Floren Capstone 2015 US Healthcare 101 Using Community Health Theories and Principles to Design Culturally Relevant Materials for Incoming Refugees
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This document discusses a capstone project to design culturally relevant health education materials for incoming refugees at Sunrise Community Health. The author conducted interviews with refugee agency staff to assess refugee health needs and barriers to care in the US healthcare system. Key themes that emerged included cultural factors like expectations of care, language barriers, and lack of familiarity with the healthcare system. The author then developed a tailored curriculum to address these needs and improve refugees' access to health services. The goal was to reduce health disparities by teaching refugees how to navigate the US healthcare system and effectively use health services.
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Running head WELLNESS EDUCATION PROGRAM 1 Copyright ©2017.docx
Running head: WELLNESS EDUCATION PROGRAM 1
Copyright ©2017 Capella University. Copy and distribution of this document are prohibited.
Wellness Education Program Proposal
Learner’s Name
Capella University
Health Promotion and Disease Prevention in Vulnerable and Diverse Populations
Wellness Education Program Proposal
May, 2017
WELLNESS EDUCATION PROGRAM 2
Wellness Education Program Proposal
I. Introduction
In the United States, vulnerable populations such as Hispanics are more likely to face
difficulties while accessing health care than less vulnerable populations. Many factors such as
low income, lack of insurance, lack of education, and lack of English and Spanish language
proficiency contribute to this disparity in accessing health care. This language barrier can prevent
Hispanics from accessing important health education material and prevent health care workers
from providing regular medical care. This proposal focuses on the importance of developing a
wellness education program for health promotion and disease prevention among Hispanics.
II. Problems and Needs
To address the health care disparities, a holistic wellness education plan needs to be
developed for Hispanics taking into consideration their affinity to complementary and
alternative medicine (CAM) and spiritual care. It is also necessary to be aware of the positive
and negative aspects of the ethical, legal, and economic principles of health promotion and
disease prevention while developing the wellness education plan.
III. Proposed
Solution
An ideal wellness education plan for Hispanics would integrate the elements of
culture, language, CAM, and spiritual care for addressing the health care disparities faced by
them. Integrating these elements would help them receive a more holistic health care as their
physical and mental states are taken into consideration while devising the plan.
WELLNESS EDUCATION PROGRAM 3
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Floren Capstone 2015 US Healthcare 101 Using Community Health Theories and Principles to Design Culturally Relevant Materials for Incoming Refugees
- 1. U.S. Healthcare 101: Using Community Health Theories and Principles to Design Culturally Relevant Materials for Incoming Refugees Kiley Floren, MPHc Community Health Education Preceptor: Erma Gonzalez, RN, Sunrise Community Health INTRODUCTION LIMITATIONS METHODS Because of their history and cultural backgrounds, newly arrived refugees have unique health needs and barriers to health care. FUTURE DIRECTIONS PURPOSE RESULTS Interview Topics Refugee healthcare needs/barriers to access Capacity to meet identified needs REFERENCES 1. United Nations High Commissioner for Refugees. (1967). Convention and Protocol Relating to the Status of Refugees. Retrieved from http://www.unhcr.org/3b66c2aa10.html 2. Office of Disease Prevention and Health Promotion. (2015). Access to Health Services. Retrieved from http://www.healthypeople.gov/2020/topics- objectives/topic/Access-to-Health-Services/objectives 3. Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice Hall. • Small sample size (6 participants) • No data collected from refugees who were not agency staff • Informal, semi-structured interviews with evolving questions • Inability to evaluate curriculum for cultural acceptance or impact on behavioral outcome due to capstone timeframe • Tailored messaging: needs differ by country of origin • Research: feedback from new refugees to inform needs assessment, intervention materials and evaluation • Collaboration: work with refugee-serving organizations to better meet non-medical needs • Training for providers: knowledge of culture-specific needs could improve message framing and targeted education • Systemic change: prolonged, deliberate cultural orientation could improve workforce diversity to serve future refugees Sunrise Community Health Member of Community Lutheran Family Services Outsider to Community Cognitive Factors Trust of provider Expectations of care Environmental Factors Employment norms Community support Behavioral Factors Making and keeping appointments Determinants of Behavior Observed themes matched the determinants of behavior described in Bandura’s social cognitive theory.3 A refugee is considered to be someone who has a well-founded fear of persecution, is outside their country of nationality, and is unable or unwilling to seek protection from that country.1 PUBLIC HEALTH SIGNIFICANCE Improving access to comprehensive, quality health care services is a goal of Healthy People 2020.2 • Persecution/Trauma • Poor Nutrition • Unhealthy Exposures • Unmanaged Disease Home Country (Burma/Somalia) • Years of Waiting • Poor Living Conditions • Limited Access to Healthcare • Brief Preparation for U.S. Refugee Camp (Neighboring Country) • Case Management • Limited Cultural Orientation • Required Steps (including health screenings) Arrival in U.S. As the site designated to screen incoming refugees, Sunrise Community Health has an opportunity to provide education to alleviate barriers and improve access to care. Centralize Refugee Health Care Assess Needs Assess Capacity Design Curriculum Implement Education The capstone objectives were to assess needs of new refugees related to accessing care in the United States, understand the organizational capacity to address these needs, and develop a curriculum that Sunrise Community Health can implement. Goal: To improve access to health care among new refugees A needs assessment was conducted in the form of key informant interviews with staff from two agencies. Interview Participants Interview Questions Informal/informational Iterative: Themes from initial interviews verified in succeeding rounds Teaching refugees to better use the U.S. healthcare system will… Reduce: • Health disparities • Rates of chronic and infectious diseases • Inappropriate use of hospital emergency departments Improve: • Economic opportunity • Mental and physical well-being • Quality of life Overview of Healthcare System Making and Keeping Appointments Burmese Only Employee Rights Patient Confidentiality Somali Only Testing and Treatment Plans Medications Questions Connections to Community Resources TAILORED CURRICULUM COMPONENTS Providers who had been refugees provided cultural reasons for differences by home country: Burmese patients were more shy and hesitant to seek care Somali patients were more likely to abuse health systems and seek support