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INTRODUCTION

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  • How do I effectively share health and nutrition information with families whose backgrounds differ from my own?

  • What are the cultural factors that affect the pediatric patient, the patient’s caregivers, and the management of childhood obesity?

  • What are the most effective means to communicate with families and individuals from differing cultural backgrounds?

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This chapter will address the following American College of Graduate Medical Education competencies: patient care, medical knowledge, interpersonal and communication skills, and professionalism.

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Patient Care: This chapter will help the pediatric health care provider understand effective strategies for working with children and families from different cultures, an essential component of family-centered, compassionate care.

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Medical Knowledge: This chapter will help the pediatric health care provider be able to define culture and cultural competency and the relationship between cultural factors such as race or ethnicity, socioeconomic status, gender, and education and use this knowledge in the prevention and treatment of childhood obesity.

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Interpersonal and Communication Skills: It is important to be able to communicate effectively with patients, family, and the public across a broad range of socioeconomic and cultural groups, and this chapter will highlight culturally competent communication skills that the pediatric health care professional can use in care delivery.

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Professionalism: This chapter will help the pediatric health care provider deliver effective cultural care by helping foster sensitivity and responsiveness to diverse patient populations.

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Culture can be simply defined as “a system of shared understandings that shapes and, in turn, is shaped by experience”1 or more broadly as “(something that is) learned, shared, transmitted intergenerationally, and reflected in a group’s values, beliefs, norms, practices, patterns of communication, familial roles, and other social regularities.”2 The key to an understanding of culture is that it is learned and thus, is dynamic and that it is formed and influenced by both individual and group experiences.

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Culture can impact all aspects of health, including beliefs surrounding healing, wellness, illness, disease, and health care services. Culture may affect health-related communications and interventions in 2 ways.3,4 The first has been termed the “surface structure” and describes the matching of materials and messages to cultural characteristics observed within the target group. An example of this would be the incorporation of music and verbiage familiar to and preferred by a specific culture into health-related communications. The second has been termed the “deep structure,” and refers to the incorporation of cultural, social, historical, environmental, and psychological forces that have been found to influence a health behavior of interest in a specific culture. An example in which deep structure is incorporated into health communications would include acknowledging (although not necessarily accepting) that a certain culture may have a belief that illness or disease is brought on by religious causes.

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Cultural sensitivity is an awareness of cultural differences without assigning inherent values to those ...

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