Cross-cultural Use of the Edinburgh Postnatal Depression Scale

Although the cultural aspects of the pregnancy-related period in women’s lives have been studied extensively worldwide, the impact of cultural factors upon pregnancy-related depression has been investigated far less. Most research into pregnancy-related depression has been conducted in Western Europe, the U.S., Canada, and Australia. This research has been based primarily on studies of Western...
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Design Your Patient Handouts and Surveys with Low Literacy in Mind 

The ability of any patient or caregiver to communicate ailments/symptoms, medical history (personal and family), and other medical information is vital to proper care. Similarly, while it is important to assess the patient and/or family’s experience of care, many satisfaction surveys used in healthcare settings are designed without attention paid to low literacy, language barriers, and...
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Reading Between the Head Nods

It is important for U.S. healthcare providers to understand some key aspects of how language and culture can affect interactions with patients and families who have come to this country from other cultures―especially recent immigrants and refugees. Providers may not be prepared for the high context communication style that is normal in many societies. A lack of awareness of how this manifests in...
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What’s In a Frying Pan?

I recently visited a practice in Aurora, CO with a client base made up largely of immigrants and refugees. Dr. P.J.  Parmar, MD is doing some tremendous work with people from a variety of cultures who come to Colorado with limited English proficiency, limited understanding of western medicine, and low health literacy. I was seeking Dr. Parmar’s ideas about using motivational interviewing...
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Taking Medicine Correctly Isn’t Easy: How to Improve Adherence

Low health literacy has been closely associated with medication non-adherence and errors which lead directly to increased hospitalizations and higher medical costs. This has direct impact on the success of the “triple aim” – reducing healthcare costs, improving patient satisfaction, and health outcomes. Providers need to identify patients with limited health literacy and tailor...
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Screening for Pregnancy-related Depression In Private Practice Settings: Cross-Cultural Considerations

  Although the cultural aspects of the pregnancy-related period have been studied extensively worldwide, the impact of cultural factors upon pregnancy-related depression ( also known as postpartum depression) has been less investigated. Most research into pregnancy-related depression has been conducted in Western, developed countries (see reviews by Kumar, 1994; O’Hara & Swain,...
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Effective Mental Health Referrals

Referrals to mental health services by medical providers are often problematic in cross-cultural encounters. Mental health services in the United States are based on cultural assumptions relevant to members of the mainstream society, but these assumptions may not be as relevant for people outside the dominant culture. Thus, clients from different cultural backgrounds may not understand what the...
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The Challenge of Low Health Literacy Among Patients and Caregivers of ALL Cultures

Recognizing the impact of low health literacy on patient compliance and health outcomes is extremely important. A strong body of evidence points directly to the importance of caregiver health literacy as a factor in child health outcomes specifically. Education, written literacy, numerical literacy, socio-economic status, limited English proficiency and culturally-based understanding of illness...
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