Overview
The Hmong community is one that has strongly followed its cultural practice until today. The medical domain is one of the major instances where cultural values and practices are highly held. Conflict exists between the Hmong community and the healthcare providers, and in a recent tragedy, conflict emanated after a Hmong child was left injured after a chemical spill. Therefore, in order to ensure that the Hmong community and the local hospital work collaboratively to ensure the provision of optimal health care, there is a need for comprehensive program development as indicated in the following 14 steps, according to Calley (2011).
Establish the need for programming
The Hmong community is an immigrant group from Southeast Asia, and it has a strong cultural belief in traditional medicine using traditional healers or shamans. The Hmong have no knowledge of Western medicine; hence, they only refer to it as an alternative. Even for the few Hmong that seek Western medical views, their level of acculturation and ability to modulate traditional beliefs act as an impediment to full participation in Western medicine, such as lack of adherence to treatment (Plotnikoff, Numrich, Wu, Yang, & Xiong, 2002). Health care providers of Western medicine, on the other hand, disregard the Hmong’s cultural beliefs.
Establish a Research Basis for the Program
It is imperative to establish the underlying reasons for mistrust between the Hmong community and the Western views. Hence, Riverbend staff will interview both the Hmong community members, including shamans and the healthcare providers at the local hospital. In addition, the literature on similar interventions that have been previously carried out to address this problem will be reviewed, and mitigation plans developed for anticipated limitations.
Program Design
This program will entail education/training and coming up with integration strategies between the local hospital and the Hmong community. The training objectives and outcomes will be developed while involving both the local community and local hospitals, who are the main beneficiaries because they have a better understanding of the issues affecting their well-being. The narrative protocol indicated below shows how the program would be executed.
Staffing Infrastructure
This program will embrace a participatory approach that will involve Hmong community members as part of the staff. The organizational chart below indicates the staffing infrastructure.
Identify and Engage Community Resources
This program will identify various community organizations and local individuals who have had a chance to utilize Western medicine. In addition, the program will identify Hmong community members working at the local hospital to act as advocates. Leaders at the local hospital will be identified and used as agents for attitude and behavior change in reference to their assigned positions, as indicated in step 4 above.
Identify and Evaluate Potential Funding Sources
The government will be approached, and the program proposal presented to them to solicit funds through its various divisions dealing with health issues, such as Healthy People 2020 and the Centers for Disease Control and Prevention. Also, the program will identify the various national movements fighting to integrate patients’ cultural beliefs and values into Western medicine and seek financial support from them.
Financial Management plan
The revenue obtained from the local hospital, Riverbend Missions, the government, donors, and well-wishers will be used to pay staff salaries, training space, purchase training materials, as shown in the table below. In the long-run, the program will encourage stakeholders to develop income-generating activities that will ensure its sustainability.
Develop the Proposal
Essential domains during proposal development will be factored in when presenting the proposal to donors, whose main focus includes the program’s objectives, desired outcomes, and budget. Hence, a grant writer and reviewers will be utilized to increase the chances of receiving funding.
Implement the Program
While using the community leaders, including the shamans, the Hmong community members will be invited to community meetings for sensitization about the prevailing problem. In addition, various meeting points for the community members will be identified, either in the form of religious communities, community groups, or any other form of community gathering for the same purpose of sensitization. The local hospital staff members will also be sensitized. Subsequently, the beneficiaries will be invited to a centrally agreed-upon venue where training will take place. The training will focus on aspects of both Western medicine and Hmong’s cultural practices, and how Hmong’s community cultural beliefs can be integrated into the healthcare practice at the local hospital.
Evaluate the Program
Both internal and external evaluators will be employed during the three stages of the evaluation process.
Fidelity Assessment
The managers will ensure that all the necessary inputs to start the program are in place.
Process Evaluation
At this stage, the evaluators will determine if the program activities are proceeding successfully based on the number of training sessions, hours per session, number of attendees, provision of information, education, and communication materials, delivery mode, and beneficiaries’ feedback.
Outcomes Evaluation
Evaluators will determine the program’s success by reviewing the outcomes, such as Hmong’s community knowledge and attitude level of Western medicine. This evaluation activity will utilize a 10-point Likert scale with at least 10 items to measure attitude. A multi-choice questionnaire with at least 10 questions will be used to assess knowledge of western medicine. Also, the local healthcare staff will be assessed on their knowledge and attitude levels about the shaman’s role in the healing process alongside associated pertinent cultural values and beliefs. Another domain that will be assessed for both groups is the most feasible way of integrating the shaman’s role in the local hospital’s practice.
Build and Preserve Community Resources
The shamans’ roles and associated cultural beliefs will be acknowledged and integrated into the hospital’s usual practice. The Mercy Medical Center in Merced is an epitome of this integration process (Brown, 2009). The center delineates a perfect example of the integration of shamans’ roles in Western medicine. Hence, Western medicine will execute its scientific role, and the shamans will also be allowed to perform their spiritual bit. Such a move is meant to enable the local community to embrace the local hospital (Western medicine) as a facility aimed at improving their health status.
Develop an Advocacy Plan
Local community groups and organizations will be supported in the endeavor to increase the Hmong’s community trust in the local hospital. Weekly meetings between the program’s public relations manager, program managers, and these local groups will be held to determine the rate of utilizing the local community hospital. Also, prevailing challenges or emerging issues will be presented, and solutions discussed. The community groups will ensure that the solutions are implemented and assure the community on the same. Team leaders in the different departments of the local hospital will oversee that the Hmong community members are treated with respect, and provided with the services of a shaman if they seek one.
Develop an Information Sharing Plan
The IT officer will develop a reporting tool that will be used to report on the program’s accomplishments. This report will be shared with relevant stakeholders on a quarterly basis. Information shared will include the financial management aspect and the program’s outputs and outcomes in reference to its objectives.
Attain Program and Organizational Accreditation
Once the program fully integrates the community’s cultural values and practices within the local hospital’s system of healthcare delivery and mutual trust is evident between the local hospital staff and the local community, accreditation of the program from a suitable health-related body will be sought.
The success of this program will act as an additional example of similar future programs. Since the goal of every healthcare giver is to ensure that the patients receive high-quality care, they should always be willing to accommodate the cultural values and beliefs of their patients. Hence, more programs are necessary to reinforce this integration.
References
Brown, P. L. (2009, Sept. 19). A doctor for disease, a shaman for the soul. The NewYork Times. Web.
Calley, N. G. (2011). Program development in the 21st century: An evidence-based approach to design, implementation, and evaluation. Thousand Oaks, CA: California.
Plotnikoff, G., Numrich, C., Wu, C., Yang, D., & Xiong, P. (2002). Hmong shamanism: Animist spiritual; healing in Minnesota. Clinical & Health Affairs, 85(6), 29-34.