This toolkit will help providers apply the Cross-Cultural Clinical Practice Guidelines, which were written for primary care practitioners serving racially, ethnically, and linguistically diverse Medicaid populations in various outpatient settings. It introduces the fundamentals of cross-cultural practice and offers steps and processes essential to delivering high-quality care to culturally diverse populations.

The toolkit includes the following sections:

• Introduction and rationale
• Overview of health disparities
• Cultural considerations in health care
• Clinical assessment processes
  • Cross-cultural views on diagnostic and treatment practices
  • Eliciting patient views
  • Patient cultural assessment
  • Sample case study
  • Summary action points
• Treatment planning and adherence
  • Considerations in treatment planning
  • Factors influencing treatment adherence
  • Negotiating treatment adherence
  • Summary action points
• Patient communication and education
  • Cultural factors affecting communication
  • Verbal and non-verbal communication styles
  • Working with language barriers
  • Patient education during the medical encounter
  • Summary action points
• Clinical decisionmaking
  • Factors affecting clinical decisionmaking
  • Sample case study
  • Summary action points
• Organizational supports and system tools
  • Impacting system change
  • Quality improvement planning
  • Interpreter service arrangements
  • Additional supports
•  Appendixes
  • Sample patient cultural assessment tool
  • Summary evaluation of case study
  • Sample case examples of cultural competence quality improvement plans
  • Summary of culturally and linguistically appropriate services standards