Evaluating Culturally Appropriate Primary Health Care

产品说明：卫生保健提供者越来越多地受到他们与患者之间的文化差异的挑战，这些文化差异抑制了有效和/或令人满意的卫生保健（Jecker，Carrese和Pearlman 1995; NCCC 2001）。因此，在提供保健服务时，文化差异的概念变得更加突出。在初级保健场所尤其如此，这些场所往往关注糖尿病和高血压等慢性病的管理，而生活方式和饮食是至关重要的因素。自20世纪80年代中期以来，大量与健康相关的研究一直在发展，以解决健康和医疗保健方面的文化差异;然而，在了解初级保健环境中“文化适当的医疗保健”的实际构成方面所做的工作要少得多。拟议的研究既建立在这项研究的基础上，又提出了解决文化差异概念的建议，因为它影响健康信念和实践。我们将使用深入和开放式的采访，在斯普林菲尔德，MA和哈特福德，CT的两个社区为基础的健康中心的供应商和患者，探索这些主题，并指导调查工具的发展，为更大的病例对照研究的有效性文化适当的医疗保健。拟议项目的具体目标如下： 1.对四个民族（越南和俄罗斯移民;西班牙裔;和非洲裔美国人）之间的文化和健康行为之间的交叉点进行形成性研究，以指导用于评估文化上适当的护理的有效性的调查工具的开发; 2.从患者和提供者的角度了解是什么使卫生保健在文化上是适当的; 3.从目前从事文化上适当的护理的卫生保健提供者那里收集定性数据，以帮助确定相关结果，以便在随后的图表审查中进行测量，对文化上适当的卫生保健的有效性进行病例对照研究。 4.从参与者中收集定性数据，这些参与者目前没有接受医生的治疗，他们的健康信念和实践与哈特福德的初级卫生保健有关; 5.进行分析和比较，以确定不同文化群体对健康和保健的信念之间的差异程度。

DESCRIPTION: Health care providers are increasingly challenged by cultural differences between themselves and their patients that inhibit effective and/or satisfactory health care (Jecker, Carrese and Pearlman 1995; NCCC 2001). As a result, the concept of cultural difference is becoming more salient in the provision of health care. This is especially true in primary care locations, which tend to be concerned with the management of chronic diseases such as diabetes and high blood pressure, conditions in which lifestyle and diet are crucially important factors. A great body of health-related research has been developing since the mid-1980s addressing cultural differences in health and health care; however, much less has been done to understand what actually constitutes "culturally-appropriate health care" in the primary care setting. The proposed study both builds on this research and carries out recommendations to address the concept of cultural difference as it affects health beliefs and practices. We will use in-depth and open-ended interviews with providers and patients at two community-based health centers in Springfield, MA, and Hartford, CT, to explore these topics and to guide the development of survey instruments for a larger case-control study of the effectiveness of culturally-appropriate health care. The specific aims of the proposed project are the following: 1. To conduct formative research on the intersections between culture and health behavior among four ethnic groups (Vietnamese and Russian immigrants; Hispanics; and African-Americans) to guide the development of survey instruments used to evaluate the effectiveness of culturally appropriate care; 2. To understand what makes health care culturally appropriate from the perspective of patients and providers; 3. To gather qualitative data from health care providers currently engaged in culturally appropriate care to help identify relevant outcomes for measurement in a subsequent chart review, case-control study on the effectiveness of culturally appropriate health care. 4. To gather qualitative data from participants not currently under the care of a physician on health beliefs and practices related to primary health care in Hartford, CT; and 5. To conduct analyses and comparisons among the groups to determine the degree of variation among cultural groups' beliefs related to health and health care.