Page 88 - Nutrition Counseling and Education Skills: A Guide for Professionals

respect, understanding, care, and efficiency. Although cultural competence is similar to cultural
understanding, there are key differences. Cultural competence consists of thinking and behaving that enable
members of one cultural, ethnic, or linguistic group to work effectively with members of another.6 Nutrition
and dietetics professionals cannot be culturally competent in every culture, but they must be culturally
competent about the various cultures they encounter on a regular basis. They also need to recognize and
investigate unique differences with each particular culture and individual, so that they can determine the best
way to treat their clients.

SELF-ASSESSMENT 2

1. Describe your own culture, origins, history, and beliefs.
2. What cultural groups do you feel competent to counsel?

Understanding Health Practices

Culture determines how a person defines health, recognizes illness, and seeks treatment.8,31,32 Each culture
holds values, beliefs, and practices about good health and disease prevention, the care and treatment of the
sick, whom to consult when ill, and the social roles and relationships between client and healthcare provider.
Most Americans, for example, believe in westernized, scientific medicine. Many cultures, however, have food
and health beliefs that are not grounded in evidence-based foundations. These practices need to be respected
and do not necessarily need to be eliminated if they do not cause harm or exploit others. An example is the
practice of intermittent fasting in many cultures or the use of integrative and complementary medicine.33,34

Americans typically make informed individual health decisions through informed consent and use the
healthcare provider as the manager of care. Westernized healthcare also separates body, mind, and spirit in
treatment programs. However, the healthcare orientation of other cultures may differ. For example, in
numerous, non-American cultures, a family member or the community as a whole may have decision-making
responsibility rather than the individual; emotional and psychological remedies may supersede scientific
medicine; and body, mind, and spirit may be seen not as separate, but as joined.10

Counseling ethnic groups requires knowledge of their foods.

88