Cross-Cultural Communication in
Health Care:
Building Organizational Capacity
Broadcast
Resource Guide
For downloading or printing:
Broadcast Resource Guide (PDF file - 25 KB)
PROJECT LEADERSHIP
Broadcast Sponsors:
Elizabeth M. Duke, Ph.D.
Administrator, Health Resources and Services Administration
RADM Nathan Stinson, Jr., Ph D., M.D., M.P.H.
Deputy Assistant Secretary for Minority Health and Director, Office of
Minority Health
Rhoda Abrams, M.B.A.
Director, Health Resources and Services Administration, Center for Health
Services Financing and Managed Care, www.hrsa.gov/financeMC
Guadalupe Pacheco, M.S.W.
Special Assistant to the Director, U.S. Department of Health and Human
Services, Office of Minority Health, www.omhrc.gov
Dorothy N. Moga, M.P.H.
Project Leader
moga@us.net
Faculty
Moderator:
Joyce St. George, M.A. - Co director, Pact Training, New Kingston, New
York
stgeorge@catskill.net
Faculty:
Shani Dowd, L.C.S.W. - Director of Clinical Cultural Competency Training,
Harvard Pilgrim Health Care, Boston, Massachusetts.
Shani_Dowd@harvardpilgrim.org
Deeana Jang, J.D. - Senior Civil Rights Analyst, U.S. Department of Health
and Human Services, Office for Civil Rights, Washington, D.C.
Deeana.Jang@hhs.gov
Robert C. Like, M.D., M.S. - Associate Professor and Director, Center
for Healthy Families and Cultural Diversity, Department of Family Medicine,
University of Medicine and Dentistry of New Jersey, Robert Wood Johnson
Medical School, New Brunswick, New Jersey.
like@UMDNJ.edu
Kelvin Quan, J.D., M.P.H. - CFO and General Counsel, Alameda Alliance
for Health, Alameda, California.
KQuan@alamedaalliance.com
Catalina Sol, M.P.H. - HIV Program Director, La Clinical Del Pueblo,
Washington, D.C. Interpreter Training Faculty, Northern Virginia Area
Health Education Center, Annandale, Virginia.
csol@ledp.org
Dinah Surh, M.P.H. - Vice President and Administrator, Lutheran Medical
Center, Sunset Park Family Health Center Network, Brooklyn, New York.
DSurh@lmcmc.com
MATERIALS REFERENCED DURING THE BROADCAST
1. U.S. Census Bureau Minority Links - http://www.census.gov/pubinfo/www/hotlinks.html
2. Pere-Stable E J, Napoels-Springer A, and Miramontes J M. "The
Effects of Ethnicity and Language on Medical Outcomes of Patients with
Hypertension or Diabetes". Medical Care, 1997, 35 (12): 1212-1219.
3. National Adult Literacy Survey - National Institute of Literacy http://www.nifl.gov/nifl/facts/NALS
4. Institute of Medicine Report on Unequal Treatment - Unequal Treatment:
Confronting Racial and Ethnic Disparities in Health Care (March 20, 2002)
- http://www.nap.edu/books/030908265X/html/
5. Video sequences in this presentation are from the video "Community
Voices" by Jennie Greene, MS, and Kim Newell, MD for the Harvard
Center for Cancer Prevention. For information, or to obtain a copy of
"Community Voices" contact: Fanlight Productions, 4196 Washington
Street, Boston, Massachusetts 02131, (800) 937-4113, www.fanlight.com.
Portions of this broadcast are protected by copyright, and may not be
videotaped, copied or duplicated without permission of the copyright holder.
6. Flores, G, Laws, M B, Mayo, S J, Zuckerman, B, Abreu, M, Medina, L,
and Hardt, E J. "Errors in Medical Interpretation and Their Potential
Clinical Consequences in Pediatric Encounters". Pediatrics, 2003,
111: 6-14. For an abstract and to order a copy access: http://www.pediatrics.org
- Click on "BROWSE AND SEARCH ALL ISSUES" - then, under "Search"
"by Citation", Volume = 111 and First page = 6 and click on
"Search".
7. Martin, R, "The Virtue Matrix: Calculating the Return on Corporate
Responsibility". Harvard Business Review, March 2002. For ordering
information access: http://harvardbusinessonline.hbsp.harvard.edu/b01/en/common/item_detail.jhtml?id=2438
8. Civil Rights Act. Title VI, Section 601 of the Civil Rights Act of
1964 (42 USC Section 2000d, et. seq.)
9. U.S. Department of Justice Guidelines - Improving Access to Services
for Persons with Limited English Proficiency - http://www.usdoj.gov/crt/cor/13166.htm
10. U.S. Department of Health and Human Services, Office for Civil Rights.
www.hhs.gov/ocr/lep
11. U.S. Department of Justice, Let Everyone Participate - Interagency
Working Group on Limited English Proficiency. www.lep.gov
12. "Communicating Effectively Through an Interpreter", produced
by The Cross Cultural Health Care Program, PacMed Clinics. For information
contact The Cross Cultural Health Care Program, PacMed Clinics, 1200 12th
Avenue S, Seattle, WA 98144, (206) 621-4161, www.xculture.org.
Portions of the broadcast are protected by copyright and may not be videotaped,
copied or duplicated without permission of the copyright holder.
13. U.S. Department of Health and Human Services, Office of Minority
Health, CLAS Standards. http://www.omhrc.gov/CLAS
14. "Providing Oral Linguistic Services: A Guide for Managed Care
Plans". U.S. Department of Health and Human Services, Center for
Medicare and Medicaid Services under contract to the Agency for Healthcare
Research and Quality. www.cms.gov/healthplans/quality/project03.asp
15. "Moms and Kids.org". A project of the Brooklyn Alliance.
www.momsandkids.org
16. Institute of Medicine Report on Medical Errors - To Err Is Human:
Building a Safer Health System (2000) - http://www.nap.edu/books/0309068371/html/
17. Hampers, L Cl, Cha, S, Gutglass, D J, Binns H J, Krug, S E. "Language
Barriers and Resource Utilization in a Pediatric Emergency Department".
Pediatrics, 1999, 103: 1253-1256.
18. Ponce, N, Quan, K. Unpublished study, under contract with the Asian
& Pacific Islander Health Forum and funded by the California Cancer
Commission.
19. National Council on Interpreting in Health Care. http://www.ncihc.org/
California Workforce Initiative. http://futurehealth.ucsf.edu/pdf_files/healthinterpreters.pdf
Massachusetts Medical Interpreters Association. http://www.mmia.org/
Minnesota Medical Association. http://www.lep.gov/statetrans.html
20. U.S. Department of Health and Human Services, Office of Minority
Health. www.omhrc.gov
21. Medical Interpreter Training Programs and Materials from The Cross
Cultural Health Care Programs - For information contact The Cross Cultural
Health Care Program, PacMed Clinics, 1200 12th Avenue S, Seattle, WA 98144,
(206) 621-4161, www.xculture.org.
22. Checklist of Key Areas - "Providing Oral Linguistic Services:
A Guide for Managed Care Plans". U.S. Department of Health and Human
Services, Center for Medicare and Medicaid Services under contract to
the Agency for Healthcare Research and Quality. Pages 76-77. www.cms.gov/healthplans/quality/project03.asp
23. Checklist of Implementation Issues - "Providing Oral Linguistic
Services: A Guide for Managed Care Plans". U.S. Department of Health
and Human Services, Center for Medicare and Medicaid Services under contract
to the Agency for Healthcare Research and Quality. Page 78. www.cms.gov/healthplans/quality/project03.asp
24. Berwick, D, "Disseminating Innovations in Health Care."
JAMA, 2003, 289(15): 1969-1975.
25. Dramatizations by Pact Training, 763 Winter Hollow Road, P.O. Box
106, New Kingston, New York 12459-0106.
ADDITIONAL RESOURCES
The resources below are a sampling the assistance and information available
on this topic and is not intended as a compete listing.
Need For Language Access And Services
U.S. Census Bureau Minority Links. http://www.census.gov/pubinfo/www/hotlinks.html
Policy Brief 2 - Linguistic Competence In Primary Health Care Delivery
Systems: Implications for Policy Makers. Georgetown University National
Center for Cultural Competency. www.georgetown.edu/gucdc/nccc/
Business Case - Lonner T. "Constructing the Middle Ground: Cultural
Competence in Medicaid Managed Care". The Cross Cultural Health Care
Program, 2000. For ordering information access: www.xculture.org
Business Case - Smedley B., Stith A., and Nelson A. Editors. Unequal
Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington,
D.C.: Institute of Medicine, (March 20, 2002). http://www.nap.edu/books/030908265X/html/
The Community Tool Box, The University of Kansas - http://ctb.lsi.ukans.edu
The Assessment-Based Community Development Institute, Northwestern University
http://www.northwestern.edu/ipr/abcd.html
Planning Steps To Increase Linguistic Competence
Arday S L, Arday, DR, Monroe S, and Zhang J. "HCFA's racial and
ethnic date: Current accuracy and recent improvements". Health Care
Financing Review, 21:4 (2000): 107-115.
Perot R, and Youdelman M. "Racial, Ethnic, and Primary Language
Collection in the Health Care System, an Assessment of Federal Policies
and Procedures". The Commonwealth Fund, 2001. http://www.cmwf.org
State Data Center (SDC) Program - links to local resources that can assist
with using census data. http://www.census.gov/sdc/www/
U.S. Census Bureau Minority Links - http://www.census.gov/pubinfo/www/hotlinks.html
"A Practical Guide for Implementing the Recommended National Standards
for Culturally and Linguistically Appropriate Services in Health Care".
Office of Minority Health, U.S. Department of Health and Human Services,
2001. http://www.omhrc.gov/clas/guide2a.asp
Assessment of the Total Benefits and Cost of Implementing Executive Order
No 13116: Improving Access to Services for Persons with Limited English
Proficiency, U.S. Office of Management and Budget Report to Congress,
2002.
http://www.whitehouse.gov/omb/inforeg/regpol-reports_congress.html
Swabey L, Thiel de Bocanegra H, Gany F, and Morrison R. An Introduction
to Medical Interpreting: A Trainer's Manual. NY Task Force on Immigrant
Health, NY University School of Medicine, 1997. Contact New York Task
Force on Immigrant Health at 2-2-263-8783.
Torres B, "Best Practice Recommendations for Hospital-Based Interpreter
Services". Massachusetts Department of Public Health, Office of Minority
Health, 2001. http://www.state.ma.us/dph/omh/interp/interpreter.htm
Durham M, Madansky D, Lowell M, et al. "Establishing Interpreter
Services in Health Care Settings". Amherst, MA: Diversity Resources,
2001. Contact Diversity Resources at 1-800-865-5549.
"Models for the Provision of Language Access in Health Care Settings".
The National Council on Interpreting in Healthcare Working Papers Series,
2002. http://www.ncihc.org
Youdelman M, and Perkins J. "Providing Language Interpretation Services
in Health Care Setting: Examples from the Field". The Commonwealth
Fund, 2002. http://www.cmwf.org
"The Role of the Health Care Interpreter: An Evolving Dialogue".
The National Council on Interpreting in Healthcare Working Papers Series,
2001. http://www.ncihc.org
The Terminology of Health Care Interpreting: Glossary of Terms. The National
Council on Interpreting in Healthcare Working Papers Series, Volume 3,
2001. http://www.ncihc.org
"Bridging the Language Gap: How to Meet the Need for Interpreters
in Minnesota, Interpreter Standards Advisory Committee". University
of Minnesota and the Minnesota State Colleges and Universities Systems,
1998. http://cla.umn.edu/pti
Interpreter Practice Standards
"Bridging the Language Gap: How to Meet the Need for Interpreters
in Minnesota". Working Group of the Minnesota Interpreter Standards
Advisory Committee. http://cla.umn.edu/pti
"Medical Interpreters Standards of Practice", Massachusetts
Medical Interpreters Association. Send check to MMIA, c/o NEMC, Box 271,
800 Washington Street, Boston MA 02111.
"Standards for Healthcare Interpreters" (draft). California
Healthcare Interpreters Association. http://www.chia.ws
Interpreter Code of Ethics
"Code of Ethics, Cross Cultural Health Care Program". http://www.xculture.org/index.cfm
"Code of Ethics, National Council on Interpretation in Health Care"
(under development). http://www.ncihc.org
Code of Ethics, Massachusetts Medical Interpreters Association. http://www.mmia.org
Assessment of Interpreters
ATLA Language Services. http://www.altalang.com/testing.htm
"Guide to the Initial Assessment of Interpreter Qualifications".
The National Council on Interpreting in Healthcare Working Papers Series,
2001. http://www.ncihc.org
Language Testing International. http://www.languagetesting.com
USEFUL WEB SITES
1. U.S. Department of Health and Human Services, Office for Civil Rights.
www.hhs.gov/ocr/lep
2. U.S. Department of Health and Human Services, Center for Medicare
and Medicaid Services. http://www.cms.gov/healthplans/quality/project03.asp
3. U.S. Department of Health and Human Services, Agency for Healthcare
Quality and Research (AHRQ). http://www.ahrq.gov/about/cods/cultcomp.htm
4. U.S. Department of Health and Human Services, Health Resources and
Services Administration, Center for Health Services Financing and Managed
Care. http://www.hrsa.gov/financeMC/bridging-cultures/default.htm
5. The Managed Care and Health Services Financing Technical Assistance
Center (MCTAC). www.jsi.com/hrsamctac.
A program of the U.S. Department of Health and Human Services, Health
Resources and Services Administration, Center for Health Services Financing
and Managed Care.
6. U.S. Department of Health and Human Services, Health Resources and
Services Administration, Bureau of Primary Health Care. http://bphc.hrsa.gov/quality
7. National Council on Interpreting in Healthcare. www.ncihc.org
8. Cross Cultural Health Care Program. www.xculture.org
9. Hablamos Juntos. http://www.hablamosjuntos.org/index/
10. DiversityRX. www.diversityrx.org
11. The Access Project. www.accessproject.org
12. National Center for Cultural Competence, Georgetown University. http://www.georgetown.edu/research/gucdc/nccc/
13. Health Disparities Collaboratives. www.healthdisparities.net
14. U.S. Department of Justice, Let Everyone Participate - Interagency
Working Group on Limited English Proficiency. www.lep.gov
15. Center for Multicultural and Multilingual Mental Health Services.
16. The Providers Guide to Quality and Culture. http://erc.msh.org/quality&culture
17. Institute for Culturally Competent Care, Kaiser Permanente, One Kaiser
Plaza, Oakland, California 94612. 510-271-2315. E-mail address: nilda.chong@kp.org
18. The California Workforce Initiative, "Health Interpreters in
California". http://futurehealth.ucsf.edu
19. "A Practical Guide to Culturally and Linguistically Appropriate
Services in Medicare+Choice Organizations". Regional workshops sponsored
by the University of North Carolina, North Carolina Institute for Public
Health. http://www.sph.unc.edu/oce/2003courses/cms.htm
20. The resources listed below provide patient education materials translated
to a variety of languages. Some material may be copyrighted and may have
to be purchased. Prior to use, organizations should assess the materials
and their translations for suitability with local needs and requirements.
Immunize.org. Immunization Action Coalition. http://www.immunize.org/catg.d/noneng.htm.
Spencer S. Eccles Health Sciences Library, University of Utah, Health
Sciences Center. http://medstat.med.utah.edu/library/refdesk/24lang.html.
Ethnomed Patient Education Resources, University of Washington, Harborview
Medical Center. http://ethnomed.org
Massachusetts Health Promotion Clearinghouse (Catalog of Materials),
a project of The Medical Foundation, http://www.maclearinghouse.com
Multilingual-Health-Education.net, A non-profit alliance of Canadian
health agencies, administered by Providence Health Care. www.multilingual-health-education.net
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