Transforming the Face of Health Professions Through Cultural & Linguistic Competence Education:
The Role of the HRSA Centers of Excellence

Appendix B: Glossary

This section provides definitions of terms in the context they were used in this curriculum.

Culture – a set of implicit or explicit guidelines transmitted to individuals from a particular society, group or subgroup, which tells them "how to view the world, how to experience it emotionally, and how to behave in it relation to other people, to supernatural gods, and to the natural environment." (Helman, 2000). These rules and guidelines are often learned and dropped out of awareness.

Culture can also be defined as the way of life of a people. It is the sum of their learned behavior, patterns, attitudes and materials. It is not innate but learned and it is shared and in effect defines the boundaries of different groups (Falicov, 1998).

Cultural Diversity includes factors of race, ethnicity, age, gender, language, country of origin, sexual orientation, religion/spirituality, socioeconomic class, political orientation, educational/intellectual levels, and physical/mental ability among other factors.

Cultural lens: influence

• how we see ourselves
  
• how we see others
  
• what we value and how we behave with others
  
• the social structures we construct for dividing people into social categories (rich/poor, men/women, upper class/lower class, normal/abnormal, etc.)
  
• the rules for moving people from one social category into another, with or against their will.

play and important role in people lives' by influencing beliefs, values, behavior, attitudes to illness, pain and other important factors to health. However, culture is never homogenous or static. Generalizations lead to stereotyping, misunderstanding, prejudice and discrimination. Thus, the role of culture needs to be understood in its multidimensionality and always seen within a particular context (historical, economic, social, political and geographic).

Diversity is defined as all the ways in which people are different. It affects how people see the world, how they behave, and what values they hold.

Enculturation is the process by which the individual growing up as a member of a particular group or society acquires the "cultural lens" of that society.

Interpretation is the oral restating in one language of what has been said in another language.

Linguistic Competence – the capacity of an organization and its personnel to communicate effectively, and convey information in a manner that is easily understood by diverse audiences including persons of limited English proficiency, those who have low literacy skills or are not literate, and individuals with disabilities. This may include, but is not limited to, the use of:
- Bilingual/bicultural or multilingual/multicultural staff;
- Cultural brokers;
- Foreign language interpretation services including distance technologies;
- Sign language interpretation services;
- Multilingual telecommunication systems;
- TTY
- Assistive technology devices;
- Computer assisted real time translation (CART) or viable real time transcriptions (VRT);
- Print materials in easy to read, low literacy, picture and symbol formats;
- Materials in alternative formats (e.g. audiotape, Braille, enlarged print);
- Varied approaches to share information with individuals who experience cognitive disabilities;
- Materials developed and tested for specific cultural, ethnic and linguistic groups;
- Translation services including those of:

• legally binding documents (e.g. consent forms, confidentiality and patient rights statements, release of information, applications)
  
• signage
  
• health education materials
  
• public awareness materials and campaigns; and
  
• ethnic media in languages other than English (e.g. television, radio, Internet, newspapers, periodicals)

Translation typically refers to the written conversion of written materials from one language to another.

Underrepresented minority is defined as racial and ethnic populations who are under-represented in the designated health profession discipline relative to the number of individuals who are members of the population involved. This definition would include Black or African American, American Indian or Alaska Native, Native Hawaiian or Other Pacific Islander, Hispanic or Latino, and any Asian other than Chinese, Filipino, Japanese, Korean, Asian Indian or Thai.

References:

Falicov, C.J. (1998) Latino Families in Therapy: A Guide to Multicultural Practice. New York, NY: Guilford Press.

Helman, C.G. (2000) Culture, Health and Illness, Fourth Edition. England: Buttersworth-Heinnemann; pg. 2-6