In the United States, healthcare disparities are prominent in racial and ethnic minorities with language and health literacy barriers causing higher rates of chronic diseases, poor health outcomes and premature deaths (Holtz, 2020, p. 29-30).  To help combat the healthcare disparities for racial and ethnic minorities, the U.S. Department of Health & Human Services Office of Minority Health (OMH) developed The National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care (The National CLAS Standards).  The National CLAS Standards provides a framework for healthcare organizations to improve healthcare quality and equity for the countrys increasingly diverse communities (HHS, 2018).  The principal standard of The National CLAS Standards is to provide effective, equitable, understandable and respectful quality care and services that are responsive to diverse cultural health beliefs and practices, preferred languages, health literacy and other communication needs (HHS, 2018).  Culturally and linguistically appropriate services (CLAS) encompasses respect for the whole individual and responds to the individuals needs and preferences by customizing healthcare to the individual’s culture and language preferences (HHS, n.d.).

            Sidhu, et al., (2015), discussed five strategies to culturally adapt services; 1) create visual information designed to appeal to the group (peripheral strategy), 2) provide evidence from population studies of exposure causing harm (evidential strategy), 3) delivering message in native language (linguistic strategy), 4) hiring members of the indigenous population to draw from their experiences (constituent-involving strategy), and 5) discuss health related issues in the context of social and cultural values (sociocultural strategy) (p. 2).    

            Based on the above information, the healthcare program discussed in the article A critique of the design, implementation, and delivery of a culturally-tailored self-management education intervention: a qualitative evaluation did not adequately address cultural competence.  The healthcare program employed lay educators who had no experience living with the chronic diseases, which hindered providing participates with positive messages of overcoming events (Sidhu, et al., 2015, p. 9). This does not meet the constituent-involving strategy.  The lay educators perceived the information they were providing was more valuable than the participants cultural beliefs, and there was disrespect of cultural beliefs by calling beliefs myths (Sidhu, et al., 2015, p. 5). This contradicts the sociocultural strategy and The National CLAS Standards as this perception and these exchanges were disrespectful to cultural beliefs and practices.  Cultural adaption was poor in this program as evidenced by the majority of modifications were focused on the South Asian participants needs, female Muslim participants needed to request a female only group, and visual aids were not applicable to all ethnic groups nor culturally relevant (Sidhu, et al., 2015, p. 5-6).  This violates the peripheral strategy, linguistic strategy and The National CLAS Standards of cultural health beliefs and practices, preferred languages, health literacy and other communication needs. Working with interpreters was also an issue as it hindered smooth communication between the educator and participant, the interpreter overstepped their responsibility by communicating more than what was asked, information was lost through the chain of translation, and there was less participation from the participants (Sidhu, et al., 2015, p. 6-8). This does not meet the linguistic strategy, constituent-involving strategy, sociocultural strategy, and National CLAS Standards.  The health education messages were designed for Western lifestyles and diets, which were difficult to translate and considered culturally irrelevant by the participants (Sidhu, et al., 2015, p. 6). This contradicts evidential strategy, sociocultural strategy and The National CLAS Standards by being culturally disrespectful and inapplicable.     

References

Holtz, C. (2020). Global Health Care: Issues and Policies (4th ed.). Jones & Bartlett Learning.

National CLAS Standards – The Office of Minority Health. (2018). U.S. Department of Health and Human Services. https://www.minorityhealth.hhs.gov/omh/browse.aspx?lvl=2&lvlid=53

Sidhu, M. S., Gale, N. K., Gill, P., Marshall, T., & Jolly, K. (2015). A critique of the design, implementation, and delivery of a culturally-tailored self-management education intervention: a qualitative evaluation. BMC Health Services Research, 15, 54. https://doi-org.ezproxy.snhu.edu/10.1186/s12913-015-0712-8

What is CLAS? (n.d.). U.S. Department of Health and Human Services. https://thinkculturalhealth.hhs.gov/clas/what-is-clas