The Training Our Providers in Cultural Sensitivity (TOPICS) Project documents six model programs that teach their health care providers about American Indian and Alaska Native culture and history.
Before he was elected Principal Chief of the Cherokee Nation, Chad Smith spent 10 years researching and writing the history of the Cherokee Nation, and developing a course to convey this information. Today, all of the Tribe's 2,000 employees are required to take the 40-hour Cherokee Nation History Course.
UIHS created an environment for health care that reflects the local culture through architectural style, basket collections, art galleries, and a land reclamation project that has transformed 40 acres into walking trails with indigenous plants and community gardens. UIHS raised $6 million from foundations and worked for 10 years to create this "expression of health for American Indians."
The PTHA has built a clinic that reflects the culture of their tribe. They have taken a comprehensive approach to assuring that their mission of culturally competent care is carried out: a cultural coordinator, three orientations for new employees, quarterly staff training, defining cultural competency and assessing it in personnel evaluations. The most unique aspect of their program is a clan structure for employees to hold a potlatch and full-day cultural training each year at the clinic.
The remote location and harsh climate of Barrow make it difficult to recruit and retain health care providers. Most providers live in housing attached to the hospital and they rarely venture outside the compound. The Arctic Slope Native Association holds quarterly cultural orientations on different topics to encourage health care providers to participate in Barrow activities and enjoy the rich Inupiat culture that surrounds them.
The Detroit urban Indian clinic is located in a donated church that has been transformed to create a supportive context for healing that includes culture, spirituality, and the environment. This model has been developed with very little funding. Western trained physicians work side-by-side with traditional healers.
CRIHB presents an annual American Indian cultural competency training program for counselors who work at the California Smokers' Helpline. This has enabled the counselors to respond more effectively to more than 1,000 American Indians who call them each year for help to quit smoking. This could serve as a model for training contract health providers.
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