Department
of Health and Community Services
MULTICULTURAL HEALTH
HCSV &
MCGS 328-01 Spring 2008
Tuesdays/Thursdays
12:30-1:45 pm
Professor: Dr. Lyndall Ellingson Office
Hours: Tuesday, Wednesday, Thursday10am - 12 pm
Office: 637 Butte
Hall Office
Phone: 898-6310
Mailbox: 607
This course will focus on the impact
of cultural variables on health and illness.
Further, this course will focus on those problems that affect African
Americans, Latinos, American Indians, and Asian Americans. The effects of history, health beliefs and
practices, and socioeconomic status on the health of different ethnic
populations will be addressed. The
emphasis in the reading collections is on changing perceptions, giving voice,
and addressing issues of racial discrimination. Current and potential
strategies to improve health care delivery to these groups will be explored. We
will often discuss topics that are sensitive, but critical, to cogent
discussions about race, ethnicity and health. Each of you is asked to be
mindful that we are a diverse group and that each person deserves your respect.
Required Text:
Huff, R. M. & Kline, M. V. (1999). Promoting Health in Multicultural
Populations: A Handbook for Practitioners. Sage Publications
Required: Functional
The CRAAP Test
(a way to analyze the appropriateness of website for use in academic papers):
http://www.csuchico.edu/lins/handouts/evalsites.html
A. The student will discuss the effects of history, cultural
assimilation patterns, and health beliefs and practices upon the health status
of underrepresented ethnic groups in the
B. The student will evaluate the effectiveness of the health
delivery system in meeting the health needs of major ethnic groups in the
C. The student will describe the nature and extent of health
disparities between U.S. Whites and non-Whites.
D. The student will examine health agencies and organizations
that are responsive to the needs of multicultural groups in the
E. The student will analyze the various cultural, social,
political, environmental and economic forces with impact the health of
F. The student will compare the effects of several major health
concerns common to ethnic groups in the U.S: infant mortality, AIDS, heart
disease, cancer, drug abuse, etc.
G. The student will assess the effect of prejudice and
discrimination upon the health and the delivery of health care services to
underrepresented groups in the
H. The student will identify personal stereotypical thinking,
common prejudices, and ethnocentrism and its negative impact upon the health and
delivery of services to ethnic groups in the
I. The student will examine one's own cultural backgrounds and
world view as related to communication with others.
J. The student will identify assets and strengths within
K. The student will develop cultural sensitivity (awareness of
differences) and become culturally competent (skillfully interact with other
ethnic/cultural groups). The student
will articulate a personal vision for improving or enhancing the health status
of communities of color in the
A. Attendance
Attend
each class, contribute to class discussions, and participate in planned
activities. Attendance will be
recorded. More than 2 absences will result in a penalty of a reduction of 1/3
final letter grade for each class period missed.
Our academic schedule is based on Western Christian
religious/cultural traditions, for example we do not meet on Sundays,
Christmas, Easter, etc. This can create
an additional burden on those students who practice other religious/cultural
traditions because they must either miss class, ask permission to miss class,
or miss important religious/cultural ceremonies and events. Please do not
hesitate to inform me of an expected absence required to follow the tenets of
your faith &/or culture. This absence will not be officially recorded as
such. However, any required academic work should be submitted in advance and
will be considered late if not submitted by the due date.
There are 3-4 articles assigned per week. For each article there are questions that must be answered. The articles and questions are on WebCT. Prepare for classroom discussion by reading, answering questions and reflecting on article assignments. Article answers and reflections are due at the beginning of the class period noted in the syllabus. Each submission should include:
1.
Your name,
article #s & titles
2.
Typed,
single-spaced answers to the assigned article questions.
3.
Your reflection regarding ONE article per weekly assignment
(especially how it affects your previous opinions or professional life).
C. Exams (2 @ 120 pts each)
Participate in 2 exams at the appointed time. The
examinations will be multiple choice and/or essay. Make up exams will only
be given under dire emergencies with prior approval and with documentation and
are administered during finals week at your professor’s convenience. See
D. Panel
Project (120 pts)
Students will be assigned to panel groups to understand
peoples of diverse cultures and to find ways health
educators/administrators/health care professionals can most effectively serve
their clients.
o
Panel groups
will present a 60-minute presentation on one assigned ethnic group. Everyone must participate equally to the
overall presentation. The panel should
consider itself as a whole and not as segmented parts to insure completeness
and avoid duplication in the oral presentation.
The focus of your research relates to health professionals and how we
may best serve. Consequently, what
information makes this culture different from the dominant culture? What are the experiences and assets of this
culture relative to the dominant culture? Determine what exceptional data we
need to know. IMPORTANT! See more detailed instructions in Section II of this
syllabus.
E. Service
Project (30 points)
You will
be creating and implementing a service project this semester related to
multicultural health and empowerment.
Projects options vary each semester and I will announce these during
class. In the past these have included…
1)
Designing
a culturally specific and competent educational pamphlet addressing a
particular health issue for a minority group
(ethnic/religious/disabilities/gender/sexual). These are designed specifically
for area health services agencies and are often translated. For example:
a. A nutrition pamphlet in Hmong for Hmong Americans
b. A domestic violence pamphlet for the hearing impaired
c. Prenatal care services in Spanish.
d. Mental health services in Cambodian.
2)
Design
and implement a nutrition and activity day for children at the Gridley
migrant farm community
3)
Design
and staff an educational booth on HIV/AIDS among ethnic minority
communities for Worlds AIDS Day
4)
Design
bus posters promoting the services of a local agency for an
ethnic/religious/disabilities/gender/sexual minority group.
5)
Participate
and contribute to culturally empowering/health education/health care related
events in the community.
F. Cultural
Event (15 pts)
Attend a
non-western cultural/ethnic public event in the
Course
Evaluation
Panel project 120
Articles 170
Exam #1 120
Exam #2 100
Service project 30
Cultural Event 15
Total 555
B+ = 88
- 89% C+ = 78
- 79% D+ = 67
- 69%
A = 94
- 100% B = 84
- 87% C = 74
- 77% D = 64
- 66%
A- = 90
- 93% B- = 80
- 83% C - = 70
- 73% F = 63%
or less
|
Date |
TOPIC
|
ASSIGNMENTS |
|
|
1/29 |
|||
|
1/31 |
|||
|
2/5 |
|||
|
2/7 |
|||
|
2/12 |
Cultural Power & Privilege |
||
|
2/14 |
Cultural Power & Privilege |
||
|
2/19 |
RP 7-9 |
|
|
|
2/21 |
|
|
|
|
2/26 |
RP
10-12
|
|
|
|
2/28 |
|
Ch 2
|
|
|
3 /4 |
RP 13-15
|
|
|
|
3/6 |
|
Ch 5 (pgs 103-107)
|
|
|
3/11 |
Cultural
Competency
|
RP 16 |
Ch 26 |
|
3/13 |
Exam 1
|
|
|
|
|
SPRING BREAK |
||
|
3/25 |
Service Project Orientation/Exam
review |
|
|
|
3/27 |
Perspectives of Indigenous
people |
|
|
|
4/1 |
American Indian health
issues panel
|
RP 17-20 |
Ch 14 |
|
4/3 |
Native Hawaiian health issues panel
|
|
Ch 22 |
|
4/8 |
African-American health issues
panel
|
RP 21- 23 |
Ch 10 |
|
4/10 |
Class cancelled |
|
|
|
4/15 |
Latino
health issues panel |
RP 24-26 |
Ch 6 |
|
4/17 |
Pilipino American health issues panel |
|
|
|
4/22 |
Religious
Minorities |
RP 27-29 |
|
|
4/24 |
Chinese American health issues
panel
|
|
Ch 18 |
|
4/29 |
Japanese American health issues panel
|
|
|
|
5/1 |
People
with Disabilities
|
|
Service projects due |
|
5/6 |
Asian Indian health
issues panel
|
RP 30-33 |
|
|
5/8 |
Southeast Asian health issues panel
|
|
|
|
5/13 |
Gender
& Sexual Minorities health issues
|
|
Cultural event reflections due |
|
5/15 |
Commitments to Cultural Competence
|
|
|
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5/20 |
Exam 2: 2 – 3:50 pm
|
|
|
Section II:
Expanded Panel Project Instructions
Panel Project
(120 pts)
Students will be assigned to panel groups to understand
peoples of diverse cultures and to find ways health
educators/administrators/health care professionals can most effectively serve
their clients. Panel groups will plan a 60
minute presentation on assigned ethnic groups. Everyone must participate equally to the
overall presentation. The panel should
consider itself as a whole and not as segmented parts to insure completeness
and avoid duplication in the oral presentation.
The focus of your research relates to health professionals and how we
may best serve. Consequently, what
information makes this culture different from the dominant culture? What are the experiences and assets of this
culture relative to the dominant culture? Determine what exceptional data we
need to know. The groups follow:
1. Black Americans 4.
Asian Indian Americans 7. Japanese Americans
2. Latino/Mexican Americans 5.
South East Asian Americans 8.
Chinese Americans
3. American Indians or Alaskan Natives 6.
Native Hawaiians 9. Filipino Americans
Panel project content:
1. Identify
ethnic groups and sub-groups:
history (when, why and how they come to the
2. Evaluate
general health data by age groups (children, adults, elders): provide a SYNTHESIS of epidemiological characteristics,
general health, morbidity and mortality (e.g. leading causes of death, or areas
where there are significant differences across ethnicities). Be sure to provide COMPARISON data between
your minority group and other ethnic groups/general population.
3. Analyze a
specific health problem & culturally focused health care/education program
that addresses this problem
Each group member must choose a
different health issue to research and present.
The emphasis should on WHY
this is a problem must be addressed, NOT on the disease process. DO NOT just provide generic disease etiology
and prevention information
4. Identify
beliefs and practices of health, disease and illness, both traditional and
adaptations. Are cultural healers available? Are they used? What belief system is used in healing? How
has acculturation affected these practices?
5. Describe the
current health care delivery: encounters with the mainstream, barriers to
treatment and services. Is Western
medicine and treatment accepted? To what
extent? When is Western treatment sought
(if at all)? Are services
available? Is there self treatment in
this community? Are there fears,
barriers, miscommunication surrounding Western medicine? How can these barriers
be overcome or reduced?
6. Describe the
traditional family lifestyle including roles of women and men, and the role of
elders. Are traditions changing in this country? What are the effects of acculturation? What intergenerational changes are taking
place? What is the effect of their
traditions (especially female/male roles) regarding health treatment and
education? How can health professionals
adjust to reach this community?
7. Ethnic
interview: Each person must
interview an individual representing your selected ethnic group. If you are of
the ethnic group, interview someone of your ethnicity that you suspect may have
had different life experiences than you. As a minimum, ask them questions
regarding the following: their ethnic background, country of origin, what they
do to maintain health, what remedies are used for common health problems, and
their views of physicians, hospitals, and medicines. Share with them what you learned in your
research and ask them what they think should be presented. How does their background affect their
beliefs concerning health and illness?
Which beliefs and practices are health preserving? Which may be harmful? Write up a summary of your results and add
how their beliefs have influenced your health beliefs and behaviors. Which beliefs are similar to yours? Where do your beliefs differ from theirs and
why? Submit a thank you note (addressed and
stamped) with your presentation.
Panel Project
Format:
There are several
components to this project:
a)
A one-hour
group oral presentation using Power Point, plus poetry, music, artifacts,
etc. As a group you will divide up the required demographic and cultural
content (see 1-7 above), plus each group member will write/present on a health
topic (#3 above). Use music, examples of clothing, food (keep it simple – no
buffet lines!), to enhance our experience of your ethnic group’s culture. These could include: poetry, music, or
visual art. Be sure to have brief
biographical information about the artist (name, year created &/or years
artist lived, country of origin).
b)
An individually
written extended, detailed outline (paper) of your portion of the group
presentation. Minimum 4 pages single-spaced
typed from each group member. This must be referenced thoroughly and
accurately using at least 4 professional (peer-reviewed or governmental agency)
sources IN ADDITION TO class sources. Wikipedia is NOT allowed!
c)
Ethnic interview
– individually conducted and evaluated interview. Submit with paper and
include in your presentation where appropriate.
d)
A
group-developed informational handout accompanying your presentation for
all class members on the day of your presentation (make 38 copies). This should
be a one page (2 sided) condensed
version of your entire panel project which is distributed at the beginning
of your presentation. Make these as
dense and thorough as possible – these are to be used as exam study
notes/guidelines on your panel.
e)
A presentation
timeline/outline submitted to instructor on day of presentation.
f)
A
group-developed organized binder that includes all detailed outlines,
Power Point slides, interviews, and any other materials associated with your
project/presentation.
g)
Member
contribution and participation evaluation. This is due on the day of
your presentation. Please submit in individual envelopes or stapled/taped shut
to ensure confidentiality
Bring this culture into the classroom; surround us with the
colors, music, spirituality, scents, food, history, experiences, clothing, and
pride of this culture. Some ideas:
·
YOU MUST
Integrate poetry, music/lyrics, traditional stories, famous speeches, or
video clips. (Bring your own portable CD player – the classroom systems are not
reliable!). The idea is to get away from a purely data based presentation and
highlight the experiences and voices of the ethnic group.
·
Other ideas to
bring your presentation to life:
o
Food – keep it
simple, though – no buffet lines!
o
Visit an
ethnic community, attend a celebration, church, etc. and tell us what you
saw. Take some pictures (ask
permission!);
o
Describe of holidays
and ways they are celebrated.
o
Accomplishments
of a person(s) of this ethnicity who has become well-known.
o
Teach us (or
invite a guest presenter to) a traditional healing practice (yoga?), or a
traditional game or prayer.
Panel Project Grading
60 points: Oral Presentation Criteria: Adequate group coverage of objectives,
material well organized, student appeared to have good knowledge of subject,
topics selected were relevant to ethnic group, presentation made sense,
questions satisfactorily answered, student showed interest in topic, student
made subject interesting, contribution will improve knowledge base in HCSV 178,
content was new information, creativity, use of overheads, films, music, art,
healthy food, etc. Quality of classroom handout. Quality of and adherence to
timeline.
40 points: Detailed outline (paper): had good content and was well written, referenced correctly and adequately,
use APA documentation style quality of sources.
10 points: Individual contributions to panel as measured
by confidential peer evaluations: member
was organized, member was motivated, a good participant, attended all group
meetings, contributed to your work, was dependable, contributed equally to the
panel
10 points: Quality
of Interview and quality of interview summary. Thank you note & stamped
envelope.
NOTE: presentation grades will not be recorded until all
evaluation forms are received.
EXAM 1
1. Understand the concept of “culture” in general – what
is it, how does it develop, what is it composed of, how does it act on
individuals, what institutions comprise culture, what is the relationship
between the individual, institutions, and ‘culture’.
2. Know Slonim’s 5 basic criteria for defining a
culture.
3. Understand the concepts of “ethnicity” and its
relationship to culture and what has been known as “race” and “minority”.
4. Understand the concepts of acculturation, bicultural,
assimilation. Understand the relationship between acculturation and
assimilation.
5. Understand “ethnocentrism” and how it affects health
promotion.
6. Know the differences between cultural awareness,
cultural knowledge, cultural skill, cultural encounter.
7. Understand the concepts related to ethnosensitivity,
including cultural relativism.
8. Understand the differences in communication styles
and how they impact interpersonal communication.
9. What process do Kreps and Kunimoto recommend?
Understand the western
bio-medical model of disease and be able to compare (in general) other models
of disease. This includes concepts of explanatory models, what causes disease
(Illness causality), different (general) methods of healing. Study the traditional
models of health care delivery of the different ethnic groups presented in this
chapter.
Chapter 5: Tips for the practitioner:
health promotion in the context of culture (pgs 103-107)
This chapter is a review and
synthesis of the concepts of culture and cultural competency from previous
chapters. Use it as a review for these issues. For example , how does culture
effect how people interpret the source (and therefore treatment) of disease?
How does this effect health care seeking behavior? What do you need to know
about cross-cultural communication to be culturally competent?
This chapter provides a
framework for assessing the culture of a community. It is a little
overwhelming. I don’t want you to get bogged down in the details, but you do
need to have a vision of what these components are and how they might impact
the individual and health and seeking healing. You need to know and understand
the factors involved (e.g. demographic variables of age, gender, etc.; cultural
characteristics of ethnic identity, cosmology, time orientation, etc.; Health
beliefs such as explanatory models, etc). I would create a dense outline to
understand these various components – these are critical to becoming a
culturally competent practitioner, educator, administrator, therapist, etc.
Student Outcome Assessment
(based on the Competency-Based Framework
for the Professional Development of Certified Health Education Specialists, The
National Commission for Health Education Certification, Inc.)
1. Assess individual and community needs for health education
(Resp I).
-Research
health of selected ethnic group by completing a panel project.
-Interview
member of selected ethnic group and complete a summary.
2. Implement health education programs (Resp III).
-Present a
group panel project and exhibit competence.
3. Act as a resource person in health education (Resp VI).
-Use the
computer and data bases effectively to meet research requirements.
-Establish
a consultative relationship with a health agency and prepare a culturally
relevant brochure/pamphlet for that
agency and their clients.
4. Communicate health education needs, concerns, and resources
(Resp VII).
-Present effectively to a group using multiple audio-visual aids and culturally relevant tools or icons.
-Be
prepared to discuss the selected readings by preparing notecards.
-Identify local, regional, and national agencies that serve
communities of color to be presented on your brochure/pamphlet.
-Evaluate effective ways to bridge
services and communication between providers and consumers of health care.
5. Have knowledge, skills, and beliefs related to the heath
care delivery system.
-Discuss, describe, and analyze the impact of politics and economics on the health care delivery system and be able to participate in influencing political decisions. Emphasis will be on undocumented immigrants, the impact of current demographics, and the historical discontent of communities of color.
-Be able to apply laws and
regulations that impact health care organizations.
-Discuss the major ethical issues
that are affecting health care and be able to articulate your own beliefs.
6. Describe the roles, responsibilities and functions of
various services within healthcare organizations and their quality of services.
-Identify
creative ways to provide services to underserved populations.
-Identify
effective health services.
7. Be able to develop program plans, including defining
problems in appropriate terms, setting goals and objectives, using statistical data,
interpreting published data, researching issues, developing alternatives, and
evaluating results and impacts. Describe research limitations and biases of
ethnic data.
Be able to
work in a team and conduct peer evaluations.
1. Service project product
2. Panel project (keep a copy on CD!)