Practicing Cultural Humility Foundations For Community Health Workers (2nd Edition) (2016) Berthold, T., Editor San Francisco, C.A.: Jossey-Bass Chapter Six Practicing Cultural Humility

Reflection of Last Session What did you learn? What did you find out about your local legislators? Local Safety Net information Intro to health policy and health care systems Have students review what they learned from the last session on these key topics.

What You Will Learn Define the concept of cultural humility Describe the changing population in the United States and how this affects the work of CHWs Discuss how historical and institutional discrimination affects the health of targeted communities and influences their work with public health providers Analyze the importance of becoming life long learners and practitioners of cultural humility

What You Will Learn Discuss and analyze concepts of traditional health beliefs and practices and how they may influence the delivery of services to clients Identify, analyze, and apply models for practicing cultural humility and conducting client-centered interviews, including the Tool to Elicit Health Beliefs and the LEARN Model Create a personal learning plan in order to become a culturally effective CHW

Words to Know Cross-cultural Sexual orientation Gender identity Heterogeneity Structural Racism Structural Discrimination

Community Health Workers (CHWs) CHWs have clients of many different cultural backgrounds and identities. In the communities where CHWs work, many people do not have equal access to opportunities such as education, affordable housing, civil rights, and culturally competent health care.

Cultural Humility is Important Cultural humility requires Studying histories of oppression and discrimination Looking at your assumptions & prejudices Putting your assumptions aside when working with clients Being respectfully to clients Truly understanding cultural diversity takes a personal journey. You must open you mind and heart in order to develop cultural humility.

Defining Cultural Humility Cultural humility is a guide that emphasizes understanding power relationships and cultural identities. Cultural humility is being flexible enough to: Engage in self-reflection and self-critique. Understand that all cultures deserve our respect.

Defining Cultural Humility Admit when you don’t know the culture or social context of clients. Use resources that broaden understanding of cultures in the communities you serve. Recognize that the client is the expert of his/her own culture, values, and beliefs. Put assumptions aside when working with clients. Ask clients to share their own experiences, knowledge, and resources so that you can support their health and well-being.

In the United States… Cultures of the world crisscross on a everyday basis The population is rapidly changing and our diversity is growing This increase in diversity leads to one day the U.S. becoming a “no-majority” country

Understanding Culture Culture includes beliefs, behaviors, attitudes, and practices that are learned, shared, and passed on by members of particular group. Culture is not static… it is dynamic, constantly changing evolving with us. Culture includes ethnic identity, immigration status and experience, sexual orientation, gender identity, religion or spirituality, social class, family background, language, physical ability, traditions, etc.

Something to Think About… Have you had someone ask you, “Where are you from?” or “What are you?” Have you ever had someone mistakenly assume one of your cultural identities? How did this make you feel? How did you react? If not…put yourself in this person’s shoes.

Take a Few Minutes to Answer These Questions… What types of clients do you think has difficulties in accessing health or social services? Why? What types of clients do you lack experience with and knowledge about? What types of clients are you less comfortable working with? Why? How can you keep personal attitudes and feelings from influencing your work with diverse clients? What can you do to acknowledge your stereotypes and prejudices?

Take a Few Minutes to Answer These Questions… Is it okay to be uncomfortable at times with clients of a particular cultural identity, or does this make you an unskilled CHW? Is it okay to talk with your colleagues when you find that you are challenged in working with a client? How can you learn to accept critical feedback about your work with diverse clients? Being aware of your perceptions of others, your attitudes and behaviors, will help you to work and live in a more culturally appropriate and sensitive manner.

Working With Diverse Clients The LEARN model is a guide to use with diverse clients: Listen with sympathy and understanding to the client’s perception of the problem Explain your perceptions of the problem Acknowledge and discuss the differences and similarities between your perceptions and that of the client Recommend resources Negotiate agreement

Faculty Interview: Cultural Humility

Role Play 1: Nutrition and Culture

Role Play 1: Nutrition and Culture Review What happened between the client and the CHW in this role play? What mistakes did the CHW make in terms of demonstrating cultural humility? What would you do differently to support the client? How would you demonstrate cultural humility?

Role Play 2: Depression, Religion, and Cultural Humility

Role Play 3: Depression, Religion, and Cultural Humility

Role Plays: Depression, Religion, and Cultural Humility – Review What mistakes did the CHW make in the first role play? How may the lack of cultural humility impact this client, or the relationship between the client and the CHW? What did the CHW do differently in the second role play? What else would you do to demonstrate cultural humility and support this client?

Practice  Step outside your comfort zone! Partner with someone in class to visit a neighborhood, church or family different than your own. Complete Chapter 6 HW & DB in Blackboard Read Chapters 7 & 8

Resources: Image on slide 2 digital-drugs-binaural-beats by digitalbob8 is licensed under CC BY 2.0 Image on slide 3 Bring Light Bulb is available in the public domain under CC0 Public Domain Video on slide 15 Cultural Humility: Faculty Interview, Foundations by Foundations for Community Health Workers is licensed under a Standard YouTube License Video on slide 16 Nutrition and Culture: Role Play, Counter, Foundations by Foundations for Community Health Workers is licensed under a Standard YouTube License Video on slide 18 Depression, Religion and Cultural Humility: Role Play, Counter by Foundations for Community Health Workers is licensed under a Standard YouTube License Video on slide 19 Depression, Religion and Cultural Humility: Role Play, Demo by Foundations for Community Health Workers is licensed under a Standard YouTube License Image on slide 14 16th c oak door from Rowallan Castle, RSM by Stephencdickson is licensed under CC BY-SA 4.0

Acknowledgements: MoSTEMWINs Adapted from the Foundations for Community Health Workers, 2nd Edition (Berthold) with permission from Wiley Publishing by the Institute of Workforce Innovation of the Metropolitan Community College Kansas City and the Workforce Solutions Group of St. Louis Community College. Unless otherwise noted this material by St. Louis Community College is licensed under a Creative Commons Attribution 4.0 International License. This product is partially funded by the MoSTEMWINs $19.7 million grant from the U.S. Department of Labor Employment and Training Administration. The product was created by the grantee and does not necessarily reflect the official position of the U.S. Department of Labor. The Department of Labor makes no guarantees, warranties, or assurances of any kind, express or implied, with respect to such information, including any information on linked sites and including, but not limited to, accuracy of the information or its completeness, timeliness, usefulness, adequacy, continued availability, or ownership MoSTEMWINs