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Cultural Competency and Adolescent Health

How Can Educators Improve Adolescent Sexual Health Outcomes

Joni K. Roberts, DrPH, CHES

Assistant Professor
Jackson State University
School of Public Health
Behavioral Health

(content from PowerPoint presentation)


Objectives

  • Discuss the relationship between culture and health in the context of adolescents
  • Utilize the framework of cultural humility to minimize bias and optimize health outcomes

 

Cultural Competency

  • Movement to address health disparities through education
  • Trainings often required by many funders, accreditation bodies, and institutions

 

Most Common Definition of Cultural Competency

  • Cultural and linguistic competence:
    • A set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective work in cross-cultural situations. (Cross, et al. 1989)

 

Cultural Competency and Adolescent Health

  • What does is it mean to provide culturally competent care to adolescents?
  • How does the "culture of adolescence" differ from commonly held notions of culture?
  • How does the culture of adolescence interact and coexist with racial and ethnic cultures? 

 

What do we mean when we say 'culture' and 'health'?

 

What do you think of when you hear the terms "culture" and "health"

culturehealth

 

Culture

  • Age
  • Race
  • Ethnicity
  • Linguistic Characteristics
  • Socioeconomic Status
  • Geography
  • Education
  • Spirituality
  • Health Beliefs and Practices
  • Environment
  • Gender Identity
  • Sexual Orientation
  • Ability

 

What influences your cultural identity?

How has it changed over the course of your life?

 

The Culture of Adolescence – Multiple Identities

  • Peer dependent
  • Egocentric
  • Distinct language and dress
  • Influenced by popular culture
  • Ongoing search for identity

An Adolescent's Identity Includes

  • Race and Ethnicity
  • Religion/Spirituality
  • Genetics
  • Geography
  • Peer Group
  • Stage of Development
  • Family Structure
  • Sexual Orientation
  • Gender Identity
  • Ability
  • Socioeconomic Status

 

The confluence of culture, communication, and care

Culture & Communication

Culture influences the way an individual communicates verbally and non-verbally

 

Building On Cultural Competency: Cultural Humility

Cultural Humility

  • Puts onus on educator to self-evaluate how personal biases may affect teaching efficacy
  • Redresses power imbalances in student-teacher dynamic (Tervalon and Murray-Garcia, 1998)

 

Educators' Identities

  • Race and Ethnicity
  • Profession
  • Education Specialty
  • Parental Status
  • Training Background
  • Religion
  • Age
  • Gender Identity
  • Sexual Orientation
  • Marital Status

 

Issues to Confront Before Teaching Sexual Health

  • How comfortable are you talking to adolescents?
  • What are your feelings/beliefs about adolescent sexuality?
  • Are you able to separate your own values in order to teach your students?

 

Self-Evaluation During Class Time

How do you react when confronted with a student situation that does not fit your expectations?

Sexually active, WSW, MSM, refusal skills…

Does the situation provoke feelings of anxiety and discomfort?

Are you able to assess what is going on within yourself as well as within the student?

 

Let's Practice Negotiating Sexual Risk Reduction

Purpose: To practice communicating comfortably and effectively about sexual risk reduction

  • Separate into 3 groups – count off (1-3)
  • Each group participant will take one index card.
  • Create three role-play presentations, one for each situation on your index cards.
  • In each role-play, one person will bring up the subject of sexual risks with another group member and say that she/he wants to use the method listed on the card.
  • The goal of this role-play is for one actor to convince the other actor to agree to practice the assigned method of risk reduction.
  • Role-plays must end with a positive and realistic behavior.
    • While two group members act as characters, the third member should act as a"coach." The coach will make suggestions to help the actors play their roles and will comment on whether the approach is convincing.
    • All participants must take a turn being the coach.
  • When each small group has finished three role-plays, members of that group will pick the most convincing presentation to perform for the entire group.

 

Group Practice – 10 Minutes

 

Discussion Points:

  1. How did it feel to try and convince someone else to go along with your (assigned) method of risk reduction? How did it feel to have someone else try to convince you? Do you think these feelings are common for youth dealing with these issues?
  2. What are effective ways for a couple to discuss abstinence? The use of condoms? The use of condoms and another method of contraception?
  3. What should a person do if his/her partner will not agree to a chosen method of risk reduction?
  4. What skills or information do you need in order to protect yourself against unintended pregnancies and STIs, including HIV?

Thank You!