural competency education of health care providers has been one way purported to help sensitize professionals to these inequities, thus seeking to address racial bias, unequal treatment, and misunderstandings of minority populations (Office of Minority Health, 2001). Such education can begin when students enter academia to commence their health care education, and certainly occurs as a student moves on through their academic career, particularly as they enter their post-graduate level studies. Investigating the required cultural competency course of a Master of Public Health (MPH) program through the perspectives of faculty, current students, and alumni for its ability to develop culturally sensitive health care practitioners was the aim of this case study. Document analysis and direct observation of the one cultural competency course required for all concentrations in one MPH program was undertaken. This was a semester-long course and was offered face-to-face and online; both were observed. In-depth interviews of faculty, current students, and alumni of the same program were also conducted. Using the public health critical race (PHCR) praxis theoretical framework (Ford & Airhihenbuwa, 2010b), data was analyzed to determine how, and to what extent, faculty teach cultural competency, students internalize this instruction, and alumni put this education into practice. By using a critical theoretical framework designed for public health program development, this study found that such a framework has effective utility as a curriculum – this framework could be used to increase students understanding of racial issues that impact health and health care. Data also revealed a schematic believed, by faculty, students, and alumni, to be important for the development of cultural competence. The findings also point to the importance of creating space in the classroom for both minority and majority voices to feel free to express difficult issues without repercussions of stereo-typing and name-calling; and for faculty to be able to effectively deal with such discourse. Curriculum that addresses issues of health disparities and social justice, classroom praxis, and faculty role-modeling can be combined to create the institutional environment where culturally sensitive and socially just health care practitioners may emerge.

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.

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Wellbriety is a multifaceted concept utilized in Native American communities that demonstrates meanings of health in Native-based discourse. Conceptually, wellbriety symbolizes strength through resilience. During this ethnographic study, I spent two years working within an Urban Indian Health Service facility where I used community-based participatory research methods. I examined complex intersections between meanings of urban native identities, colonization, and tribal sovereignty. Through deconstructing structural violence, I seek to place current urban native health status in a socially-informed context. This research explores how Native peoples define wellbriety and wellness through the lens of healthworld, which addresses how Native communities attempt to heal from traumas inflicted by the U.S. Federal Government. Additionally, I analyze dimensions of food sovereignty among Native community members by exploring how the act of consuming food shapes social and identity meanings which impact community members’ health.

Considering the geographical setting of the Southern region of the U.S., which is mostly divided into two races, Black and White, this study is to examine human science-related major undergraduates’ cultural competence and attitude toward the intersectionality group, elderly immigrants. The data, a total of 444 human science related major undergraduates in Mississippi, were collected. Through the principal factor analysis, attitudes toward elderly immigrants were divided into three factors: discrimination, avoidance, and tolerance, and cultural competence was into attitude, awareness, and sensitivity factors. The further related data analysis is to be completed by spring 2020. Through the study, it is expected to increase awareness of the need for culturally competent programs to educate the students on diversity and help to prepare undergraduate students to meet societal demands related to the intersectional minority population in the future.

Despite American College of Radiology guidelines for breast cancer screening, the Appalachian Kentucky population has an increasing number of advanced stage breast cancer diagnoses related to a delay in mammogram screening initiation. A potential contributing factor for the delay in screenings is a lack of culturally competent care to support the need for early detection of breast cancer in the identified population. The purpose of this staff education project was to improve the knowledge base and skill set of health care employees concerning the most advantageous practice to increase cultural competence in the health care setting. A practice-focused question related to cultural competence through staff education as well as current research served as the foundation for this evidence-based project. Leininger's cultural care theory, Knowles's adult learning theory, and Kirkpatrick's 4 levels of training evaluation provided guidance for the project. Using the cultural competency checklist of 20 questions, the pre- and posttest responses of participants (n = 14) in the employee orientation setting were assessed to determine the outcomes of the staff education project. Statistical analyses were performed using a 2-sample proportion hypothesis test for each result, positive and negative responses, and a mean hypothesis test on weighted responses. In each statistical analysis, a significance level of .05 (5%) was reported. As a result of the statistical outcomes, permanent implementation of a staff education program to increase cultural competence, create social change through cultural awareness, and aid in decreasing advanced stage breast cancer diagnoses in the Appalachian Kentucky population was recommended.