Cross-Cultural “Allies” in Immigrant Community Practice: Roles of foreign-trained former Montagnard health professionals

Authors

  • H. Xin Southern Illinois University
  • S. Morrison University of North Carolina
  • J. Dharod University of North Carolina
  • A. Young University of North Carolina
  • M. Nsonwu North Carolina Agricultural & Technical State University

DOI:

https://doi.org/10.5195/hcs.2014.143

Keywords:

Foreign-trained medical graduates, Cross-cultural allies, Community health workers, Montagnard refugees

Abstract

This pilot case study describes foreign-trained former Montagnard refugee physicians’ practice experiences in Vietnam and their current community health worker and “ally” roles within the Montagnard refugee community. It highlights key features that facilitate cross-culturally responsive health care. We interviewed five Vietnam-trained former Montagnard refugee physicians using an open-ended interview format during March, 2012. We used content analysis procedures to identify key themes characterizing Montagnard physicians’ former and current practice experiences and emphasizing the roles they currently play in their new homeland. Montagnard physicians were fighting infectious diseases in homeland Vietnamese communities. Since coming to the U.S., Montagnard physicians have reoriented their competencies to fit within a community health workers model, and have shifted practice to fighting chronic disease in this refugee community. Tasks now include describing and contextualizing unique characteristics of the Montagnard languages and cultures to outside constituents. They become cross-cultural allies to the U.S. health care and facilitate individuals’ medical adherence with mainstream physicians’ orders. They ensure accuracy of interpretation of Montagnard patients’ medical complaints during a medical visit. Our findings reveal the potential roles that can be ascribed to a cross-cultural ally and can be built into practice to fulfill the Montagnard community’s unmet health needs: oral historian, mediator, facilitator/negotiator, quality assurer, psychosocial confidant, and health advocate.

Author Biographies

H. Xin, Southern Illinois University

Huaibo Xin, Dr.PH, MD, is Assistant Professor at the Department of Kinesiology and Health Education, Southern Southern Illinois University at Edwardsville

S. Morrison, University of North Carolina

Sharon Morrison, PhD, MSPH, is Associate Professor with the Department of Public Health Education, University of North Carolina Greensboro

J. Dharod, University of North Carolina

Jigna Dharod, PhD,  is Assistant Professor with the Department of Nutrition, University of North Carolina at Greensboro

A. Young, University of North Carolina

Andrew Young, MFA, is Center Fellow at the Center for New North Carolinians, University of North Carolina at Greensboro

M. Nsonwu, North Carolina Agricultural & Technical State University

Maura Nsonwu, PhD, is Assistant Professor with the 
Department of Sociology and Social Work, North Carolina Agricultural & Technical State University

References

Ayala, G. X., Vaz, L., Earp, J. A., Elder, J. P., & Cherrington, A. (2010). Outcome effectiveness of the lay health advisor model among Latinos in the United States: An examination by role. Health Education Research, 25(5): 815-840.

Brownstein, J. N., … Satterfield, D. (2007). Effectiveness of community health workers in the care of people with hypertension. American Journal of Preventive Medicine, 32(5): 435-447.

Center for New North Carolinians. (2012). Immigrant demographics of Guilford County. Retrieved from http://cnnc.uncg.edu/immigrants/demographics-asia.htm

Creswell, J. W. (2007). Qualitative inquiry and research design: Choosing among five approaches. (2nd edition). Thousand Oaks, CA: Sage.

Dorgan, K. A., Lang, F., Floyd, M., & Kemp, E. (2009). International medical graduates-patient communication: A qualitative analysis of perceived barriers. Academic Medicine, 84(11):1567-1575.

Fleury, J., Keller, C., Perez, A., & Lee, S. M. (2009). The role of lay health advisors in cardiovascular risk reduction: A review. American Journal of Community Psychology, 44(1-2): 28-42.

Han, H., Lee, H., Kim, M.T., & Kim, K. B. (2008). Tailored lay health worker intervention improves breast cancer screening outcomes in non-adherence Korean-American women. Health Education Research, 24(2): 318-329.

Heisler, M., Kieffer, E. (2009). Participants” assessment of the effects of a community health worker intervention on their diabetes self-management and interactions with healthcare providers. American Journal of Preventive Medicine, 37(6suppl 1): S270-279.

Kaafarani, H. MA. (2008). International medical graduates in surgery: facing challenges and breaking stereotypes. American Journal of Surgery, 198(1): 153-154.

Leon, L. R., Ojeda, H., Mills, J. I., Leon, C. R., Psalms, S. B., & Villar, H. V. (2008). The journey of a foreign-trained physician to a United States residency: Controversies surrounding the impact of this migration to the United States. Journal of the American College of Surgeons, 206(1): 171-176.

Love, M. B., Gardner, K., & Legion, V. (1997). Community health workers: Who they are and what they do. Health Education & Behavior, 24(4): 510-522.

Mock, J., Bui-Tong, N. (2007). Effective lay health workers outreach and media-based education for promoting cervical cancer screening among Vietnamese American women. Research and Practice, 97(9): 1693-1700.

NC State Refugee Office. (2009). NC refugee statistics.

Norris, S. L., … Satterfield, D.W. (2006). Effectiveness of community health workers in the care of persons with diabetes. Diabetic Medicine, 23(5): 544-556.

Rhodes, S. D., Long Foley, K., Zometa, C. S., & Bloom, F. R. (2007). Lay health advisor interventions among Hispanics/Latinos: A qualitative systematic review. American Journal of Preventive Medicine, 33(5): 418-427.

Skolnik, R. (2012). Global Health 101 (2nd edition). Burlington, MA: Jones and Bartlett Learning.

Taylor, V. M., Yasui, Y. (2009). Evaluation of a Hepatitis B lay health worker intervention for Chinese Americans and Canadians. Journal of Community Health, 34(3): 165-172.

Taylor, V. M., Ramsey, S. (2010). Evaluation of a cervical cancer control intervention using lay health workers for Vietnamese American women. Research and Practice, 100(10): 1924-1929.

U.S. Department of Labor. Standard occupational classification: 21--1094, Community Health Worker. Retrieved from www.bls.gov/soc/2010/soc211094.htm

Viswanathan, M., Jonas, D. E. (2010). Outcomes ad costs of community health worker interventions: A systematic review. Medical Care, 48(9): 792-808.

Witmer A., Seifer, S. D., Finocchio, L., Leslie, J., & O’ Neil, E. H. (1995). Community health workers: Integral members of the health care work force. American Journal of Public Health, 85(8 Pt 1): 1055-1058.

World Health Organization, (2007). Community health workers: What do we know about them? Retrieved from http://www.who.int/healthsystems/round9_7.pdf

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Published

2014-05-19

Issue

Vol. 6 No. 1 (2014): Cultural Realities To Health

Section

Articles

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