Page 83 - Cultural Competence in Health Education

Cultural Competence and Health Education 61

because, throughout his life, people have overlooked his interpersonal skills and
rewarded his computational skills. Another example can be seen in the case of the
health educator who is faced with gender issues when a female student refuses to seek
a male - dominated career. The internal origin of gender issues appears in this individ-
ual who feels more comfortable in a caring and nurturing position, such as being a
nurse or a teacher. The success of health educators in addressing cultural values and
practices rests in part with their consideration of the etiology of the problem.
Acculturation. The interactions that come out of circumstances when two cul-
tures meet are numerous and fluid. Sometimes the health educator recognizes that the

minority culture looks and acts like the majority culture. At other times the majority
culture may be totally immersed in the minority culture. For example, at a health fair
for a minority group, a health educator may provide an infrastructure that displays
American information about health problems while the health fair workers from the
minority community bring their own food, music, dress, and folk medicine and their
extended family members. The health fair may be a culmination of the impact that the
health educator has had on the dissimilar cultural group and the impact of the dissimi-
lar cultural group on the health educator and the work environment. Thus the health
fair becomes a credible celebration of connectedness and of diversity.

Goals of counseling. As a counselor the health educator may facilitate decision
making, prevent problems, or remediate problems. Although using the skills of assess-
ment, planning, and identifying resources, the health educator ’ s counseling role is
guarded by the basic principles of the profession. For example, the goals of counsel-
ing, which determine the health educator ’ s role, are set by the youth or student in a
school setting. It is the student who decides the goal for a weight loss effort or a drug,
self - image, or school attendance problem. Knowledge of the problem - solving process
and the ability to identify antecedents surrounding the problem, and the resources
available to remediate the problem, are valuable skills when the health educator deter-
mines the role to be played with clients of dissimilar cultures. How much counseling
influence (to facilitate decision making, prevent problems, or remediate problems)

the health educator has in this setting may readily be determined through knowledge
of the student, the student ’ s home life, the community the student represents, previ-
ous and current interactions and any rapport between the student and health educator,
and a host of other variables that will affect expectations, readiness, and the goals
of counseling.

Once consideration is given to these three factors (etiology, acculturation, and
counseling goals), the roles of the health educator as a counselor become more exten-
sive. This three - dimensional model constructed by Atkinson can support delineation
of the health educator ’ s roles as an adviser, advocate, facilitator, change agent, and
consultant. Training for cultural competence should center on these roles.
Many academic and walk - in - my - shoes learning adventures and strategies can assist
the health educator who has gained others ’ trust and has exhibited sensitivity and con-
nectedness in providing advice, speaking for, making happen, altering environmental

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