It All Starts at the Front Desk' - PowerPoint PPT Presentation

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It All Starts at the Front Desk'

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Title: It All Starts at the Front Desk'

1
It All Starts at the Front Desk.

How to enhance first impressions for Latinos
seeking services

2
Todays Objectives

Acquire an understanding of some fundamental
characteristics of the Latino population in the
US
Cultural values and beliefs that influence Latino
Behavior
Discussion of barriers Latinos face when seeking
services.
Understand why it is important to provide
culturally and linguistically appropriate
services to Latinos at the Front Desk

3
A Word about Cultural Competence.

There are five abilities that are considered
necessary to achieve individual cultural
competence
We value diversity
We are able to understand our own cultural views
(and those of our affiliated organizations and
systems)
We are aware of how culture may be affecting a
life situation
We are willing and able to learn about other
cultures
We are able to change our behavior to meet the
needs of others and other cultures

4
Generalizing vs. Stereotyping

Using generalizations to understand a group of
people is productive and helps one gain insight
into communication styles and behaviors
Using stereotypes to categorize or judge people
is destructive and discriminatory.

Who are the Latinos in the United States?

6
Most Latinos were born in the US

Of the 40 foreign born
27 arrived before 1980
30 arrived in the 1980s
43 arrived in the 1990s

7
Reasons Latinos immigrate to the US

Hispanics/Latinos travel to the United States can
be understood in terms of pull and push factors.
The network theory Those who migrated first
would help their family and friends come to US,
who would then help others, and so on.
Pull Factors
-Higher living standards
Push Factors
-Shortage of jobs, unemployment, low wages
-Political conflicts
-Forced displacement
-Persistent poverty, hunger
-Violation of human rights, corruption, high
crime indices
-Insufficient lands (specially in Central
American countries)

8
The Latino Profile

The Established Sector of the Community
National Origin
Mexican/American/Cuban//P.Rican/
Dominican Republic
Language
Bilingual
Legal Status
US Citizen
Academic Training
B. A. or more
Religious Affiliation
Catholic
Occupation
Professional/ Services/ Sales/ Office
Average Income
24,784.00
Residence
Metropolitan Areas

The More Recent Immigrant Population
National Origin
Mexican, Central or South America
Language
Spanish
Legal Status
Permanent residences, TPS, Undocumented
Academic Training
H.S. or less
Religious Affiliation
Catholic/Some traditional religions
Occupation
Production, transportation, construction,
maintenance
Average Income
12,700.00
Residence
Metropolitan, Suburban areas

This slide developed by Latinas who work closely
with Hispanic/Latino families in this community.
Dilcia Colindres (Shelter for Help in Emergency),
Marcela Estay (ASG), Ivonne Lopez (RHOP), Linda
Winston (VSDVAA), Florencia Aranda (SHE).
9
Language

Although most Latinos living in the US speak
English and/or Spanish, there are over 700
indigenous languages spoken in Latin America
Nahuatl Mexico
Mayan languages Mexico and Guatemala
Mixtec Oaxaca, Mexico
Purépecha Michoacán, Mexico
Quechua Ecuador, Peru, Bolivia

10
There are more immigrants from Asia than from
Latin America in Virginia
10
11
Immigrants who have been here for a shorter time
are more likely to have language barriers
12
Who is Latino?

Term conflates diverse populations
History of Mexicans in Southwest distinct from
Puerto Rico
Long-term residents with recent arrivals
Émigrés from El Salvador vs. émigrés from Cuba
Term homogenizes class experiences and neglects
many different linguistic, racial, and ethnic
groups (Delgado Stefancic)

Slide developed by Dr. McKenna Brown for a
presentation at Western State Hospital- February,
2009
13
Are they Latino or Hispanic?

Both terms are commonly used and to a large
degree are interchangeable. The use of Hispanic
is probably more institutional, conservative and
external, while Latino/a is used in more
individual, liberal and internal contexts.

Slide developed by Dr. McKenna Brown for a
presentation at Western State Hospital- February,
2009
14

Cultural scripts are a way to explain values and
behaviors. They are patterns of social
interaction which is characteristic of a
particular cultural group.
Because people bring these assumptions with them
into everyday interactions, cultural scripts can
influence their encounters and relationships.
The claim of the cultural scripts approach is
merely that the scripts form a kind of
interpretative background against which
individuals position their own acts and those of
others.

15
Latino Values and Beliefs

Trust Confianza is built on mutual respect over
time. Showing personal interest in Hispanics
individual may help establishing trust.
Machismo Hispanic Families are characterized by
traditional gender roles. Men are expected to be
rational, strong, authoritarian, independent and
strong. Women are expected to be submissive,
dependant as well as take care of children and
household.
Fatalism Many Hispanics believe that events are
meant to happen because of fate, because of power
and that they can not control it. Many clients
will say Its my cross to bear, or If God
wishes so. This may prevent them to seek for
help.

Espiritismo In Latino/Hispanic culture
spiritual healers play an important role in
helping people with physical as well as mental
concerns. Curanderas, espiritistas, Santeria.
Religion In general Latino/Hispanics are very
religious. The church serves as a guide for
perceptions and behaviors, influencing decisions
and judgments. The church is often an important
source for social support and interaction.
Catholic- Dominant religion but Protestantism on
the rise. Don't forget the indigenous religions.
Belief in black magic or curses Some
Latino/Hispanics believe that bewitching is often
the cause of a change in behavior or illness. It
involves the use of magical acts and supernatural
powers either by humans or supernatural beings.
This may simply involve the casting of a spell.

Personal space Personal space tends to be
closer, Latino/Hispanic cultures are more open
to physical contact and less aware of personal
space
Time orientation Latino/Hispanics are generally
more concerned with the present than with the
future or planning ahead. Often times Latinos
need to be reminded the day before of an
appointment or activity.

Importance of Family Family is the primary
social unit and source of support. Family goes
beyond parents and siblings, it includes the
extended family (cousins, uncles, aunts, etc).
Respect It indicates appropriate behavior
towards others based on age, gender, social and
economic position and authority. Formality is
seen as a sign of respect. Use of suffixes are
very important such us Señor/Don, Señora/Dona.
Personalismo Latinos/Hispanics tend to stress
the importance of personalismo, personal rather
than institutional relationships. Person to
Person contact its very important to develop
trust . Its very common that Latino clients find
uncomfortable to leave messages in office
voicemails.

In many ways, cultural competency is the ability
to empathize with the plight of others and change
your behavior to meet them where they are at.
In order to understand how to work better with
Latinos with whom we work, it is important to
understand what barriers they face while
attempting to seek services.

21
Issues Latino Families Face When Seeking Services

Poverty Approximately 23 of Hispanic families
live below the poverty level.
Misunderstanding of cultural values Lack of
bilingual/culturally competent staff in agencies
and organizations lead to misunderstandings of
cultural believes and values.
Language barriers Lack of interpreters or
bilingual staff available.

Lack of knowledge on how the US health care
system works. They may think its cheaper to go
to the ER than to a PCP.
Many of the Hispanic families wont have access
to health insurance coverage. Latino children who
are not US citizens or legal residents will not
be eligible for the health insurance state
programs.
Lack of knowledge on how the US educational and
legal system works. Hispanics may think they
cant file for protective orders, custody, or
request additional services from the school
systems.

Lack of information that leads to misconceptions
about resources in the community. Hispanics may
think that they are not eligible for WIC or other
services or they have incorrect ideas about
services they can qualify for.
Transportation Local Public Transportation does
not provide services to some of the Latino
neighborhood.
Legal Status and fear of deportation Many of the
Hispanics will be not be eligible for services
for being undocumented.

Why the Front desk?
The front desk is the first impression for people
using services. Front desk staff have the power
to make people feel welcome and valued or
unwelcome and uncomfortable. These are the
principles of customer service.

25
Why start at the Front Desk?

A great deal of training and effort has been
directed at supporting health care and other
professionals to provide culturally and
linguistically competent services but for most
families, there are many interactions that
actually precede the actual encounter with the
health care provider.

26
Why start at the Front Desk?

Before seeing the provider, families must
Call for information
Make appointments
Fill out paperwork
Ask questions about payment
Provide information at each visit
Make their way to the providers office

27
Why start at the Front Desk?

When front desk staff fail to meet the cultural
or language needs of the individuals we serve,
they may
Perceptions of being insulted or being treated
rudely
Fear or embarrassment about contacting the health
care provider or office
Confusion about appointments or treatment
Or feeling unwelcome, unwanted or not valued.

28
Why start at the Front Desk?

Adults and children with special needs may not
receive optimal treatment because
they are uncomfortable calling for advice, needed
appointments, or medications, leading to delayed
access in care.
May not keep follow-up appointments resulting in
less effective care
Providers may not have complete information about
the visit and needs because the front desk has
not been able to communicate effectively with the
individual or family members.

29
Why starts at the Front Desk?

Providers may face problematic outcomes
including
Time wasted due to missed appointments
Loss of referrals or reputation when families
report their negative experiences with the front
desk
Time wasted and incorrect diagnosis as
information collected was not totally accurate
due to language and cultural barriers
Possible filing by individuals and families of a
grievance or report of discrimination based on
treatment by the front desk.

30
VIDEO

El Anillo
The Ring

31
Suggestions

Strive to spell and pronounce names correctly.
Avoid asking if a person speaks Mexican or
Puerto Rican. Spanish is Spanish.
Use qualified interpreters. Children should never
be asked to act as interpreters.
Try to learn Spanish. Speaking in Spanish
facilitates a greater level of comfort. A few
phrases will make people feel welcome and
comfortable.
Identify and address the decision-maker or
spokesperson, the Patriarch and Matriarch. At
the very least, include them in your
conversation.
Be formal in interactions with older Hispanics.
Encourage the family to ask questions. Explain
thoroughly and confirm understanding.
Check to make sure recommendations will fit into
the family lifestyle.
And finally listening is the key