Promoting Cultural Sensitivity

Promoting Cultural Sensitivity

A Practical Guide for Tuberculosis Programs That Provide Services to Hmong Persons from Laos

U.S. Department of Health and Human Services

Centers for Disease Control and Prevention

Hla dej yuav hle khau; Tsiv teb tsaws chaw yuav hle hau.

"When you cross a river, take off your sandals;

when you emigrate from one country to another, take off your hat."

?Hmong Proverb

Promoting Cultural Sensitivity

A Practical Guide for Tuberculosis Programs That

Provide Services to Hmong Persons from Laos

Female elder. ? Frank Carter.

U.S. Department of Health and Human Services

Centers for Disease Control and Prevention 2008

For Additional Information

For more information or for a list of available guides, please contact: Division of Tuberculosis Elimination National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Coordinating Center for Infectious Diseases Centers for Disease Control and Prevention 1600 Clifton Road, NE, Mailstop E-10 Atlanta, GA 30333 Phone: (404) 639-8120 Web site: Suggested Citation Centers for Disease Control and Prevention. (2008). Promoting Cultural Sensitivity: A Practical Guide for Tuberculosis Programs That Provide Services to Hmong Persons from Laos. Atlanta, GA: U.S. Department of Health and Human Services.

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Contents

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Intended Audience . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 About the Guides . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 How to Use This Guide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Cultural Competency in Tuberculosis Service Delivery . . . . . . . . . . . . . . . . . . . . 7 Considerations When Using This Guide . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Clarification of Terms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Tips for Providing Culturally Competent Tuberculosis Services to Hmong Persons from Laos . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Chapter 1. Lao Hmong History and Immigration to the United States . . . . . . 11 Lao Hmong Geography and History . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Immigration and Resettlement to the United States . . . . . . . . . . . . . . . . . . . . . 12

Chapter 2. Overview of Lao Hmong Culture. . . . . . . . . . . . . . . . . . . . 13 Ethnicity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Social Structure, Family, and Gender . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Language and Communication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Naming Conventions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Communication in the Health Care Setting . . . . . . . . . . . . . . . . . . . . . 16 Education and Literacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Religion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Food and Dress . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Changing Values, Changing Roles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Socioeconomic Position in the United States . . . . . . . . . . . . . . . . . . . . . . . . . 18 Traditional Health Beliefs and Practices. . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Medical Decision Making . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Hmong Perspectives on Health Care in the United States. . . . . . . . . . . . . . . . . . . 22

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