Action research: Development and implementation of a training program to address health access and cultural competency for the Southeast Asian population in the central San Joaquin Valley of California

This applied organizational development project examined the barriers Southeast Asian refugees face in accessing health care services, which led to the development of a training curriculum that will enable health care providers to become more culturally competent in serving Southeast Asians. The training program was pilot tested in five hospitals in Central California, and the researcher applied Kolb and Frohman's (1970) guidelines for assessment to the diagnosis of health access barriers. Focus group studies were conducted with 83 Cambodians, Hmong, Lahus, Laotians, and Miens, and a review of secondary data on the status of minority health disparities was completed.; This qualitative and quantitative study found health disparities that were defined by ethnicity in three problem areas. First, refugees had limited knowledge about their health needs; and access to care was hindered by language differences; cultural practices and religious beliefs; socioeconomic factors of race, disability, and poverty; and acculturation difficulties. Second, individual care providers were often insensitive to patients with different backgrounds because they lacked cultural competency, practiced discrimination, and had inappropriate attitudes toward the population group. Finally, the health organizations, as revenue generating businesses, were often driven by bureaucratic systems with inflexible processes and procedures, and their use of the scientific approach to treatment frightened many refugees away from seeking medical care. These findings indicated a need for the development of a cultural competency intervention that would be implemented in health care organizations serving this population.; A Southeast Asian cultural intelligence model of cultural competency training was developed with an emphasis on cultural awareness and integration of knowledge and skills. This model was designed to increase the understanding of refugee and acculturation experiences, cultural practices, and health beliefs so that health care providers could cultivate acceptance and value inclusion rather than tolerance of patients who were different from them. The model did not emphasize Eastern and Western cultural differences but encouraged appreciation for the benefits of Southeast Asian cultural practices. The evaluation results affirmed the validity and effectiveness of the training model, and participants in the study rated it as a successful intervention. This research project demonstrated cultural competency was instrumental to better the quality of health care service delivery, mitigate barriers to equitable health care, and address the urgency for multicultural health through further empirical research guidance.