Running head: HEALTH EDUCATION 1

Health education on cultural competence

Student’s Name:

Institutional Affiliation:

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Society is diversifying at a higher rate, which offers unlimited opportunities for growth

and development, but it also presents new challenges in different sectors. With advancements

towards quality health care, cultural competence is a significant concept that may improve access

to healthcare and increase the effectiveness of interventions when dealing with patients from

minority groups (Truong, Paradies & Priest, 2014). Cultural competence acknowledges the

different cultural, linguistic, professional, and organization complexity barriers between

caregivers and patients, which inhibits safe and quality healthcare delivery. The consequence of

such obstacles is that they propel inequalities and discrimination, which are outcomes not

required in the current society. This paper aims to outline the implementation of a program to

teach health care professional cultural competence in a long term care facility in Westfield,

Massachusetts. The program will target the elderly Hispanic population as they are the most

vulnerable in the largest minority group.

Assessment of the situation and community.

Westfield, MA, has a population of about 41,667, with a medium household income of

about $62,212 and a poverty rate of about 8.46% (Census Bureau, 2020). The population of the

community is 86.4% whites, 8.33% Hispanic, and 2,22% Asians. Most people commute on the

drive alone for an average of 21.1 minutes, with an average of 2 cars per household. Over 90%

of the population in Westfield, MA, have health coverage either in employee plans, Medicaid,

Medicare, non-group, and military plans (Census Bureau, 2020). Hispanics represent the largest

and fastest-growing minority group, which calls for special attention. The majority of the elderly

Hispanic patients do not have fluency in the English language and mainly speak Spanish, a

culture that they have extended to their homes since the younger generations have fluency in

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both Spanish and English languages. Nurses, therefore, have to strive to meet the needs of that

specific group as they have a right to health care, health literacy, and increased access.

A situation that I have observed in our long term care facility is a surge in caregivers

from diverse backgrounds, including whites, Hispanics, Asians, Indians, African Americans, and

other races, which creates a challenge in communication and cultural understanding. The elderly

Hispanic patients are most vulnerable in our facility as they suffer from different chronic

conditions with diabetes and hypertension, taking the majority cases. I observe that caregivers

from diverse backgrounds struggle to understand the Hispanic elderly and end up seeking help

from family members, a factor that lengthens patient waits and time wastage since nurses with

Spanish competency may be busy elsewhere. Most times, the Hispanic elderly admit to not

seeking health services since they have difficulties understanding and expressing themselves and

navigating the healthcare system due to cultural, educational, and language barriers.

The role of nurses is to improve the wellness of the community, hence the best approach

to reaching and helping the elderly Hispanic population would be through the incorporation of

cultural competence education programs in the diverse pool of staff. The expected outcomes are

that it will improve the elderly Hispanic utilization of healthcare facilities, better relationships

between patients and practitioners, caregivers would understand the Hispanic culture, improved

patient outcomes, and staff satisfaction (Handtke, Schilgen & Mösko, 2019). Availing

interpreters would be efficient to providers and patients that do not understand English. The

elderly tend to use media that use Spanish; hence using health promotion methods that combine

English and Hispanic would fast spread the intended awareness to the target population.

Hispanics in the community live as an extended family of grandparents, uncles, aunts, cousins,

and godparents, which using the two languages will be efficient.

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The theoretical framework for diagnosis

In order to provide culturally competent care, it is best to understand the values, beliefs,

and healthcare practices of the Hispanic people. The transcultural Assessment model advanced

by Giger and Davidhizar provides a base in which the nurses can be educated on the culture of

Hispanics and the practices if the elderly. The model focuses on the aspects of communication,

biological variations, space, social organization, time, and environmental control (Albougami,

Pounds & Alotaibi, 2016). The afore-mentioned aspects determine the perspectives on sickness,

health, disease prevention, adherence to treatment, and health-seeking behavior. Impacting

nurses from different backgrounds with all the cultural elements of the Hispanics would increase

their competence in understanding the patient’s physical, psychological, and spiritual needs, and

most importantly, their communication methods. This will aid in providing culturally specific

care, which leads to improved outcomes.

Planning

Nurses have the capacity to be pioneers of change to improve patient care, and training

them in cultural competence would facilitate the successful transition of the facility. The primary

objective of the nurses’ education program is to ensure that they foster a habit of safety and clear

communication, which aims to overcome language and literacy barriers of the elderly Hispanic

patients (Truong, Paradies & Priest, 2014). The plan will also involve the use of interpreters to

aid the nurses in proper diagnosis, treatment, and patient education. The other idea is to provide

nurses with the competency to use and provide educational materials in Spanish to facilitate

caring communication to manage and control chronic illnesses. Nurse education will start as a

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small program that will be enhanced in the long run in order to be part of the organization's

culture.

The outcomes of the program can be assessed in provider related results, outcomes

related to healthcare access and utilization, and patient-related outcomes (Truong, Paradies &

Priest, 2014). Measuring provider associated issues in terms of knowledge and attitude of

Hispanic culture would be difficult since some aspects such as attitude, implicit bias, and ethnic

identity are not measurable. The SMART goals that will be utilized are on client outcomes since

they are situations that can be assessed based on patient improvement and reporting (Truong,

Paradies & Priest, 2014). The other SMART goal will be evaluated based on the number of

elderly patients that seek, access, and utilize outcomes. The evaluation of the caregiver’s

education program will be based on the difference in patient outcomes and health service access

and utilization outcomes before and after the project was implemented.

Implementing health education activity.

Implementing the Hispanic cultural competency educational activity will only take place

after the planning is over. Planning has to consider the involved stakeholders, budget, venues,

speakers, materials to be used, cost of publicity, and audio-visual support material. The

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implementation process will be dictated by the number of nurses that will be involved, the

availability of facilities and nurses, scheduling of guest speakers of Hispanic origin, and among

other resources. The education and training program is expected to run for a month, and a large

amount of material will be provided to the trainees as reference material. Training will be

scheduled to favor nurse availability with minimal disruption on the duties of the long term care

facility. Nurses. Program reminders and confirmation of attendance will be done a week before

the program starts.

Evaluation of SMART goals.

The evaluation of the outcomes of the program is not expected to be immediately after

the program but somewhat after two to three months to have ample time to collect patient

outcomes on their chronic problems of obesity and hypertension data and assess the number

elderly patients that seek, access, and utilize outcomes. The compiled data will be compared to

that collected before implementation of the education program, and inference will then be made.

The expected goals of the program are that the nurses’ competency in Hispanic culture,

availability of Spanish material, and the work of the interpreters will increase the number of

elderly patients that seek and access healthcare and that the positive outcomes cases of improved

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health will surge due to adherence to treatment guidelines. Such outcomes will prove that the

program was successful, while negative results will demonstrate the inefficiency of the program.

Reflection

Implementing a culturally based education program in a clinical setting with diverse staff

has its strengths and challenges, which are appropriate to acknowledge in order to develop better

approaches in the future. The objective of the course, choice of speakers, materials used, and

availability of resources do much favor the support and continuity of the education program. The

weakness likely to occur with my approach is that of scheduling for different nurses, speakers,

and lack of objective criteria to assess nurses’ competence and understanding of Hispanic culture

and ability to implement in a clinical context. A nurse’s perspective can be clouded by their

different customs, bias, attitude, and their ability to grasp and relate concepts (Handtke, Schilgen

& Mösko, 2019). Continuous collection of information through assessments offer new

opportunities on how objectives, goals, and outcomes have or have not been achieved to make

informed decisions that will improve the program. What I would alter in my program is on

schedule for speakers and staff based on their availability and better ways of evaluating nurse’s

competency in culture care.

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References

Albougami, A. S., Pounds, K. G., & Alotaibi, J. S. (2016). Comparison of four cultural

competence models in transcultural nursing: A discussion paper. International Archives

of Nursing and Health Care, 2(3), 1-5.

Census Bureau. (2020). Westfield, MA | Data USA. Retrieved 8 April 2020, from

https://datausa.io/profile/geo/westfield-ma#health

Handtke, O., Schilgen, B., & Mösko, M. (2019). Culturally competent healthcare–A scoping

review of strategies implemented in healthcare organizations and a model of culturally

competent healthcare provision. PloS one, 14(7).

Truong, M., Paradies, Y., & Priest, N. (2014). Interventions to improve cultural competency in

healthcare: a systematic review of reviews. BMC health services research, 14(1), 99.