Cultural Competency in Haitian-Serving Community Health Centers in South Florida
Bibliographic record
Abstract
The purpose of this research was to explore the perspectives of health care administrators, practitioners and patients regarding the role and operationalization of cultural competency in their organizations. This work was conducted in three Haitian-serving Community Health Centers (CHCs) in South Florida. CHCs were established in the United States to provide services to underinsured individu- als. In recent years cultural competency discourse has become prominent in these institutions through the establishment of federal regulations mandating these pro- grams. The data was collected primarily through ethnographic methods: interviews and participant observation. Conversational interviews were held with the following groups of informants: staff, patients and members of the community at large. Semi-structured interviews were held with 15 physicians and administrators of the cen-ters. Unexpectedly, institutions largely devalued cultural competency and were able to sidestep federal regulations by hiring Haitian staff. However, through interactions with patients, it was discovered that aspects of cultural competency were in fact important to them. The qualities they most desire in physicians are: accessibility, linguistic profciency, and the ability to treat them as individuals within their cultural context.“Cultural humility” is proposed as the resolution to this dilemma. Cultural humility involves a redefning of medicine’s understanding of culture. It does not involve complex training programs or the hiring of physicians who are similar to the patient population, but is patient-centered medicine, practiced refexively. This approach is proposed to improve communication without the undesirable assump-tions and effects of the cultural competency paradigm.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.011 | 0.005 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.004 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".