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New book promotes cultural competencies in health care.

Health providers who serve American Indians and Alaska Natives face special communication challenges that go far beyond language barriers. With their identities woven tightly into the fabric of their tribes, many American Indians and Alaska Natives believe their health providers must understand the history and culture of their tribes in order for a successful patient/provider relationship to occur, according to a new APHA book.

Teaching health care providers about a tribe's history and culture is a foundation for communication. Nationally, however, only about a third of tribes and approximately half of urban Indian clinics have programs to teach health care providers about their history and culture. But some of the programs have met with great success, said the new book, "Strategies for Cultural Competency in Indian Health Care." The book highlights six programs around the nation that have overcome obstacles to develop and sustain effective ways of training health care providers about the culture and history of the patients they serve.

Cultural competency is essential to eliminating health disparities, which for American Indians and Alaska Natives are among the greatest in the United States, according to the book's authors, Mim Dixon, PhD, MS, and Pamela E. Iron, MA.

"We both have a passion for making an impact on the health disparities of American Indians and Alaska Natives," said Iron, executive director of the National Indian Women's Health Resource Center in Tahlequah, Okla. A Cherokee/ Laguna Pueblo native, Iron founded the Tulsa Indian Health Care Resource Center and is a former health director for the Cherokee Nation.

Dixon, a Boulder, Colo.-based consultant in the field of American Indian and Alaska Native health care, said she became interested in cross-cultural communication and cultural competency while serving as health director for the Cherokee Nation in 2000. Cherokee Nation Principal Chief Chad Smith had just taken office, Dixon said, and had mandated that all employees take a 40-hour history session.

"I couldn't believe how much it changed me and my view of American history through the eyes of the Cherokee Nation," Dixon said. "There was so much I didn't know."

Wondering if any other tribes were formally teaching their history and culture to their health care providers, Dixon teamed up with Iron and the two launched a preliminary survey.

The book describes six programs across five states wher tribes and tribal organizations take charge of teaching health care providers about their culture and history.

Authors Dixon and Iron said the book, with its practical models and insight on how the programs can be replicated elsewhere in the country, will likely appeal to a broad audience, including tribal health care administrators, health care professionals who work with American Indian and Alaska Natives, architects interested in designing health care facilities for the Indian Health Service and tribal health entities and academics working to include cultural competency in curriculums for health care providers.

The book comes with a free 30-minute DVD film, "Creating Space for Culture and History in Indian Health Care," that enhances the compelling narrative with visual images and interviews at each of the six sites.

To purchase the book, visit <www.aphabook> or call (888) 320-2742. The price is $18.85 for APHA members and $26.95 for non-members.
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Title Annotation:Strategies for Cultural Competency in Indian Health Care
Author:Johnson, Teddi Dineley
Publication:The Nation's Health
Article Type:Book review
Date:Sep 1, 2006
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