LANGUAGE

Communication and language are initial challenges when client interaction involves diversity. (Kavanagh & Kennedy, 1992). Communicating with the African American client is best accomplished by utilizing key conversational skills (e.g., social introduction, demonstrating respect, lack of hurriedness), choosing personalized interaction modes, and the therapeutic use of silence, and touch. African American patients prefer to be involved in clinical decision making and are more apt to be compliant with their plan of care if the educator uses language to present themselves "as a colleague rather than as an authority; not requiring direct or immediate responses from audience members; establishing ties through relatives, friends, or common locations"(TrippReimer, T., et al., 2001). This is known as an indirect approach. African Americans respond to this approach, and it is helpful to offer suggestions when interacting with this client, rather than being authoritative (e.g., saying that "someone who has such abiological The humans basic problem, might do the following" rather than needa directive approach). to eat cannot be using Incorporating from symbols and separated humor during serious discussion provides balanced giftmetaphors of status, communication. In the African giving, feasting, socialstrong kin American culture having a and oral tradition, a number of ritual. relations, and sacred formats have been demonstrated to be effective, including the use of cultural themes and imagery, metaphors, storytelling, or pictures to convey health messages; reconfiguration of group structure and inclusion of target community members as role models or co-leaders.

The Sugar and Soul Food

Soul Food Recipe Sampler

Barbecue Pulled Pork

(From The New Soul Food Cookbook, 2nd ed., p. 33)

Diabetes in the African American Population

Preparation time: 10 minutes Serves 4: Serving size 4 oz Ingredients: 1 lb boneless pork tenderloin 1/2 tsp pepper 1/2 tsp red pepper flakes 1 Tbsp canola oil 1 cup diced onion 2 cloves garlic, minced 1/2 cup barbecue sauce 1/4 cup catsup 1/4 cup water 1 tsp vinegar Directions: 1. Heat the oven to 350F. Seat the whole tenderloin on all sides in a hot, nonstick skillet. Remove from the heat and season with the pepper and red pepper flakes. 2. Cover the tenderloin with foil for 25 minutes. Heat the oil in a medium saucepan and saut the onion and garlic for 5 minutes. 3. Add the barbecue sauce, catsup, water, and vinegar. Simmer for 10 minutes. Shred the pork with two forks. Add the pulled pork to the sauce. Serve on buns. Exchanges: 1 carbohydrate

Cultural sensitivity
The extent to which ethnic/cultural characteristics, experiences, norms, values, behavior patterns, and belief of a target populations relevant historical, environmental, and social forces are incorporated in the health promotion materials.

Cultural Tailoring
Is the process of creating culturally sensitive interventions, often involving the adaption of existing materials and programs for racial/ethnic subpopulations.

History of African Americans History and Culture

African Americans may come from many different cultures: Ask the patient how they would categorize themselves to better understand how they relate with their own culture within the African American community. Understand that there are no set standards for use of touch or personal space. Ensure that patients are comfortable with your use of touch and personal space. Speak directly with them about their personal feelings. African Americans may exhibit a relaxed sense of time and may put personal relationships and obligations above time constraints set by doctors visits. BE RESPECTFUL: Always address the patient by Mr. or Mrs. unless directed otherwise. Be aware that due to the long history of prejudice and social injustice, there may be perceived feelings about health care disparities and prejudices within the African American population. Maintain eye contact and speak directly and clearly with patients. Historically African Americans have used clothing to express their cultural points of view. While the typical African American may have no specific culturally associated attire there may be several subsets within the community with defining attire. Attire is often tied to perceived wealth or importance.

An Alternative Approach
How important is food in your social, business, intimate, and family interactions? How would your relationship with your family and friends change if you radically changed your diet? Are you willing to be an instrument of cultural change in your community, which may require that you go through some tense and uncomfortable times with family and friends directly related to the dietary changes youre trying to make to be healthy? List the foods you know you are unwilling to eliminate from your diet. Is cooking something you enjoy doing? If yes, how often do you cook? Are you willing to substitute other types of gifts?

Common Traditional Foods

Leafy green vegetables, such as collard greens, mustard, turnip, and dandelion greens, kale are staples of soul food. Corn is also a mainstay. Starchy vegetables including dried beans, fresh and dried peas, with pork, corn, and sweet or white potatoes are popular. Popular combinations of rice with black-eyed peas and corn with lima beans are common. Cornbread, grits, and macaroni are also basic to their diet. Most meats are breaded and fried usually because of the short cooking time during the heat of summer.

Hoppin John (Rice and black-eyed peas)

"Have you ever heard in the Black culture someone say to another "I'm going home to grease?" or "Mama can sure burn." Do they mean that literally? Is there a lot of grease in soul food? Do African Americans like their food well done or almost burnt? Do greens and beans require pork to satisfy as soul food? Is this a legacy from slavery that remains with us 135 years later?" These rhetorical questions are solutions to why diabetes is most prevalent in the African Americans community. "Fifty percent of African American women suffer from obesity. African American adults have substantially higher rates of obesity than white Americans." Sugars are killing the African Community.