National Center for Cultural Competence

Benefits to the Health Care Setting

Health care settings can create a reputation for being committed and inclusive community partners, which improves access and use.
Health care settings can increase the use of preventive services to minimize the use of cost-prohibitive emergency care.
Health care settings can increase cost effectiveness in service delivery by decreasing return visits from patients/consumers who did not clearly understand treatment protocols.
Health care settings may be able to reduce potential liability through improved communication (Physicians Risk Management Update, 1995; American Medical News, 1966; Virshup, Oppenberg, & Coleman, 1999; Meryn, 1998; American Family Physician, 1997; Hospital Topics, 1997; JAMA, The Journal of the American Medical Association, 1997).
Health care settings can engender mutual respect and trust within the communities they serve, which assures sustainability.

RURAL CLINICÕS COMMUNITY BOARD ENHANCES PROGRAM INCLUSIVENESS AND SUSTAINABILITY

Dianne Smith, executive director of Dove Creek Community Health Clinic in rural Colorado, used her knowledge of the community to seek respected community members to sit on the volunteer board of trustees. Smith, who grew up in the remote town of Dove, where the closest hospital is 26 miles away, knew many of these individuals were from farming families like hers and clearly understood the health care needs of the community. She chose individuals from banking, retail, schools, local government, and health care to identify ways (1) to raise funds for the clinic to expand its services and (2) to help create programs that would improve access for the community, which in recent years, suffered economically from years of drought. The board organized a telethon that raised $37,000 for clinic equipment and for room expansion. ÒTheir work gave them a sense of pride,Ó Smith notes. ÒBecause the board represents the community, the community feels strongly this is their clinic, and that they all are part owners in it.Ó The benefit to Dove Creek Community Health Clinic is a sustained effort that strengthens the clinicÕs capacity to continue to serve the health needs of the community. Smith exemplifies the role of cultural broker by knowing both community needs and community members and their quest to improve community health.

NATIVE AMERICAN WOMEN BRING DATE RAPE PREVENTION TO THE CLASSROOM

Date rape and unhealthy relationships that lead to violence against teens and young women are significant problems on the Yankton Sioux reservation and in nearby areas in South Dakota. The Native American WomenÕs Health Education Resource Center identified these as serious problems and decided to create a program that would increase awareness and educate girls, starting at an early age. The Health Education Resource Center relied on its youth advisory council for expertise and for guidance on developing curricula and programs. The youth advisory council served as cultural brokers by sharing experiences about real-life situations involving dating and unhealthy relationships, a perspective the adult staff could not possibly have. The center developed a curriculum, complete with a guide for facilitators and teachers, and a workbook for young women that has been widely disseminated to schools, tribal youth programs, shelters in South Dakota, and across the country.