Achieving cultural proficiency: The intersection of health and culture

This is the third in a series of 2019 "Fresh Perspectives" blog posts presented by the de Beaumont Foundation. The posts, leading up to APHA’s 2019 Annual Meeting and Expo, feature perspectives from some of the inaugural “40 Under 40 in Public Health” leaders, which were announced by the foundation in May. Today’s post is by Jovonni R. Spinner, MPH, CHES, public health advisor with the U.S. Food and Drug Administration's Office of Minority Health and Health Equity.

Improving health among diverse populations is only possible with effective communications, tailored messaging and careful consideration of communications methods.

In the Office of Minority Health and Health Equity at the U.S. Food and Drug Administration, we aim to create a world where health equity is a reality for all, with a strong focus on reducing health disparities.

During my time at OMHHE, I’ve been proud to be a part of a team that uses new digitally focused outreach strategies to disseminate information about health issues to diverse communities. At the APHA Annual Meeting, our team will present our findings during session 3279, “Public Health Agencies’ Use of Innovative Communicative Approaches for Improving Public Health.” I hope you’ll join us on Nov. 4 from 1- 2:30 p.m.

In the meantime, I want to share a few highlights of the trainings we hold for health professionals. Our work addresses the intersection of health and culture. “Culture” encompasses the beliefs, customs, values, language and practices that a group of people share. This can include things we can see like behaviors and practices, language or food, for example.

Other things, like attitudes toward authority, religion, concept of family and approaches to decisionmaking, may not be easily visible or understood. But what does culture have to do with health? Health and culture intertwine in many ways.

For example, culture influences:
• how patients view health,
• patient and provider communication and shared decisionmaking,
• adoption of health promoting behaviors,
• how illness and pain are experienced or expressed,
• when and how someone seeks medical attention and
• the degree of understanding and compliance with treatment options.

All these examples showcase why it is important to appreciate and understand different cultures when designing health education materials, tools and resources. It helps better assist people in making decisions about their health for themselves and their family.

Our office focuses on providing education and resources to racial and ethnic minority groups. We know these groups may have difficulty accessing or using health education materials due to culture and language barriers. So not only is it imperative to have culturally and linguistically tailored health education materials, but also we need to be savvy in how we disseminate these materials.

With the belief that education starts at home, OMHHE developed an internal training for FDA staff to address these issues and ensure that we are being culturally aware to meet the needs of our diverse consumers.

Our training is called “Communicating with Confidence: Strategies to Create Effective Communications for Diverse Audiences.” It aims to increase knowledge, attitudes and behaviors around cultural competency and its importance; the role of cultural competency in determining health communication sources, messages and channels; and how to create a culturally competent strategy and plan of action for staff to complete their work.

We want to make sure we understand the impact that culture has on the health of our communities. We need to be able to competently communicate complex health information in a way that diverse groups can understand and act upon.

During the training, participants exchange ideas in a safe space, exploring what it means to be culturally competent and how implicit biases can impede our work. Participants gain skills, awareness and sensitivity to cultural needs to improve their communication with diverse audiences.

Cultural competency is a continuum that ebbs and flows. It is highly dependent upon the individual to recognize cultural differences and to seek advice from diverse groups to learn about these differences. This is how we move toward cultural proficiency.

Through this exploratory and reflective process, we can implement changes to improve culturally tailored services. This is the intent of our training, and based on initial feedback, we were highly successful!

Participants share that this is a one-of-a-kind interactive training experience that really helps shape their perceptions of how culture impacts health and move them toward becoming culturally proficient.

To bridge the health divide, we must not shy away from addressing culture as a factor in improving health outcomes. This training is one of many strategies we employ at FDA to create a world where health equity is a reality.

We aim to purposefully remove barriers to ensure our communities have the best quality and credible health information available. We look forward to sharing more information during our presentation at APHA’s Annual Meeting.

The "Fresh Perspectives" blog series is presented by the de Beaumont Foundation, a private foundation that advances policy, builds partnerships and strengthens public health to create communities where people can achieve their best possible health. For more information, visit www.debeaumont.org.