Local governments can invest in this strategy using State and Local Fiscal Recovery Funds (SLFRF) from the American Rescue Plan Act (ARPA).

  • This strategy can help residents access health services. The U.S. Department of Treasury has indicated that strategies that help achieve this outcome are eligible for the use of Fiscal Recovery Funds.
  • Investments in this strategy are SLFRF-eligible as long as they are made in qualified census tracts or are designed to assist populations or communities disproportionately impacted by COVID-19.

Program overview

  • Health care tailored to patient cultural background: Culturally adapted health care (or culturally competent health care) is an approach to providing health care that adapts services to a patient’s language, communication styles, beliefs, attitudes, and behaviors. It has been shown to improve physical and mental health outcomes and chronic disease management as well as to increase health-related knowledge and the uptake of cancer screening.

  • Relies on culturally competent leadership and workforce: To provide culturally adapted care, healthcare systems must commit to interacting with patients in an intentional way and provide a range of supplemental services to ensure equitable access to health care. Incorporating these changes relies on a variety of staff members, including clinicians, administrators, language support staff, community health workers, and health curriculum creators. There may also be dedicated individuals or teams focused on training for staff and facilitation of culturally competent services.

  • Provides equitable communication and language assistance: Communicating with patients in a way that they can easily and fully understand is a central tenet of culturally adapted health care. This may involve providing trained medical interpreters for patients with limited English proficiency or creating educational materials that are adapted for patients’ literacy level.

  • Incorporates a community’s beliefs and attitudes: Adapting health care to a community’s values and attitudes entails addressing norms about faith, self-image, or the role of medicine as part of treatment. This is particularly relevant in mental health care, where it is important to adapt therapeutic approaches to a patient’s understanding of illness and it can be beneficial to utilize common cultural metaphors or references.

  • Involves ongoing engagement, improvement, and accountability: As part of a commitment to improving cultural competence, health care organizations set clear goals for care delivery and embed those goals within internal planning and budgeting. Organizations regularly collect data on patient demographics and care outcomes and conduct internal assessments to ensure equitable treatment.

Multiple studies with rigorous designs demonstrate that culturally adapted health care is a well-supported strategy for improving physical and mental health outcomes and chronic disease management, and increasing health-related knowledge and uptake of cancer screenings.

  • Recruit and train culturally responsive and representative staff: Culturally competent health care staff are essential to providing culturally adapted health care. Recruiting a workforce that reflects the experiences and social identities of those served can increase cultural competence when interacting with patients. All staff can also benefit from training on cultural competence and from soliciting and reviewing feedback from patients on organizational practices.

  • Approach interactions with patients through the LEARN model: The LEARN model asks providers to listen with empathy to a patient’s perception of the issue, explain their own understanding of the issue, acknowledge and discuss similarities and differences between the two, recommend a treatment, and then negotiate an agreement on that treatment with the patient.

  • Communicate clearly in conversation and written materials: Communication is a key component of culturally competent health care. Health care providers should use plain, non-medical language; use the patient’s own words to describe issues and treatments; keep key messages concise and repeat them; and utilize images and graphics. Providers should also rely on trained interpreters rather than informal interpretation systems such as patients’ children and explore a variety of language assistance options (e.g., translators, bilingual staff members, technology translation for messages).

  • Address common barriers to health care access: Culturally competent health care relies on ensuring that patients are able to access health care services. Practices should ensure that there are supports in place to facilitate this access, including services such as childcare, transportation, or office hours during evenings and weekends that make it possible for patients to attend appointments.

  • Tailor lifestyle interventions to cultural norms: Behavioral interventions are most effective when they fit within existing cultural norms. For example, dietary interventions should include culturally acceptable food choices. Additionally, cultural norms for familial and community relationships should be viewed as a valuable asset for establishing support systems; this support can be a valuable method for ensuring patients attend appointments regularly, take medication as scheduled, or receive encouragement when quitting smoking or increasing physical activity.