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• Diversity and Cultural Competence in Health Care: A Systems Approach
• Copyright
• Contents
• Figures and Tables
• List of Figures
• List of Tables
• Preface
• Who Should Read this Book?
• How this Book is Organized
• Challenges to the Students
• Acknowledgments
• The Authors
• Part One: The Diversity Imperative
• Chapter 1: Systems Approach to Cultural Competence
• Dimensions of Diversity
• Ethnicity and Race
• Gender
• Sexual Orientation
• Age and Generation
• Socioeconomic Status
• Language
• Religion
• Health Care Diversity Challenges
• Health Care Disparities in the United States
• Changing the US Health Care System
• Systems Approach in the Health Care Delivery Organization
• The Importance of Leadership
• Summary
• Key Terms
• Review Questions and Activities
• References
• Chapter 2: Systematic Attention to Health Care Disparities
• What Are Health Care Disparities?
• Race and Ethnic Disparities in Health Status
• Socioeconomic Sources of Racial and Ethnic Differences in Health Status
• Genetic Differences as a Source of Racial and Ethnic Variation in Disease Risk
• Racial and Ethnic Disparities in Health Status as the Focus of National Attention
• Disparities Across Other Diversity Dimensions: Gender, Sexual Orientation, the Elderly
• Health Care Disparities Associated with Gender
• Health Disparities Among Lesbian, Gay, Bisexual, and Transgender (LGBT) People
• Health Issues Unique to the Aging Population
• Stakeholder Attention to Health Care Disparities
• Systematic Strategies for Reducing Health Care Disparities
• Summary
• Key Terms
• Review Questions and Activities
• References
• Chapter 3: Workforce Demographics
• Trends in the US Labor Force
• Diversity and the Health Professions
• Drivers of Disparities in the Health Professions
• Checklist of Recommended Organizational-Level Actions
• Workforce Diversity Challenges
• Summary
• Key Terms
• Review Questions and Activities
• References
• Part Two: The Development of Cultural Competence
• Chapter 4: Foundations for Cultural Competence in Health Care
• What Is Cultural Competence in Health Care?
• The Meaning of Culture in Cultural Competence
• Culture and Concepts of Health and Illness
• Culture, Categories, Complexity, and Confusion
• Subcultures: An Important Part of Most Cultures
• Acculturation as an Aspect of Cultures in Contact
• Cultural Competence and Immigrant Populations
• Culture Is Best Discovered in Local Populations
• Long Journey Toward Cultural Competence
• Cultural Competence and Disparities Reduction
• Cultural Competence and Changing Delivery Models
• National Institutional Support for Cultural Competence
• Cultural Competence and the Health Care Provider Organization
• Cultural Competence and the Multicultural Health Care Workforce
• Summary
• Key Terms
• Review Questions and Activities
• References
• Chapter 5: Hallmarks of Cultural Competence in Health Care Professionals
• Personal Journey of Cultural Competence
• A Dilemma for the Health Care Professional
• Readiness for Self-Development
• The Challenge of Implicit Bias
• Professional Values as a Foundation for Cultural Competence
• Psychology of the Health Care Professional
• Human Fear of Difference and the Culture of Exclusion
• Framework for Role Development
• Person
• Context
• System
• Role
• Journey of Self-Discovery
• Person: Who Am I?
• Context: What Influences Me?
• System: What Structure Do I Operate In?
• Summary
• Key Terms
• Review Questions and Activities
• References
• Chapter 6: Training for Knowledge and Skills in Culturally Competent Care for Diverse Populations
• Eight Principles for Knowledge and Skills Training
• Cultural Competence Knowledge and Skills for Administrators and Directors
• Cultural Competence Training for Health Care Professionals in Direct Patient Care
• Support from the Clinical Professions
• Cultural Competence Training in Clinical Education
• Strategies for Training Health Care Professionals in Culturally Competent Care: A Knowledge Base and
• Considering the Universal Aspects of Culture That Affect Health Care
• Some Tools Useful in Teaching Cultural Competence to Health Care Professionals
• Obstacles to Cultural Competence Training for Health Care Professionals
• Cultural Competence Training for Support Staff
• The Role of Assessment in Cultural Competence Training
• Summary
• Key Terms
• Review Questions and Activities
• References
• Part Three: Cultural Competence and Health Care Delivery
• Chapter 7: Cultural Competence in Health Care Encounters
• Models from Transcultural Nursing
• Leininger’s Sunrise Model
• Purnell Model for Cultural Competence
• Campinha-Bacote’s Process of Cultural Competence in the Delivery of Health Care Services
• Jeffreys’ Cultural Competence and Confidence (CCC) Model
• Andrews and Boyle’s Transcultural Concepts in Nursing Practice
• Giger-Davidhizar Transcultural Assessment Model (GDTAM)
• Communication
• Space
• Social Organization
• Time
• Environmental Control
• Biological Variations
• Being Culturally Responsive
• Summary
• Key Terms
• Review Questions and Activities
• References
• Chapter 8: Language Access Services and Crosscultural Communication
• Language Use in the United States
• Language Differences in Health Care Encounters
• Attitudes Toward Limited-English Speakers
• Changing Responses to Language Barriers in Health Care
• Major Resources for Providing LAS
• Model Systemic Approaches to LAS
• An Expanding Profession: The Health Care Interpreter
• Translation in Written Health Care Communication
• Communication Is More Than Words
• Communication of Culture and Meaning
• Summary
• Key Terms
• Review Questions and Activities
• References
• Chapter 9: Group Identity Development and Health Care Delivery
• Research Highlights
• Minority Status Group Identity Development
• Conformity
• Dissonance
• Resistance and Immersion
• Introspection
• Synergy
• Majority Status Group Identity Development
• The Acknowledgement of Privilege
• Establishment of a Positive Majority Group Identity
• Using the Models
• Summary
• Key Terms
• Review Questions and Activities
• References
• Part Four: Cultural Competence and the Health Care Organization
• Chapter 10: The Centrality of Organizational Behavior
• The Science of Organizational Behavior
• Organizations as Contexts for Behavior
• OB Research Highlights
• Leadership and Diversity Management Strategies
• Teams and the Performance of Groups
• Need for Additional Research
• Can Culturally Competent Health Care Professionals “Go It Alone”?
• Enable
• Cultivate
• Reinforce
• Summary
• Key Terms
• Review Questions and Activities
• References
• Chapter 11: The Business Case and Best Demonstrated Practices
• Evolution of the Business Case
• The Business Case for Cultural Competence in Health Care
• Cultural Competence and Expanded Health Plan Market Share
• Reductions in the Cost of Health Services and Increases in the Efficiency of Service Delivery
• Reduction of Health Care Disparities and Improved Health Outcome for Minority Populations
• How Different Is the Health Care Business Case?
• Workforce, HRM, and the Business Case
• Landmark Publications
• Early Pioneers
• Best Demonstrated Practices
• DiversityInc Selection Criteria
• Top Three on the 2012 DiversityInc Top Fifty Companies for Diversity List
• Top Five Health Systems List
• Assessment and the Systems Approach
• Benchmarking
• Role of Metrics in the Systems Approach
• Application of Six Sigma and DMAIC
• Summary
• Key Terms
• Review Questions and Activities
• References
• Chapter 12: The Future of Diversity and Cultural Competence in Health Care
• Trends That Support Widespread Adoption of the Systems Approach
• Trend One: The Demographic Imperative Is Well Established
• Trend Two: Diversity Is Increasingly Nuanced, Complex, and Multifaceted
• Trend Three: Support for Inclusion Is Broad Based and Growing, Especially Among the Young
• Trend Four: Mandates Continue to Grow in Breadth and Depth
• Trend Five: The Business Case for Diversity Continues to Build
• Trend Six: Global Interest in Diversity and Cultural Competence in Health Care Is Growing
• The Sustainability Movement and the Systems Approach
• Change Management and Force Field Analysis: Tools to Envision and Shape the Future
• Summary
• Key Terms
• Review Questions and Activities
• References
• Glossary
• Index