Latest News

Get Diabetes Education Video in Khmer
Seattle-based EthnoMed has a new resource available to help clinicians discuss diabetes and diet with Khmer-speaking (Cambodian) patients.

Cambodian Foods that Affect Blood Sugar: A Guide for Cambodian Patients is a 10-minute video slideshow presentation, narrated in the Khmer-language,that is tailored to reflect foods commonly consumed by Cambodian Americans. It is intended for patients to learn how these foods raise, lower, or have little effect on a person's blood sugar. The presentation is also viewable as a PDF with 59 slides that is great for color printing/laminating.

View the narrated slideshow and PDF.

Free Health, Safety DVD in 8 Languages
Get health and emergency video messages in eight languages by ordering a free DVD from ECHO Minnesota. The DVDs contain a year's worth of programming on subjects such as home safety, prenatal health, obesity, and emergency preparedness.

These programs and public service announcements are crafted with input from subject matter experts, and presented by ethnic spokespersons and bi-lingual guest-experts.

Get more information and order your DVD here.

End of Life Interpreter Training, Free
Forty percent of patients receiving palliative care speak limited English. Are your interpreters prepared to be sensitively involved in providing emotionally complex end-of-life care?

Palliative care depends on regular, clear communication between patients, providers, and families. Interpreters are key members of any palliative care team.

For interpreters, conversations involving palliative care, especially those at the end of life, can be among the most difficult to convey — not only linguistically and culturally, but personally. Yet to date, there has been little training for interpreters in this field.

A seven-hour workshop curriculum, available from the California Healthcare Foundation, is free and can be downloaded. The curriculum is designed for health care interpreter trainers for use in preparing experienced medical interpreters to work in palliative care.

Languages included are traditional Chinese, simplified Chinese, Korean, Russian, Spanish, Tagalog, and Vietnamese.

Texting Toward Health
Innovative programs in New Zealand and the Netherlands are using texting and online programs to keep people healthier, especially in underserved communities. In a new blog post, former Commonwealth Fund Harkness Fellows Robyn Whittaker and Hedda van't Land share experiences that could be adapted by US providers.

New Zealand created one of the first free public health campaigns using text messages—the smoking cessation program Text2Quit. In the Netherlands, a large Web-based depression prevention program uses educational and social media tools to engage those with mild to moderate depression.

Find a deeper discussion on the Commonwealth Fund's blog.

Get the Holidays Right
Looking for tips on approaching the holidays in a culturally sensitive manner? Check out this article, Culturally Responsive Instruction for Holiday and Religious Celebrations by Dr. Cynthia Lundgren and Giselle Lundy-Ponce.

The article was originally written for the American Federation of Teachers, so you'll have to make some slight adjustments for a health care environment. But it's loaded with useful tips on how recognizing your own cultural conditioning, establishing relationships, adding cultural content to teaching, and observing cultural and religious holidays throughout the year.

Learn the Basics at Refugee 101
Do you need basic information on where refugees come from, how they get here, and what their situation looked like before their arrival? Check out Refugee 101, a quick overview provided by Bridging Refugee Youth and Children's Services.

The page links to interactive websites where you can learn more about refugee youth on pages that chronicle the experiences of 15 teenagers who fled war in eight countries. Additional links allow you to place yourself in refugees' shoes as they navigate daily life in a refugee camp, struggling to find shelter, food and medical care.

Help Improve Refugees' Flu IQ
Flu season is here. You can get free material developed by the Centers for Disease Control to improve refugees' knowledge of influenza. Written in the native languages of refugee populations commonly resettled in the United States, the documents are tailored for low literacy populations. Each handout uses graphics and minimal text to portray influenza information.

Titles include:

• Influenza (Flu) and You
• Cleaning to Prevent Flu
• Talking to Children about Flu
• If Your Child Gets Sick with Flu

Exchange members can find these materials in the Exchange library in Amharic, Arabic, English, Karen, Nepali, Oromo and Somali. You can also go to the CDC's Immigrant and Refugee Resources web page to find versions in the languages above, plus Burmese; Dzongkha; Farsi; and Kirundi.

Get a Field Guide on LGBT Care
The Joint Commission has released a field guide on how to improve communication and provide culturally competent care to lesbian, gay, bisexual, and transgender patients. This field guide is a followup report to the Joint Commission's roadmap to culturally competent care, and provides details specifically for the LGBT population.

The field guide includes chapters on leadership; providing care; workforce; data collection; and patient, family, and community engagement. You'll also find useful checklists, plus citations to resources and references.

Given the Joint Commission standard prohibiting discrimination based on sexual orientation, gender identity and expression, this field guide is a valuable resource to all health care organizations.

Download the field guide here.

Reform: How Other Countries Do It
In a new series on The Commonwealth Fund Blog, Jonathan Cohn explores the health care systems of four countries: the Netherlands, France, the United Kingdom, and Germany.

In his first two installments, available here, Cohn looks at the Dutch health care system, which includes many features of a high-performance health system.

"It provides virtually everybody with high-quality and convenient medical care, and at a much cheaper price than the U.S. system—per capita health spending in the Netherlands in 2009 was only $4,914, compared with $7,960 in the U.S," Cohn writes. Like the U.S., the primary source of coverage in the Netherlands is private insurance, though it's made available through a highly regulated marketplace.

Closing the Health Care Divide
A new set of strategies released by the Commonwealth Fund Commission on a High Performance Health System could improve how the U.S. health care system serves vulnerable populations, including people without health insurance, low-income families, and members of racial and ethnic minority groups.

The new report, Ensuring Equity: A Post-Reform Framework to Achieve High Performance Health Care for Vulnerable Populations, shows again that a health care divide exists between vulnerable populations and their wealthier counterparts in a number of areas, including screenings and preventive care, control of chronic diseases, and hospital admissions that could be prevented by better primary care.

The Commission argues that closing these gaps will require a policy framework that ensures adequate access to health care and financial protection for vulnerable populations, and better coordination between the health care system and other community resources.

Download the report to learn more about these strategies and how they can help us achieve a better health system for all.

Ready for New Cultural Care Standards?
Ready or not, the new Joint Commission standards on cross cultural care and effective communication will start to be applied in 2012. Is your hospital ready?

You can find out more about where you stand by checking out this guide from the Joint Commission, Advancing Effective Communication, Cultural Competence, and Patient-and Family-Centered Care: A Roadmap for Hospitals.

This roadmap was developed to help hospitals integrate concepts from the communication, cultural competence, and patient- and family-centered care fields into their organizations. The Roadmap for Hospitals provides recommendations to help hospitals address unique patient needs, meet the new Patient-Centered Communication standards, and comply with existing Joint Commission requirements. Example practices, information on laws and regulations, and links to supplemental information, model policies, and educational tools are also included. The Patient-Centered Communication standards will be presented in a separate appendix that provides self-assessment guidelines and example practices for each standard.

A PDF version of the Joint Commission roadmap can be downloaded here. You can also check out a brief video by Patricia Adamski, Director of the Joint Commission's Standards Interpretation division, that provides background on implementation.

Field Notes: Traditional Healing in Chiapas
For an interesting glimpse inside folk medicine traditions in Mexico, check out this account recently published on the CLAStalk online forum (sign up here), maintained by DiversityRx.

In this brief but fascinating eye-witness story, Suzanne Salimbene, Ph.D, of Inter-face International, describes a trip to a remote Catholic Church where traditional healers diagnosed and treated their patients.

This is just one example of the type of information available on the CLAStalk forum. The forum is a place where participants can raise issues, ask questions, and share information about topics related to the design, delivery and evaluation of culturally and linguistically appropriate services (CLAS) in health care.

Get Help Building a Ped Cultural Care Plan
Looking for resources to develop a pediatric cultural care program? A great first stop is the American Academy of Pediatrics website, where you can find the organization's online Cultural Care Toolkit.

Modules within the toolkit provide basic information and resources on subjects including:

• health beliefs and practices;
• nutrition, feeding and body image perspectives;
• behavior and child development;
• interpretive services;
• literacy and health literacy;
• and tips, tools and resources for implementing new programs.

Get the free toolkit here.

When the Diagnosis Is Poverty
In a recent piece in the San Francisco Chronicle, physician Laura Gotlieb examines how her training left her coming up short when confronting physical problems caused by poverty. Her article, Funding healthy society helps cure health care, is an insightful look at the wide disparity of wealth in America, and the frequent inability of people on the top to recognize the true cause of physical distress in people on the bottom rung of the economic ladder.

Here's a sample of Gotleib's story: "In Jeremy's case, I had diagnosed "abdominal pain" when the real problem was hunger; I confused social issues with medical problems in other patients, too. I mislabeled the hopelessness of long-term unemployment as depression and the poverty that causes patients to miss pills or appointments as noncompliance. In one older patient, I mistook the inability to read for dementia. My medical training had not prepared me for this ambush of social circumstance."

Get Somali Mental Health Stories

Here's a hour-long program that provides mental health information for Somalis and organizations working with Somalis. Through storytelling it encourages Somalis to seek resources to help with mental health issues. English subtitles are provided in this video produced by the St. Paul-based Egal Shidad and available on the New Routes to Community Health website.

If you haven't checked out the New Routes site previously, it's well worth the visit. You'll find an impressive collection of videos and other resources on health and other community-building topics, easily sortable by immigrant population.

Immigrant Kids and Language Barriers
Promoting positive outcomes for children in immigrant families is critical given that they are among the fastest growing segment of the US child population. This brief provides Minnesota-specific information about the strengths of immigrant families that promote success, and barriers such as education, income and overcrowding that make it harder to get a leg up.

Download the free report, produced by The Center for Social and Demographic Analysis at the University of Albany, NY.

A Video for Fighting Stereotypes

This short, wordless video may be the piece to help break the ice in your next training on unconscious bias. The five-minute film was produced at the University of Southern California School of Cinema-Television by Jon M. Chu. It makes the not-entirely-unexpected point that you never know who you can trust and who you can't.

For Latinos: Help Getting Out of the Closet

Here's a video series from Somos Familia that helps to increase acceptance of lesbian, gay, bisexual and transgendered youth within Latino families. "Tres Gotas de Agua" is a short video of three Latina immigrant moms, sharing their stories of their children's coming out process. The stories can be seen as separate videos or combined into a single 13 minute video. They are in Spanish with English subtitles. Somos Familia's YouTube channel.

Find Cultural Info on End-of-Life Decisions
Honoring Choices Minnesota supports community-based conversations regarding end-of-life care planning. The organization offers a free toolkit of video, text and web links to support these conversations within family, faith, cultural or community groups. You can find out more at the Honoring Choices website. (Be forewarned — some portions of the site are still under construction.)

Get Language Access Policy Help
Here's a great source of information on language access from the National Health Law Program. The organization's Language Access Publications web page includes numerous reports of interest to anyone wrestling with translation or interpretation issues. On the NHLP site you'll find examinations of the high cost of language barriers in medical malpractice, resource guides for pharmacists, a summary of federal laws and policies to ensure language access services and much more. The nicely formatted reports are available for free download.

After Childbirth: Hot or Cold?
Sometimes it's the simple things that can trip you up. For example, what kind of liquids should be offered after childbirth? Here are some observations from Geri-Ann Galanti, a UCLA Medical School faculty member:

"One simple tip is to offer liquids other than ice water.  In many traditional Asian and Hispanic cultures, ice water is to be avoided after giving birth, since pregnancy is considered a "hot" condition, and thus giving birth leaves the body "cold."  You don't want to shock the system with more cold. 

"Although most younger women will probably not follow this custom, there may be older women around who try to enforce it.  The simple, and culturally competent thing to do is to ask the woman whether she would prefer ice water or water at room temperature.  In fact, this should be asked of ALL patients, since people have different preferences."

Another Look at Hmong Assimilation
Here's an inside view on aspects of Hmong culture that may have slipped right past you. University of Minnesota graduate student Pao Lee's dissertation, Racial Assimilation and Popular Culture: The Persistence of the Color Line, offers an in-depth view of Hmong hip-hop and street-racing. Lee uses these pursuits to explore the where, why and how of second generation Hmong assimilation into the American racial landscape.

What Would You Do?
Here's just one of the scenarios set out for discussion in the Critical Incidents for Intercultural Communication in Health Care project guide, developed in Alberta, Canada, by the Centre for Excellence in Intercultural Education at NorQuest College:

"As a nursing administrator I mostly had issues with groups of nurses from the same country. The majority were very hard workers, but they were almost always late for duties within the hospital. The reason they often gave was that they were detained by the physicians. I spoke to many of those physicians about the issue, and they said they hadn’t been aware; the nurses had never said anything about having other commitment."

This resource offers 18 such scenarios for discussion. The accompanying trainer's guide uses these critical incidents to "provide access to real experiences without cultural markers and support the development of intercultural competence by developing more complex interpretations and responses to situations."

The incident package and trainer's manual are available as free downloads.

Bookmark This Website
The remade DiversityRx website is worth a place in your bookmarks file. New features include three extensive databases, with resources,
organizations and professional profiles related to working in cross cultural health care. A free membership option allows you to contribute content and network with colleagues in the field. New content added to the blog line-up: communicating about health disparities, and how to deal with cultural friction among organizational staff.

Obesity Videos Free in Seven Languages

With local and national obesity rates steadily rising, Blue Cross and Blue Shield of Minnesota and Emergency, Community and Health Outreach (ECHO) teamed up on a new, 20-minute television program called “Obesity and Your Health.”

More than two-thirds of Minnesota adults are either overweight or obese, and many low-income and racial or ethnic groups suffering disproportionately from obesity and related health conditions. The program is available in low-literacy English, Hmong, Khmer, Lao, Somali, Spanish and Vietnamese.

Minnesota’s obesity-related health care costs are estimated at more than $1.3 billion. Blue Cross projects that Minnesota’s obesity-related health care costs could increase to more than $5 billion annually by 2020 if the obesity rate is unchecked.

Find the English version of the obesity video here. For other languages, click on the right menu of the ECHO web site.

Get Vaccine, Autism Videos in Somali

These Somali-language videos, each with English subtitles, focus on giving Somali-American parents general information about vaccines and autism.

Both videos were developed by the Mayo Clinic Department of Pediatrics and Adolescent Medicine and the Somali community of Rochester, MN, and are available on YouTube.

The Case for Trained Interpreters, Again
In Doctoring Across the Language Divide, a moving first-person account in Health Affairs, California physician Alice Chen provides the story of her complex interactions with a Yemeni woman who came to her for treatment. With no other initial options, she relied on the woman's husband to provide interpretation. In a later appointment, after Chen secured the service of a trained, professional interpreter, a far more nuanced portrait of the woman's condition emerged. This is another piece well worth circulating to anyone who doubts the value of trained interpreters.

Another Excellent Language Resource
If you haven't already checked out Healthy Roads Media for health education material in various languages, take a look at its website. Healthy Roads offers a variety of patient education pieces in translation, and in a variety of mediums. You'll find written material, audio, video and video for mobile devices. Subjects range from the specific ("Clostridium Difficile Infections," for example) to the more general (such as, "Prevent Errors in Your Child's Care"). Material is available in 22 languages, though not all subjects are covered in all languages.

If You Can't Do It in English…
…then how will you do it in Somali? Here's a fascinating piece from the New York Times that underlines an essential fact about communication in any language. It's only partially about the words.

In 18 Stethoscopes, 1 Heart Murmur and Many Missed Connections, writer Madeline Drexler describes her experience as a patient with an interesting heart condition for a class of 18 Harvard medical students. Read this cautionary tale here.

Point of Departure: Bhutanese Refugees
Here's a quick look at a Nepal camp from which Bhutanese refugees depart for resettlement. The three-minute video is provided by the UN World Food Programme.

The U.S. offered to resettle 60,000 of the 107,000 Bhutanese refugees of Nepalese origin now living in seven U.N. refugee camps in southeastern Nepal. Refugees began arriving in 2008.

According to World Relief Minnesota, an additional 10 Bhutanese refugees arrived in Minnesota in Feburary, joining an estimated 350 already settled here. The video is also available on YouTube.

Who Is Asian?
Or black? Or Latino? Or white? This New York Times article explores the increasingly complicated reality of assessing patients by race and assigning them to categories that may not actually apply. Interesting reading and insight into the changing definition of race in America.

Get a Free Spiritual Practices Guide
Health care professionals need to be sensitive to the spiritual practices of patients — both because it's an integral part of treating the whole person, and because the Joint Commission says so. The Commission holds hospitals accountable for addressing and maintaining patient rights, which include the accommodation of spiritual values and practices.

Resources offered by the Health Care Chaplaincy can help improve your knowledge and skills. Go to its website to get these free resources:

• A Dictionary of Patients’ Spiritual & Cultural Values for Health Care Professionals
• Cultural & Spiritual Sensitivity – A Learning Module for Health Care Professionals

Local Refugee Health World, in Print
Looking for the latest word on virtually every metro-area refugee health-related event and opportunity? Subscribe to the bi-weekly Metro Refugee Health Task Force Update. To get on the subscriber list, simply send a note to editor Sara Chute.

The Update, which reaches about 500 people per issue, gets you news about job opportunities, seminars and conferences, information fairs, and other events within local refugee communities. It's a stunningly encyclopedic round-up. Say Chute, "We try to keep it to 40 pages every two weeks."

Help Meeting Needs of Iraqi Refugees
The inevitable product of war is refugees. Count on seeing more Iraqi refugees in the months and years ahead. Here's an extensive resource guide from the Washington DC based group, Bridging Refugee Youth and Children’s Services (BRYCS), that will give you more information on the cultural background and adaptation issues experienced by Iraqis who are building a new life in the US.

An Inside Look at Faith Healing
Here's a New York Times story that offers a look at the work of an Iraqi faith healer. The author, an assistant professor of psychiatry and global health at George Washington University, describes his trip with the healer to treat a woman suffering from fainting fits, nightmares, foul moods and an inability to walk shortly after her engagement. His report and conclusion are available here.

The Argument for Interpreters
Having trouble making the case within your organization for easy access to interpreters? Here's a video from the Texas Association of Healthcare Interpreters and Translators that shows English-speakers how incomprehension in a medical environment feels when the health of a loved on is at stake. Check out other related videos on the Texas Association's YouTube channel.

Cultural Profiles: A Cautionary Note
Profiles of various cultural and national groups are a common feature of cross-cultural care web sites. How much should you rely on them for guidance? Not much, says Marjorie Bancroft, director of the Maryland-based company, Cross-Cultural Communications. Her pointed comments, below, were posted on the CLAStalk forum.

"Any document claiming to describe what Canadian patients are like would horrify me. (And what could it say? That we are boring, white, conservative??)

What about American patients? How would you describe them in a training or cultural competence textbook? If you feel that Americans are too diverse to characterize in such descriptions, be aware that the same is true of Mexicans, Chinese, Africans, Canadians... (Read more)

Get Communication Help for Lao Patients
Here's an excellent two-part video that explains to Lao patients both the importance of clear communication with medical providers and common sense steps toward getting there. Produced by New Routes to Community Health, the videos underline the benefits of professional interpretation and the significant drawbacks to using family members to interpret. These Lao language films (with English subtitles) also provide tips to enhance communication, such as urging patients to write down questions before their appointments. Get a full-screen view by clicking on the image here. This is just one of many useful resources on the New Routes website.

Language, Culture Help for Med Assistants
Medical assistants are usually the first human contact that patients have in a health care setting. This video underscores the importance of communication by medical assistants that lets patients know they've been heard, understood and respected. The two video series from the California Academy of Family Medicine is about 38 minutes long. View in full-screen mode by clicking the icon in the lower right side of the image above.

Free Translated Videos on Vaccination
Get a free DVD that explains in seven languages why people need vaccines, how they work and where to get them. Developed by the Minnesota Department of Health and the Office of Emergency Preparedness, and produced by ECHO-TV, the 20-minute videos are available in English, Hmong, Khmer, Lao, Somali, Spanish and Vietnamese.

Each version was taped using bilingual and bicultural hosts and healthcare providers. All non-English programs are subtitled in English. Each version makes these key points:

• Getting vaccinated protects you against disease – by teaching your body to fight disease germs.
• Getting vaccinated and vaccinating your family also helps to protect your entire community.
• Vaccines are tested – and their use is monitored – to help ensure their safety.

The show is available in DVD and web streaming formats. DVDs are available in limited quantities at no cost to organizations that serve diverse populations. Each DVD contains all seven languages. Download the DVD order form, or view the videos on the ECHO website.

Keeping on Top of the (Many) Holidays
Sherri Klaers, staff education coordinator at Rice Memorial Hospital, passes along this tip to Exchange members: "Here’s a website I use at least once a month. The BBC has a multi-faith holy day calendar — the only one I could find on the net. Our hospital puts a list of holy days for five major religions (Christian, Muslim, Jewish, Buddhist and Hindu) once a month in our weekly employee newsletter. It’s not a huge thing – but we hope to make staff more aware of other cultures and religions. This site also has a lot of information about many religions and specifics on their holy days and times. Using it, I was able to look up details about Ramadan to pass on to clinical staff."

Free Tool Kit for Meeting Cultural Needs
Better Communication, Better Care: Provider Tools to Care for Diverse Populations is a downloadable PDF guide from the California-based Industry Collaboration Effort that helps you provide services to diverse clients in a respectful manner that inspires trust. The tool kit is organized into sections containing background information and tools that can be reproduced and used as needed. Resources include:

Encounter tips for providers and clinical staff

• a mnemonic to assist with patient interviews,
• help in identifying literacy problems,
• and an interview guide for hiring clinical staff who have an awareness of diversity issues.

Communication across language barriers

• tips for locating and working with interpreters,
• common signs and common sentences in many languages,
• language identification flashcards,
• and language skill self-assessment tools.

Understanding patients from various cultural backgrounds:

• tips for talking with a wide range of people about sex,
• pain management across cultures,
• and information about different cultural backgrounds.

New Care Site for Spanish Speakers
The U.S. Department of Health and Human Services just unveiled CuidadodeSalud.gov, a Spanish-language site that connects consumers to new information and resources that will help them find quality, affordable health care coverage.

Using this site, families, and small businesses can easily compare both public and private health coverage options. The website connects consumers to quality rankings for local health care providers as well as preventive services.

The Spanish-language site is particularly important for Latinos, who have the highest rates of un-insurance in the nation — more than one in three Latinos are uninsured. Half of Latinos do not have a regular doctor. Twenty percent of low-income Latino youth have gone a year without a health care visit – a rate three times higher than that for high-income Whites.ß

Make the Case for Quality Language Service
Need help arguing for quality language services within your organization? Here's a resource to help you make your case. Funded by Robert Wood Johnson, this PowerPoint from the National Language Services Network is downloadable here. Among the research-backed premises of this piece is that poor doctor-patient communication results in more diagnostic procedures, more invasive procedures, and more over-medication. Only 16 percent of Asian-American non-English speaking regard information received during a doctor's visit as easy to understand, this presentation reveals. Then again, results for English speakers aren't great either — only 57 percent say their doctor is easy to understand.

Multiple Languages at Medline Plus
Check out the new look of Medline Plus, an online service of the National Library of Medicine and the National Institutes of Health. The entire site has been redesigned. Highlights include:

• A Videos and Cool Tools page that makes multimedia content easier to find and searchable
• A clickable option to display the site in English or Spanish
• Downloadable patient health information in 47 languages — a great option when you're stuck for a language not included in the Exchange library.

Get County Demographic Profiles
Demographic characteristics and socioeconomic status can influence a person's health behaviors, affect access to health care, and indicate an increased likelihood of certain health conditions. Stratis Health has developed the Culture Care Connection County Profiles to help you learn more about the community you serve, so you can develop and deliver culturally sensitive services.

These profiles show the characteristics of individual counties, their economic development region, Minnesota statewide, and the nation. Each report contains data on:

• Demographics: age, gender, race, foreign born
• Socio-economic status: income, education and occupation
• Health status data: birth rate and morbidity

Free: A Health Lit Test Tool
Here's a free bilingual (English and Spanish) screening tool that identifies patients at risk for low health literacy. The tool, developed by Pfizer with University of Arizona and North Carolina health literacy experts, can be administered in a clinical setting in just three minutes. The test result provides information about the patient that allows providers to adapt their communication practices and get better health outcomes.

This tool assesses general reading and number skills, yielding an overall estimate of health literacy. Unlike other instruments, it can be administered in about three minutes and is available in both English and Spanish. The complete package includes tips for providers on producing easy-to-understand materials, and links to readability-testing applications.

Here's Help for Hispanic Clients
Children's Defense Fund (CDF)-Minnesota recently launched a Spanish language version of its popular Bridge to Benefits website. CDF seeks to improve the economic stability of low-income families by helping connect them to public work support programs and tax credits.

The site uses a simple screening tool to help individuals and families determine their eligibility for:

• MinnesotaCare
• Medical Assistance
• General Assistance Medical Care
• Energy Assistance Program
• Food Support
• School Meal Program
• Child Care Assistance
• Earned Income Tax Credit
• Working Family Credit
• Women, Infants and Children (WIC Program)

The site also includes guidelines for how to apply, and downloadable applications. To learn more, visit the website and click on 'En Espanol' in the left-column menu.

Using Interpreters: A Common Glitch
Interpreters are a common part of the medical environment these days. But how many providers use them to best effect? When researchers presented UCLA medical students with best practices on using interpreters, then tested them eight weeks later, they found that the simple matter of where to position the interpreter in relation to the patient was a common error with negative effect on patient satsfaction.

Instructing the interpreter to sit behind the patient helps sustain
eye contact between clinician and patient. But even after training, seven out of ten students forgot or ignored this best practice. See the complete article, Working with interpreters: how student behavior affects quality of patient interaction when using interpreters.

Literacy: Not Just a Patient Problem
For a deeper look at the health literacy issue, check out this article, Health Literacy: Achieving Meaningful Use for Patients, in Minnesota Physician by Exchange member Lane Stiles.

Stiles, director of Fairview Press, makes the point that literacy is a two-way street. Consistently communicating with patients in a manner they cannot understand is its own form of health illiteracy. Without the inclusion of health educators and patients in the design and development of electronic health record systems, the gap in intelligible communication with patients will only increase, Stiles warns. This is timely and essential reading within any organization implementing an electronic records.

New Vietnamese Videos to View Online
New Routes to Community Health offers an interesting set of videos in Vietnamese with English subtitles that provide quick, easy and sensible patient education on the doctor/patient relationship, and on high blood pressure. Find the videos here:

• Doctor/patient relationship, Part 1
• Doctor/patient relationship, Part 2
• High blood pressure, Part 1
• High blood pressure, Part 2

While you're there, take a spin around the New Routes site. It offers and deep and entertaining collection of videos and more that address the concerns of immigrant patients.

Download a Free Health Literacy Toolkit
The Agency for Healthcare Research and Quality is offering a free Health Literacy Universal Precautions Toolkit, available for web-viewing or as a download. The toolkit offers specific actions your organization can take to make health information more understandable to all patients. It is designed for all levels of staff in adult and/or pediatric primary care.

The toolkit includes:

• A Quick Start Guide
• The Path to Improvement, which outlines six steps to fully implement the toolkit
• Twenty short tools to identify and address areas that need improvement
• Links to Internet resources
• Sample forms, posters, PowerPoint presentations, and worksheets.

Download the toolkit, or view an online version.

Get Help with End-of-Life Issues
Hospice Minnesota's Opening Doors to Multicultural Communities is a state and national resource for hospice and palliative care providers facing challenging multicultural end-of-life situations. You can find the group's easy-to-read brochure, What is Hospice?, translated into Hmong, Spanish and Somali, at the Hospice Minnesota website.

While you're there, take a look at an broad range of resources that will help increase your general cultural competency when dealing with death and dying issues. You'll also find a deep collection that addresses the specific needs of Hmong, Muslim, African American, Native, Jewish, Latino and Somali people on the group's Multicultural Resources page.

Check It Out: A Rich Source of Video
Looking for cross cultural care videos to educate both you and your patients? Take a look at the New Routes to Community Health video library, available here. You'll find numerous short pieces for recent immigrants, in Cambodian, Hmong, Lao, Vietnamese, Somali, Russian and Spanish, plus a host of other languages. Topics range from sexually transmitted disease to a discussion on why Somali men take their coffee with double cream and double sugar.

New Routes is a Madison, Wisconsin-based group that works to improve the health of immigrants through immigrant-created media. In addition to a Minneapolis/St. Paul collaborative, New Routes works with immigrant groups in Atlanta, Boston, Chicago, Los Angeles, Oakland, Philadelphia and San Francisco.

Get Emergency Info in ASL, Braille
Help special needs patients be prepared for emergencies with video and downloadable print information from the Northeast Texas Public Health District, available for free use at this link. ASL interperters present information on food safety, flooding, storms, infectious disease, basic first aid and general emergency preparation.The videos include an English language voice over, plus text. Also available are Braille formatted and large print emergency preparedness documents.

Get the Word on Language Access
Amid growing concerns about racial, ethnic and language disparities in health care, the Joint Commission and the federal government's Office for Civil Rights have released Improving Patient-Provider Communication, a video on language access in health care organizations.

The video identifies tools that health care organizations can use to build effective language access programs. It also addresses the obligations of health care organizations concerning translation of written documents. Watch the video here.

Free Cultural Competence Training Tools
Free courses with CME, CE or CNE creit for physicians & pharmacists sponsored by the US Office of Minority Health (OMH) offer the latest resources and tools to promote cultural competency in health care.
They include A Physician's Practical Guide to Culturally Competent Care,; Culturally Competent Nursing Care: A Cornerstone of Caring. Learn more here.