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Healing by Heart: Culturally Responsive Health Care. Kathie Culhane-Pera, MD MA Healthy Generations Videoconference March 7, 2005. Table of Contents. Part I: Health related cultural beliefs, practices, values Parts II - VI: Case Stories and Commentaries Women’s Health Children’s Health

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Healing by Heart:Culturally Responsive Health Care

Kathie Culhane-Pera, MD MA

Healthy Generations VideoconferenceMarch 7, 2005


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Table of Contents

Part I: Health related cultural beliefs, practices, values

Parts II - VI: Case Stories and CommentariesWomen’s Health

Children’s Health

Chronic Disease

Mental Illness

End-of-Life Care

Part VII: Culturally Responsive Health Care

A model for culturally responsive health care with recommendations for health care practitioners, administrators, and policy makers


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Healing by Heart: Part I

  • Hmong Culture: Tradition and Change

  • Health-related cultural beliefs, values, and practices, both in Laos and in the United States.





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Part II-VI: Cases

  • Women’s Health, Children’s Health, Chronic Disease, Mental Illness, and End-of-Life Care

  • Cases especially pertinent to maternal-child public health:

  • Controlling Fertility

  • Woman with Pregnancy Complications

  • Woman with Vaginal Bleeding

  • Children with High Fever

  • Bottle-fed Toddler with Anemia

  • Infant with Down Syndrome and a Heart Defect

  • Domestic Violence

  • Hospice Patient with Gallbladder Cancer

  • Pregnant Woman with a Brain Hemorrhage


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Bruce T. Bliatout, PhD, MPH

Helen Bruce, CNM

Donald Brunnquell, PhD

Karen G. Gervais, PhD

Mymee Her, PhD

Chue Pao Heu

Peter Kunstadter, PhD

Stephen Kurachek, MD

Pacyinz Lyfoung, JD

Mayly Lyfoung Lochungvu

Deborah Mielke, MD

Christopher L. Moertel, MD

Mai Neng Moua, BA

Vang Leng Mouanoutoua, PhD

Elanah D. Naftali, DrPH, RD

Kevin A. Peterson, MD, MPH

Gregory A. Plotnikoff, MD, MTS

Marline Spring, PhD

Carol A. Tauer, PhD

Mao Heu Thao, LPN, BA

Va Thao, LPN

Cher Vang, MPA

Lu Vang

Maylee Vang, MA

Thomas Vang, MS

Elizabeth C. Walker Anderson, BA

Patricia F. Walker, MD, DTM&H

Joseph Westermeyer, MD, PhD

Chue Xiong, RN

Yer Moua Xiong, MPH

Deu Yang, LPN

Nkaj Zeb Yaj

Anonymous family members

Parts II-VI: Case Commentators


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Healthy Generations Newsletter

  • Xong Mary Hang: 1 yo with milk-induced iron deficiency anemia

  • Questions about cultureWhat cultural beliefs/ values contribute to anemia? What assumptions about bottles in mainstream and Hmong?

  • Questions about cross-cultural health care ethicsHow did parents/ grandparents/ providers’ assessments differ? How closely must her care resemble standard of care?

  • Questions about culturally responsive health careHow can providers help refugees whose experiences with trauma and deprivation provide barriers to accepting healthcare recommendations?


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The Healing by Heart Model: Culturally Responsive Health Care

I. Be aware of the influence of culture on health status, beliefs, practices, and values.

II. Increase self-awareness about your own health beliefs, practices, and values.

III. Learn about the prevailing health beliefs, practices, and values of the cultural groups you serve.

IV. Identify potential areas of congruity and difference between your own health beliefs, practices, and values and those of the cultural groups you serve.

V. Increase self-awareness about your cross-cultural health care ethics.

VII. Develop attitudes culturally responsive to the groups you serve.

VI. Learn skills to identify, evaluate, and respond to cross-cultural ethical conflicts, with special attention to challenges to professional integrity.

VIII. Learn communication skills culturally responsive to the groups you serve.

IX. Develop skills in applying culturally responsive knowledge, skills, and attitudes to particular clinical relationships.


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Healing by Heart Model

  • I. Be aware of the influence of culture on health status, beliefs, practices, and values.

  • II. Increase self-awareness about your own health beliefs, practices, and values.

  • III. Learn about the prevailing health beliefs, practices, and values of the cultural groups you serve.

  • IV. Identify potential areas of congruity and difference between your own health beliefs, practices, and values and those of the cultural groups you serve.


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Healing by Heart Model

  • V. Increase self-awareness about your cross-cultural health care ethics.

  • VI. Learn skills to identify, evaluate, and respond to cross-cultural ethical conflicts, with special attention to challenges to professional integrity.


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Healing by Heart Model

  • VII. Develop attitudes that are culturally responsive to the groups you serve.

  • VIII. Learn communication skills that are culturally appropriate to the groups you serve.

  • IX. Develop skills in applying culturally responsive knowledge, skills, and attitudes to particular clinical relationships.


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Hla dej yuav hle khau.Tsiv teb tsaws chaw yuav hle hau.

—White Hmong Proverb

When crossing a river, remove your sandals.

When crossing a border, remove your crown.


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