Facilitating Culturally Integrated Behaviors among Allied Health Students.

This article offers a perspective on why culturally integrated behaviors are important for allied health education and suggestions of methods to facilitate such behaviors. Literature and theory are used to support cultural integration in allied health curricula. Examples of learning experiences from students in cross-cultural environments and reflections on those experiences further elucidate facilitation methods. J Allied Health. 2002; 31:93-98. "If you wish to help a community improve its health, you must learn to think like the people of that community."1 AS THE UNITED STATES becomes more diverse in race and ethnicity, allied health students increasingly are working in cross-cultural practice sites. Preparing students for practice sites in diverse cultural settings is a challenging and crucial process for allied health curricula to address. Academia no longer can afford to focus only on knowledge and skill levels of students; curricula need to be broadened to facilitate humanistic behaviors in students to foster positive interactions with others. Today allied health professionals are more likely to encounter patients from different cultures that have varying beliefs regarding medicine and therapy. Increasingly, health care is recognizing the importance of culture in practice. Dilliard et al2 stated that when patients perceive an environment of open-mindedness and acceptance from therapists, they may begin to share their own culture and suggest treatment ideas consistent with their culture. When patients' beliefs clash with dominant cultural beliefs underpinning U.S. health care, patients may be perceived as foreign, irrational, or simply wrong which may provide an obstacle to delivering care. Academic curricula can prepare students better with an understanding of their personal beliefs, their professional values, and tools to understand and use culturally integrated behaviors and to mitigate potential cross-cultural problems. Culture and Health Care When defining culture, one must be cautious. Culture has been used too often to describe only that which appears different in looks, behavior, or values.3 Using the term culture in such a way would suggest that familiar looks, behaviors, and values do not qualify as culture. Everyone has culture, whether it appears familiar or foreign. Culture implies the integrated patterns of human behavior that include thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups.4 It provides a road map or a lens from which one comprehends and gives meaning to the world. Culture is the order shaping meaningful action.5 Habits, behaviors, and beliefs regarding health all are influenced by one's culture.6 Habits are actions that are performed spontaneously with little thought or difficulty.7 Behaviors are people's observable actions performed under given environmental circumstances.7 Beliefs include "conviction, opinion, confidence in the existence of something that is not immediately susceptible to rigorous proof, confidence, faith, or trust."8 Most ideas about health and illness come from everyday experiences.9 There are many ways to define health or illness and to determine what they mean in people's daily lives. People learn from the time they are born how to be healthy, how to recognize illness, and how to be ill.10 An example of a culturally influenced unhealthy habit is eating a high-fat, high-cholesterol diet. Food that is prepared for a sick family member is a behavior that often is influenced by culture, for example, whether to give someone cold or hot fluid. Culture often influences beliefs about why someone becomes sick. In some cultures, it is believed that sickness is a punishment for having done something wrong. Many authors have referred to the importance of approaching culture in health care as a process that includes reflection. According to Padilla and Brown,ll a willingness to acknowledge one's own culturally biased predisposition is key to integrating a cultural approach in health care. …