Demonstrate your understanding of the theoretical relevance and relationship between social determinants, human rights, cultural competence and health outcomes

Job App. Topic I choose is Personal Development Health Physical Education secondary teacher
You are applying for a position as a cultural liaison in the NSW Health Community Programs unit. You need to address the following topic with reference to specific theory as well as putting that theory in context.
Cultural and social diversity are increasingly recognised as major issues in the delivery of health care. As such, cultural competency and cultural safety are important skills health professionals must have in order to improve individual and population health outcomes.
First, this assessment asks you to focus specifically on the relevance and relationship between cultural and social diversity (i.e., ethnicity/culture and socioeconomic status), for the individual health care provider (your specific health profession), health care institutions and the health consumer. Second, how can cultural competency at the healthcare provider (your specific health profession) and institutional levels help to improve health outcomes. Finally, how will you know that your answers to the first two points promote a culturally safe healthcare environment?
Answer this questions
1. What about your profession/discipline, makes you the best candidate for the role of ’cultural liaison’ within the NSW [insert your discipline] Health Service? (approx. 100 – 150 words)
2. Demonstrate your understanding of the theoretical relevance and relationship between social determinants, human rights, cultural competence and health outcomes. (approx. 150 – 200 words)
3. Identify, with practical examples and links to your professional guidelines, how you would support and/or enact the five key constructs of cultural competency within the NSW [insert your discipline] Health Service. (approx. 300 – 400 words)
4. Demonstrate knowledge of your professional guidelines/policy and their relationship to cultural safety. (approx. 250 – 300 words)
5. Demonstrate an understanding of the barriers and facilitators to culturally safe and competent professional practice for both staff in your profession and health consumers. (approx. 200 – 250 words)
6. Given your disciplinary expertise, understanding of cultural competence and cultural safety demonstrate how your understanding of health theory (e.g., social determinants, human rights, etc.) makes you the best person for this role/position at the NSW [insert your discipline] Health Service? (approx. 150-200 words)
7. References
Here is an example but please don’t copy it
1. What about your profession/discipline, makes you the best candidate for the role of ‘cultural liaison’ within the NSW [insert your discipline] Health Service? (approx. 100 – 150 words)
Satisfactory
I consider myself to be the best candidate for this job due to the study I am currently undertaking as an Occupational therapist including my recent and past work experience. My degree is equipping me with the skills to recognise that it is not only specific OT frameworks relating to the person, environment and occupation, (Willard, Schnell & Boyt, 2014). However, culture, identity and one’s social economic status are also pivotal in impacting health outcomes. I am learning to interpret, understand, engage and implement legislation including the Occupational Therapy Board Code of conduct (2014) and the New South Wales Health Policy – Code of Conduct (2015) to provide a holistic service to people from diverse cultures, genders, social backgrounds and abilities. I will utilise examples and theoretical underpinning to address my suitability in relation to the selection criteria.
Needs Improvement
As a Sports and Exercise scientist I explore the therapeutic benefits of physical exercise. My ability to facilitate social cohesion and formation of bonds amongst Culturally and Linguistically Diverse (CALD) people renders me the ideal candidate for the role of Cultural Support Worker. This allows me to target social, emotional, and mental health providing a highly comprehensive regimen.
2. Demonstrate your understanding of the theoretical relevance and relationship between social determinants, human rights, cultural competence and health outcomes. (approx. 150 – 200 words)
Satisfactory
I have come to understand through my study, that the ideas stated above are integral to the holistic and integrated framework of the social determinants of health (Baum et al., 2014). Cultural competence (CC) is required when engaging with this framework to avoid a variety of barriers that inhibit good health outcomes (Jackson and Gracia, 2014). During my work experience within the paediatric ward at Campbelltown Hospital, I applied my theoretical knowledge in practical based scenarios in accordance with my placement. Considering the social determinants of health, I suggested to my supervisor that an information flyer be produced for parents/carers from culturally and linguistically diverse (CALD) groups regarding a unique MLAK key that provides entry to accessible locations throughout Sydney for people living with a disability. This is aligned with human rights as it supports the need for access to health services as fundamental facilitators for improved health outcomes (Eckermann et al., 2010). Through client interaction, I became aware of the difficulty CALD parents/carers face when endeavouring to access equitable facilities to provide opportunities for inclusion for their child while still endeavouring to avoid the consequential discrimination (Steed, 2010). This led to the updating of organisational cultural competence practices for CALD groups of people living with a disability. This practical application shows my grasp of the importance of relationship linking cultural competence, social determinants and human rights towards improved health access and outcomes.
Needs Improvement
According to the world health organisation, the social determinants of health are “The conditions, in which people are born, grow, work, live and age” (“Social Determinants Of Health”). This theory encompasses the inter-twined issues of culture, socioeconomic status and cultural competence. Cultural competence involves cultural competence of the other two variables, culture/ethnicity and socioeconomic status. My past experience in ‘Save the World Day’ included working within a group composed of CALD individuals, of varying socioeconomic status. It was to my satisfaction that my previous donations had helped fund the trees and equipment that these volunteers were able to use, bridging the gap between socioeconomic statuses (Morrow-Howell, Hong and Tang 91-102). This collective effort brought various cultures together under a well-intentioned objective cause. This friendly practice was able to increase cultural competence for all of those involved.
3. Identify, with practical examples and links to your professional guidelines, how you would support and/or enact the five key constructs of cultural competency within the NSW [insert your discipline] Health Service. (approx. 300 – 400 words)
Satisfactory
Increasing CC within the OT field involves implementing the elements and principals of CC into everyday business practices. Change needs to occur at the highest levels of the National Health and Medical Research Council (2006) and have a cascading affect downward. For example, CC elements and principles need to be incorporated into the mission statement, policies and procedures of an organisation which in turn affects the culture and practice of the business (National Health and Medical Research Council, 2006) (Ethnic Community Councils of Victoria, 2006). Actions at each National Health and Medical Research Council (2006) level are stated in Table 1.
Table 1. Links between Cultural Competence and Codes of Conduct (TABLE IS INCOMPLETE)
NHMRC levels & CC Dimensions CC Constructs Polices/Guidelines for OT’s NHMRC Actions
Systemic:
CC Dimension:
? Education
? consumer participation Awareness
Knowledge
Skills
Encounters
Desire NSW Health policy – Code of conduct
OT code of conduct
Cultural competency training courses Encourages culturally competent behaviour through:
Policies & procedure
Monitoring mechanisms
Providing sufficient resources
Policies that support involvement of culturally diverse communities in health matters
Working on the paediatric ward most communication is via parents/caregivers. I had to obtain medical history for a child, but due to cultural etiquette, I had to gain consent from the child’s father to speak to the child’s mother. An interpreter enabled a deeper level of communication so all parties could speak, be heard and then listen (Mu et al., 2016). By gaining consent from the husband to converse with his wife, the family instantly relaxed, were at ease freely and shared information with me through the interpreter. Interacting with the family at an individual level (Table 1.1) and sidestepping the traditional OT jargon/language because we were using an interpreter meant that I could enact culturally competent and sensitive behaviour which was backed up by the hospitals CC framework when interaction with individuals from CALD groups and the use of interpreters.
The New South Wales Health Policy – Code of Conduct (2015) and the Occupational Therapy Board Code of conduct (2014) provide guidelines to practitioners regarding standards of behaviour in the provision of equitable and ethical health service to clients, in relation to CC, safe and social professional practice which links into all National Health and Medical Research Council (2006) levels as stated in Table 1. The National Health and Medical Research Council (2006) levels interact in a reciprocal relationship, through interaction initiated in the dimensional areas, supported and solidified by policy and guidelines which in turn provokes action.
The systemic and organisational levels encourage consumer participation from CALD and vulnerable people groups retrieved from population data on diversity and culture in the structured planning, development, research and evaluation stages of policy and guidelines within health organisations which ultimately impact the internal business culture and the community (National Health and Medical Research Council, 2006). Culturally competent and responsive education is provided on these levels to equip business and employees on roles, responsibilities and accountability procedure and providing a culturally competent vision for the organisations future (National Health and Medical Research Council, 2006). During my work experience within a project for Macarthur Access Group for Inclusive Communities or MAGIC, (2015) I completed a short training program for my role, which included responsibilities and the projects accountability mechanisms. Once completed I produced a report providing evidence that I fully comprehended the MAGIC projects business practice. The CC dimensions for professional and individual are stated in Table 1. Self-reflection and information in both dimensions requires respectful service to CALD patients, acknowledging the influence their heritage has had on health outcomes by being able to acquire knowledge and data on CALD groups (Booth and Nelson, 2013). Section 3.7 of the Occupational Therapy Board Code of conduct (2014) and the New South Wales Health Policy – Code of Conduct (2015) detail responsibilities for the delivery of ethical and culturally appropriate business and professional practice.
Needs Improvement
There are five essential elements of cultural competence as identified by Campinha-Bacote (2002). I will promote these five key concepts in my practice by firstly integrating individuals of various cultures into exercise groups. As individuals commonly possess misconceptions of unknown cultures rendering them anxious or scared, I draw upon current research which in fact states that exercise significantly diminishes this feeling. This evidence also demonstrates decreases in depression, neurosis, and increases in extraverted activity (De Moor et al. 273-279). Results were found to be very consistent across gender and age, meaning it this theory can be very malleable in regards to a diverse populous. The double whammy of team sport will simultaneously force individuals to work together objectively, furthering bonding.
Another key aspect is institutionalising cultural knowledge. I will integrate aspects of many cultures in to programs, boosting comfort levels of individuals of which share that culture, whilst also building on understanding of those foreign. Exercise will not be limited to specific activities, pastimes popular in various cultures will be included. For example, the most popular sport in India is currently Cricket (Russell), Lacrosse is the national summer sport of Canada (“National Sports Of Canada Act”), and football being dominant in many European countries. With this in mind I will design group activities to include a range of sports. Regular cultural self-assessment is paramount in my method as to keep track of progress.
With a combination of all of these features I hope to ensure a high level of cultural competence within my cohort and myself.
4. Demonstrate knowledge of your professional guidelines/policy and their relationship to cultural safety. (approx. 250 – 300 words)
Satisfactory
The phrase Cultural safety started to be used in reference to indigenous New Zealanders and Australians, regarding health care provider’s cultural values towards power imbalances because of colonisation (Taylor & Guerin, 2010) though can be adapted to CALD groups.
Within my first week as an OT student at Campbelltown hospital I utilised the CC training I received as part of the hospitals induction policy process. My supervisor and I visited a school to ascertain if the facilities were up to standard for a CALD student living with a disability. My supervisor requested an interpreter accompany us on this visit so that the student’s mother fully understood the assistance and accommodations her child would be receiving from the school and hospital. The use of an interpreter to CALD for Indigenous peoples is part of hospital policy, in the provision of an equitable health service ensuring the practitioner and client are enabled to communicate on a practical and contextual level avoiding communication barriers. The main link between columns 1, 2 and 3 is the emphasis put on self-reflection. Continually practicing their own cultural self-reflection enables the practitioner to adapt health service provision in a social/culturally safe way to diverse groups (Booth & Neilson, 2013).
Benefits for the health consumer can be seen in columns 1 with the engagement of CC elements within each dimension. The National Centre for Cultural Competence (2006), has recognised the five elements of CC within each dimension stated in Table 1, when relating to health consumers in a socially and culturally competent manner (National Centre for Cultural Competence, 2006). As a cultural support worker within NSW health, adhering to the NSWHCC would be essential in the ethical delivery of professional practice.
Needs Improvement
Being a future cultural support worker no elements of the criteria can be overlooked if I wish to provide a well-rounded service. As such I will apply these criteria in my work by first of all encouraging healthy personal habits, advancing in to social habits. Meditation has been shown to decrease stress and anxiety (“Effectiveness Of A Meditation-Based Stress Reduction Program In The Treatment Of Anxiety Disorders” 936-943), promotion of this among not only my cohort but myself will result in clearer and calmer thinking, acting as social lubrication. This will directly target sections a to c and significantly raise social competence via improving sociability.
Sports are a reflection of the host culture of which they came from; as a result a diverse mixture of sporting games incorporated will objectively overhaul subject’s levels of social and cultural competence. The team work required to achieve a set a goal, in the context of many different sports is a direct manifestation of the theory behind section d. Of course referring back to section c, this method won’t be executed without regard for various genders, physical capabilities and age. Furthermore, whilst also respecting the disparities among socioeconomic status, equipment required will be minimal and that which is essential will be provided free of charge.
5. Demonstrate an understanding of the barriers and facilitators to culturally safe and competent professional practice for both staff in your profession and health consumers. (approx. 200 – 250 words)
Satisfactory
Colonisation and contemporary institutional racism is still impacting indigenous people’s ability to access and sustain employment affecting their sustainable income, and ultimately health outcomes (Keleher 2016). Working as a cultural support worker would enable me to put your CC policy into practice. I would complete and continue to update my CC awareness training toward CALD and Indigenous groups, by collaborating with Indigenous support units/workers and CALD community groups. Acquiring and institutionalising cultural knowledge as stated in National Centre for Cultural Competence (2006), through gaining a knowledge of diverse cultures then integrating this knowledge into daily practice will benefit not only the health consumer but also National Health and Medical Research Council (2006) levels and dimensions by reducing institutional racism.
As technology advances the provision of health services needs to progress and adapt to benefit all stakeholders. Core aspects of the Occupational Therapy Code of Ethics (2014) and Occupational Therapy Board Code of conduct (2014)) states practitioners should develop and maintain professional behaviour and skills while, responsibly contributing to the virtue and productivity of the health system. Evidence of my commitment to the above concepts include the two online CC training courses I have complete and the CALD community events I attend throughout the year. To practically apply the training courses in an innovative way a health facility could hold a cultural community day attended by local CALD community leaders/groups, where food from that specific country would be served in order for the staff to interact with CALD groups in an informal relaxed environment. Staff would have the opportunity to socialize with different cultures, by attending CALD community events as part of CC training.
Self-development, staff development and business development occurs at each NHMRC level of the elements and principles (the National Health and Medical Research Council, 2006) and needs to be an ongoing process to ensure that staff and business practices do not stagnate but update as policy and socioeconomic status of community’s changes, to provide best practice to clients.
Needs Improvement
There are numerous issues affecting CALD health consumers. Examples include overall poorer health outcomes of those born outside of Australia, higher rates of diabetes complications for those born in Lebanon, Fiji, Italy. Individuals born in the United Kingdom experiencing higher than usual instances of lung cancer (NSW Health 2004). In order for a practice to remain professional these instances must be accounted for not only for the consumer but also for the professionals themselves. Practice must also be socially safe by preventing the occurrence of hateful outbursts among CALD individuals. Social inclusion must be achieved as this will result in participation in community lifestyles and healthy social and cultural outcomes. Racism and alienation will both be combatted. Strong leadership and guidance can aid in achieving our goals, ensuring that no policies are broken (McCormick 22-33).
6. Given your disciplinary expertise, understanding of cultural competence and cultural safety demonstrate how your understanding of health theory (e.g., social determinants, human rights, etc.) makes you the best person for this role/position at the NSW [insert your discipline] Health Service? (approx. 150-200 words)
Satisfactory
I believe I am the best candidate for this job because my commitment to self-improvement is demonstrated in my studies as Occupational therapist, relevant work experience and CC training undertaken. I have participated in many CALD and community events in my previous jobs which include, cook, waitress, barista and hospitality trainer. Policy and guidelines encourage me to continue self-development and study to ensure best practice for the health consumer, by recognising that CC, concepts in criteria 1 and the social determinants are linked to the health outcomes of venerable people groups (Occupational Therapy Board Code of conduct (2014).
Needs Improvement
I am a highly motivated individual with a dynamic work style ready to adapt to new theories, expectations and cultural phenomena. As a punctual and well-spoken individual I feel as though my ability to synthesize ideas in to actual results is hard to come by. Apart from that, being a CALD person myself I understand how the world looks under such a lens and can offer a great deal of understanding in my work.