A hospital is opening a new primary care clinic on the outskirts of a diverse, major metropolitan city with numerous non-English-speaking, immigrant, and refugee populations. Approximately one-third of the city's population speaks Spanish, and one-fourth identifies as Black. 10% of the clinic providers belong to various minority ethnic backgrounds. The medical director is aware of significant chronic-disease–related health disparities affecting Black and Spanish-speaking patients, who are more likely to experience severe disease and preventable disease complications. Which of the following organizational actions is most likely to improve provider health care communication for patients of minority backgrounds?
Cross-cultural care improves provider-patient communication and health outcomes, especially for minority populations that experience significant health disparities (eg, preventable differences in health linked to demographic attributes). Cross-cultural care reflects high-value care principles common to all populations, including:
Patient-centeredness: identifying the patient's values and aligning care with the patient's priorities
Cultural sensitivity: exploring the patient's cultural beliefs and understanding how sociocultural background influences perceptions of health decisions
Enhanced communication: addressing language barriers (eg, use of interpreter services) and tailoring communication styles (eg, adjusting eye contact, addressing family) to a patient's preferences
Cross-cultural care emphasizes the importance of avoiding stereotyping, since minority groups (eg, Black) comprise a variety of subcultures (eg, Caribbean, African) and patients' preferences vary within groups. For example, although some minority patients may prefer family involvement or minority providers, providers should avoid assuming that all minority patients share this preference and explore individual patient preferences (Choices A and D).
(Choice B) Providing translated materials can be effective as a complement to patient-centered counseling. However, training providers to actively deliver patient-centered, cross-cultural care represents a more comprehensive and versatile approach that can improve communication outcomes across multiple, diverse populations (eg, immigrants, refugee groups).
(Choice C) Providing information about cultural beliefs of specific ethnic populations can be useful but represents a more passive approach, addresses only certain ethnicities, and may promote stereotyping given the diversity of beliefs within ethnic groups. Cross-cultural care is more likely to improve outcomes across patient populations because it promotes learning about individual patient beliefs and tailoring communication accordingly.
Educational objective:
Cross-cultural care improves health outcomes and communication in diverse populations. It involves components of high-value care common to all populations, including patient-centeredness (ie, exploring an individual patient's beliefs), avoidance of stereotyping, and cultural sensitivity (responding to a patient's sociocultural paradigm).