Cultural brokers can help to ease the historical and inherent distrust that many racially, ethnically, and culturally diverse communities have toward health care organizations. Two elements are essential to the delivery of effective services: (1) the ability to establish and maintain trust and (2) the capacity to devote sufficient time to build a meaningful relationship between the provider and the patient/consumer. Cultural brokers employ these skills and promote increased use of health care services within their respective communities. For instance, cancer researchers have had to find ways to ease the concerns of the African American community about participating in clinical trials. For many African Americans, the Tuskegee study is a painful reminder of medical research gone wrong. In that study, conducted from 1932 to 1972, poor Black men were not fully informed about their participation in medical research on syphilis. They also were not given treatment for their disease, despite the eventual availability of drug treatment. Cultural brokers often can bridge this chasm of distrust that many cultural communities have toward researchers. Cultural brokers can be instrumental in reestablishing trust and reinforcing the importance of participating in research, particularly related to the elimination of racial and ethnic disparities in health.

4. Cultural broker as a catalyst for change

In many ways, cultural brokers are change agents because they can initiate the transformation of a health care setting by creating an inclusive and collaborative environment for providers and patients/consumers alike. They model and mentor behavioral change, which can break down bias, prejudice, and other institutional barriers that exist in health care settings. They work toward changing intergroup and interpersonal relationships, so that the organization can build capacity from within to adapt to the changing needs (Heifetz & &aurie, 1997) of the communities they serve.

Whatever their position or roles, cultural brokers must have the capacity to:

• assess and understand their own cultural identities and value systems;
• recognize the values that guide and mold attitudes and behaviors;
• understand a communityÕs traditional health beliefs, values, and practices and changes that occur through acculturation;
• understand and practice the tenets of effective cross-cultural communication, including the cultural nuances of both verbal and non-verbal communication; and
• advocate for the patient, to ensure the delivery of effective health services.