Page 91 - Nutrition Counseling and Education Skills: A Guide for Professionals

decision maker.8,9 Women may be more likely to breast-feed if they have strong family support.
Nutrition counseling must also identify whether the family is monocultural or bicultural. Monocultural

families identify with one primary ethnic group; those that are bicultural identify with two or more groups.
Clients may move back and forth among cultural groups easily. Consequently, the food choices made by
clients may depend on situational factors or a diverse cultural identity.

Multicultural Awareness

To achieve multicultural competence in nutrition counseling, health professionals must first strive for
multicultural awareness. A personal awareness of the various cultures within the United States first requires
that the individual become aware of his or her own culture or heritage. Each individual has a cultural, ethnic,
linguistic, and racial identity. Awareness of personal values, beliefs, assumptions, biases, and prejudices must
be brought to the level of conscious awareness before one can become culturally competent. Therefore,
professionals should learn about the customs and traditions of their own family and culture, identify the
historical connections between their culture and those of others, and examine their worldviews and cultural
assumptions.

Individuals may be unaware of the ways in which their own culture influences other people’s behaviors,
reactions, and interactions. This examination might begin by assessing all of the values, beliefs, or behaviors
that shape one’s self, including family and heritage, socioeconomic factors, politics, biases, religion,
educational level, occupation, gestures, and terms of endearment. There are three key proficiencies that
healthcare professionals must develop in order to be multiculturally competent. First, dietetics professionals
must develop a multicultural competent attitude, that is, a mindset that respects cultural differences and
similarities, while tolerating unclear intercultural communication due to language barriers. This attitude
requires that healthcare professionals maintain a high level of patience for the additional time needed for
effective communication. It also requires that the professional may need to modify usual training materials by
making them easier to read and interpret (see Chapter 14). In some cases, use of visuals or pictures may have
more success with certain clients. Second, dietetics professionals must develop multicultural competent
practices. These practices should ensure that clients’ traditional health beliefs and diet are being balanced with
healthy American food choices. Third, nutrition professionals must develop multicultural counseling skills.
These skills may include listening skills, bilingual communication skills, diet modification skills, or evaluation
skills.35

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