24 / 34
22
Active Living Everyday (ALED)
ALED is a group-based program developed at the Cooper Institute that focuses on helping sedentary people become
and stay physically active. Participants come together for one-hour, weekly sessions for 12-20 weeks of education and
discussion to learn skills (i.e., identifying and overcoming barriers, setting goals, creating an action plan) needed to become
more physically active. A variety of moderate and vigorous physical activities are discussed in the program, providing a
background for individuals to draw from when setting their personal goals for the type and amount of exercise they want to
do. Participants do their actual physical activity outside of the group setting. Facilitators that teach the course are trained
and certified.
71
ENHANCING CULTURAL COMPETENCE IN YOUR PERSONAL PRACTICE
Cultural competence is obtaining cultural information and then applying that knowledge to
improve the quality of care and health outcomes for patients. To be culturally competent,
HCPs need to first understand their personal views and those of the patient, while avoiding
stereotyping and misapplication of clinical knowledge. Meyer describes four major challenges
for providers and cultural competency in healthcare.
72
Awareness. The first challenge is recognizing clinical differences among people of different
ethnic and racial groups (e.g., higher risk of pain in African Americans and Hispanic/Latino
Americans).
Communication. The second is communication, from the need for interpreters to nuances of
word choices in various languages.
Ethics. Healthcare professionals should consider the care choices they make; such as noting if
a decision would be different if the patient was another gender or ethnicity
.
Respect. Honoring the belief systems of others and understanding the effects of those beliefs on
well-being is critically important.
Trust. For some patients, authority figures are immediately mistrusted. Having been victims of trauma or witnesses of such
in their homelands, many people are wary of both the caregivers and the care.
Adapting to different cultural beliefs and practices requires flexibility and a respect for others’ viewpoints. It requires
healthcare
professionals
to listen to the patient and learn about the patient’s personal beliefs about health and illness. A
culturally competent clinician can provide the most appropriate care and influence beneficial health behaviors.
Cross, T., Bazron, B., Dennis, K., and Isaacs, M. lists five essential elements that contribute to the ability to become more
culturally competent. They include:
73
1. valuing diversity;
2. having the capacity for cultural self-assessment;
3. being conscious of the dynamics inherent when cultures interact;
4. having institutionalized cultural knowledge; and
5. having developed adaptations of service delivery reflecting an understanding of cultural diversity
The American Psychology Association (APA) similarly delineates culturally competent healthcare providers as having the
capacity to:
74
1. conduct self- reflection and assessment;
2. manage the dynamics of difference;