National Center for Cultural Competence

Cultural brokering involves delivering services in settings that are accessible and tailored to the unique needs of the communities served.

To meet the unique needs of communities, health care settings must have the capacity to provide services through non-traditional approaches, particularly in relationship to where, when, and how such services are provided. It is essential that cultural brokering programs have the resources and flexibility to adapt to the community context and the lifestyles of individuals served.

Cultural brokering acknowledges the reciprocity and transfer of assets between the community and health care settings.

The interchange of skills and knowledge between health care organizations and communities is a dynamic occurrence. Culturally competent health care settings recognize and acknowledge that inherent in any community are resources and assets to support service delivery. Collaborative relationships between health care settings and communities have many benefits. Selected examples of knowledge exchange and transfer of assets follow.

REST BREAKS PROVIDE HEALTH EDUCATION MOMENTS FOR FARM WORKERS

Promotoras (lay health educators) in the Campesinos sin Fronteras program distribute their health care material and talk with migrant farm workers at times when the farm hands are not working—at 4 a.m. when they are waiting at local sites to be picked up for work and at lunch breaks in the fields. “ They go to the pick-up sites, find out who the foreman is, and tell them who they are, and ask permission to talk with the workers,” says project director Emma Torres. Farm workers invite the promotoras to join them for lunch, sharing their burritos as they sit on the ground and talk. They discuss health-related issues on HIV/AIDS and high-blood pressure using Spanish-language flip cards. “ Latinos have a love of food, and sharing with others signals a bond among those who eat together,” she adds. As a result, the farm workers benefit from this transfer of knowledge in a setting that is accessible and convenient.

Building a community network of cultural brokers/medical interpreters.
The MATCH program conducts medical interpreter training for individuals speaking South Asian languages who work with the Hmong refugees. An interpreter training curriculum, “Bridging the Gap,” developed by the Cross Cultural Health Program in
Seattle, WA, has been adapted for the Laotian languages of Hmong, Lao, and Mien. This curriculum, “Connecting Worlds,” has sections that are taught in these Laotian languages
Leadership and workforce development.
Campesinos sin Fronteras hires women trained as promotoras into leadership and administrative positions for the migrant health program in Yuma, AZ. Grant writing and development skills are taught to women who are interested in the administrative aspect of health education. They learn professional skills in communicating with health care foundations, government health agencies, and other collaborators, such as the Yuma County Division of Health and Human Services and the University of Arizona College of Public Health.