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Chronic Care Management | Care Coordination

Culturally Sensitive Chronic Care Management

October 31st, 2023 | 7 min. read



Content Team

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An individual’s culture and language play a large part in their health. Healthcare professionals see the impact that culturally sensitive approaches can have on building greater awareness, closing care gaps, and spurring health-driven patient action.

These interventions are particularly impactful when embedded in a Chronic Care Management (CCM) program.

Why are culture and language influential in healthcare?

The US is becoming more diverse. More than 10% of adults living in the US speak a language other than English. Nearly half of those individuals report speaking English less than “very well.” Racial and ethnic minorities are also disproportionately affected by chronic illness.

Language and communication barriers have been shown to affect healthcare access and quality. One study uncovered five critical predictors of culture-related communication problems, including:

  • Cultural differences in explanatory models of health and illness
  • Differences in cultural values
  • Cultural differences in patients’ preferences for doctor-patient relationships
  • Racism and perceptual biases
  • Linguistic barriers

The study found that physicians were unaware of how their communication patterns may vary when treating individuals from different cultural backgrounds. This is considered to be  implicit bias, and includes attitudes or stereotypes that unconsciously impact understanding and treatment decisions.

Research highlights the downsides that bias and lack of cultural sensitivity can have on helping patients access and receive high-quality care. But what is cultural sensitivity, and how can it improve healthcare adherence and outcomes, particularly for patients with chronic conditions?

What are cultural competence and cultural humility?

Culturally sensitive healthcare is born out of cultural competence and humility.

The Agency for Healthcare Research and Quality provides a definition: 

"Culturally competent care is defined as care that respects diversity in the patient population and cultural factors that can affect health and healthcare, such as language, communication styles, beliefs, attitudes, and behaviors."

Cultural competency equates to how well professionals and systems provide high-quality care to patients with diverse values, beliefs, and behaviors. This also includes their ability to tailor care delivery to meet patients' social, cultural, and linguistic needs.

Through cultural competence, a healthcare organization is aware of and responsive to patients’ cultural perspectives and backgrounds. They respect and consider patient and family preferences, values, cultural traditions, language, and socioeconomic conditions.

Ultimately, cultural competency is an essential strategy to reduce racial and ethnic disparities in healthcare.

Cultural humility entails an ongoing process of self-exploration and self-critique, led by a willingness to learn from others to better serve them. While cultural competence is a skill that can be taught, cultural humility emphasizes interpersonal sensitivity, openness and valuing intracultural variation and individuality to avoid stereotyping.

Culturally sensitive Chronic Care Management can improve health outcomes

A study published by Health Psychology discovered significant links between patient-perceived provider cultural sensitivity and adherence to provider treatment regimen recommendations.

Other studies have demonstrated the efficacy of embarking on a journey of cultural sensitivity.

Five interventions were used most often, including:

  • Leveraging community-based bi-lingual health workers
  • Training health workers and clinicians in cultural competency
  • Offering interpreter services
  • Providing patients with multimedia and culturally sensitive health education videos
  • Establishing community point-of-care services for patients with chronic disease

One study demonstrated that cultural sensitivity increases awareness of disease risks, promotes preventive action, and closes care gaps, achieving the following improvements:

  • 19% increase in knowledge about disease prevention factors
  • 54% increase in mammography screenings
  • 46% increase in women seeking Pap tests

Again, there was a correlation between patients receiving care from culturally-informed professionals and their adherence to care plans, as well as higher satisfaction survey results.

How to build greater cultural competence and humility 

Delivering patient-centered care now entails a new level of respect and consideration of a patient’s culture, heritage, and lifestyle. Attaining a greater capacity for providing culturally sensitive healthcare offers opportunities to connect with and engage patients living with chronic illness.

Plus, Chronic Care Management (CCM) programs are uniquely suited to provide support and attention that engages patients around unique aspects of culture and lifestyle. 

For example, suppose a Latina woman receives nutrition guidance. In that case, it can be more valuable that someone understands or asks about the social role of food and the specific types of dishes created. This way, a conversation with a dietitian, care manager, or diabetes educator can explore how recipes may be adjusted to achieve health goals.

Through consistent, goal-oriented communication and care planning, care team members have opportunities to make culture and lifestyle vital topics. 

Consider adding or adjusting existing training, processes, and approaches to make a CCM program more culturally sensitive. This can include:

  • Create or select an inclusive language resource that guides the care team in managing interactions and conversations with those from a culture different from one’s own.
  • Offer educational and other clinical material in the main languages spoken in your region. If interpreters are available, inquire before appointments if that service is needed. Try to match medical assistants or care managers with patients with a similar background.
  • Make culture, lifestyle, and diversity topics of conversation. In addition to formal training, infuse meetings with issues around how care can be more culturally sensitive. Ask for staff input from their own experiences or those of family members. Determine how the physical environment, policies, and procedures can honor each patient’s preferences.
  • Pay attention to the role and impact of assumptions during patient care delivery. Discuss with the care team when assumptions were wrong, leading to unfortunate issues in providing the best care possible.
  • Inquire without judgment about cultural practices, treatments, or herbal remedies that the patient has used and whether they helped. Respect for their cultural norms can open the discussion to more Western approaches.
  • Create a handy reference that reminds staff of salient takeaways from cultural training. This could include lists of common health beliefs, behaviors, and critical “dos” and “don’ts.” While each person has a unique life experience, generalities can be used as a starting point for inquiry and conversation.
  • Make it clear that the goal of care is to understand and address the patient as a “whole person” who comes with experience, family, social norms, and cultural influences. Establish a clear desire to know them and include these factors in shared decision-making.

Building cultural competence takes time. It’s an ongoing learning process where greater cultural humility develops one conversation at a time.

Putting cultural sensitivity into practice

The US Office of Minority Health offers a principal standard to guide any effort to create competence and capacity to deliver more culturally sensitive care.

The goal is to “provide effective, equitable, understandable and respectful quality care and services responsive to diverse cultural health beliefs and practices, preferred languages, health literacy, and other communication needs.” 

Building greater cultural sensitivity for CCM programs can help teams achieve care objectives like greater awareness and commitment to preventive screenings, care plan action, and health maintenance.

How ThoroughCare can help

Healthcare organizations use ThoroughCare to deliver integrated care management services to foster patient engagement and enhance revenue. Our platform provides the digital infrastructure to leverage fee-for-service programs for value-based success.

With seamless EHR integration and data interoperability across health information exchanges and remote devices, our platform supports solutions for:

  • Chronic disease management
  • Remote patient monitoring
  • Behavioral health services
  • Wellness assessments
  • Transitional care

Providers use ThoroughCare to seamlessly manage populations, capture and act on patient data with interactive care planning and assessments, and visualize business performance to inform decision-makers.

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