Building Competency in Diabetes Education THE ESSENTIALS

SELF-MANAGEMENT EDUCATION & SUPPORT: PROGRAM DEVELOPMENT| 11-43

The impact of culture In the preparation and delivery of educational materials the cultural beliefs and values of the participants are a major consideration. A person’s cultural background is a key determinant of his or her health-related beliefs and behaviours. These beliefs are deeply embedded, learned over a lifetime and may be resistant to change.

Cultural beliefs are core, inherent values affecting all aspects of patient’s behaviours particularly in regard to health (58).

Educators need to be aware of how the management of diabetes may fit into the cultural life of the person with diabetes. However, they must also be careful not to stereotype people within a culture; people are unique and different even within a similar cultural background and they experience different levels of enculturation when exposed to a new environment (59). You will also need to reflect on your own cultural beliefs and ensure you do not impose your own values. Culture has been the focus of the literature in recent years. For example, one study centered on the Hispanic population reflects similarities in other literature reviews involving various ethnic groups (60). Aspects of each culture are unique but there are similar concepts to consider in view of education. Five major implications for SME were described: • Congeniality with the care provider is important. • The honour/power in the mother role may be derived from self-sacrifice. • The value of family is paramount. • Herbal remedies are often used in conjunction with, or as a substitute for, “Western prescriptions”. • More than 60% demonstrated health beliefs that may be contrary to SME philosophy. i.e. their perception of the cause of diabetes is related to things outside their control (external locus of control), referred to as fatalism or God’s will (61). There are many resources available through Diabetes Canada and cultural centers to help the educator in their endeavour to understand the cultural milieu before engaging in an education program to specific ethnic groups. The educator is strongly recommended to seek out these resources to develop an appreciation of our Canadian diversity and how it relates to education.