"I take one of that and one of the other."
"In the morning?"  "In the morning."  "Like this."  "Okay."
(Narrator) Effective healthcare communication policies and practices, 
including provider health literacy
contribute to improving the quality of services for culturally and linguistically
diverse populations as well as people with limited health literacy
skills. At HRSA, we view healthcare communication
as a synergy of three factors:
health literacy, cultural competency, and linguistic competency.
It is important to emphasize a dynamic view
of healthcare communication. These three factors 
interplay with each other in dynamic ways. "What?"
"This is a generic drug
from Walgreen's." (Narrator) For example, a person's
health literacy may be influenced by socio-cultural factors
including education, income, country of origin
level of assimilation to the host culture, to name a few.
Cultural factors not only include language, gender
socio-economic status, sexual orientation, and 
gender identity but also physical and mental
capacity, age, religion, housing status
and regional differences. Culture also includes
diversity within specific cultural and ethnic groups,
even the culture of western medicine. All of the
factors that I have mentioned are very dynamic and highly interdependent.
They are difficult to isolate and they tend to interact
and influence each other. It is important to note that
low health literacy is not language dependent.
Additionally culture seems to be a prime mediator
among these various factors.
The U.S. is becoming ever more linguistically and culturally
diverse. The number of people who spoke a language other than English
at home has more than doubled in the last three decades and at a
pace four times greater than the nation’s population growth.
In that time frame the percentage of non-English
language speakers grew by one hundred and forty percent
while the nation’s overall population grew by thirty-four percent.
"So, she says in this moment she's feeling better; yesterday she felt a little
bit of pain but she's feeling much better today." "And her chest?"
"In your chest was the pain, correct?" (Narrator) The rise in our nations non-
English speakers calls for rapid and innovative responses
on the part of health care systems to ensure that trained healthcare
interpreters are immediately available when required.
Health equity is the attainment of the highest level of health
for all people. A disparity is a particular type of
health difference that is closely linked with social or economic
disadvantage. Health disparities adversely affect groups of people
who have systematically experienced greater social and economic
obstacles to health. HRSA views effective cross-cultural communication
as health disparity, quality, safety and 
civil rights issues. Health literacy
must be viewed within a cultural context.
HRSA has a web-based health communication training tool designed
to improve interaction between healthcare providers and
their patients. This interactive training course
"Effective Communications Tools for Healthcare Professionals" aims to
raise the quality of provider-patient interactions by teaching
providers and their staff how to gauge and respond to their patient's
health literacy, cultural background and
language skills. The course's five modules take five hours
to complete. Modules one through four provide an
introduction to health communication, health literacy, cultural
competency and limited English proficiency.
In module five, participants can apply information learned in
previous modules to test their ability to communicate effectively with
patients. This year we are working to expand this course
to include more ethno-cultural specific information:
tools and resources on particular ethnic and racial groups,
including LGBT patients, with clinical aids 
related to the cultural diversity of LGBT patients 
within ethnic and racial groups. Here is the 
front screen of this course. It is important to note that a number of
accrediting bodies, including the American Academy of Family
Physicians, the American Diabetes Educators Association,
the American Academy of Physician Assistants,
the American Association of Health Education and the
National Association of Social Workers award up to five free credits
for completing this course. The HRSA mission statement
is the framework that supports a healthcare system that assures
access to comprehensive, culturally competent quality
care. In order to fully integrate
cultural and linguistic competence and health literacy factors in
into HRSA funding opportunity announcements, new suggestive
guidelines have been developed to improve the effectiveness of healthcare
communication between providers and their patients.
Programs are encouraged to apply these principles whenever appropriate
in their policies and practices. Please remember
that these are guidelines and suggestions for preparing
responsive applications. They are not directives.
Please feel free to contact the name listed in the funding opportunity
announcement at any time for further clarification
regarding this effective healthcare communication policy.
Also available on these web pages are links to 
other public resources and tools of cultural competence,
linguistic competence and health literacy that we have found
for you to use. We encourage you use these links
to assist in the preparation of your application.
(Music)
 
