263156 Culture and disability: A structure-process-outcome framework

Tuesday, October 30, 2012 : 11:29 AM - 11:47 AM

René I. Jahiel, MD, PhD , President, Ecole Libre des Hautes Etudes, Riverdale, NY
Rooshey Hasnain, EdD , Disability and Human Development, University of Illinois at Chicago, Chicago, IL
BACKGROUND: The importance of culture and cross-cultural interactions of those who are in situations of disability has been stressed and yet understudied. It is a highly diversified field, and a framework that encompasses and organizes the full scope of that field might be useful in developing cross-cultural research, policy, and rehabilitation practice. OBJECTIVE: To present a rights-based structure-process-outcome framework to address disparity and access issues in relationship to culture and disability. METHOD: Theoretical development based on professional and field experience and literature review.RESULTS:The framework applies to situations in which persons with disabilities have differing cultures and worldviews from others in their environment. Cross-cultural conflicts between clients and their providers are one such issue. Structure includes categories of culture (such as national, religious, community, or professional cultures), their subcultures, and relevant social structures. Process includes the cultural content of interactions between individuals and environment,translation across cultures, cultural brokering, and acculturation. Outcomes include health, function,and participation; environmental modifications; dignity constructs; meanings and values of the outcome for the person; acculturation; and, accountability. Vignettes and case histories will illustrate these concepts. CONCLUSION. Cultural aspects of disability research and rehabilitation praxis have been somewhat neglected. The proposed framework may highlight them and promote cross-cultural development of the field.

Learning Areas:
Diversity and culture
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
The learner will be able to describe Donabedian's structure-process-outcome approach to public health problems and to explain how it can be used to address disparities and access issues in relation to culture, disability, and related cross-cultural conflicts.

Keywords: Disability, Cultural Competency

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have extensive research, teaching and service experience in disability, recognized expertise in disability theory research, and personal as well as professional experience in cross-cultural problems including those related to disablity. I was rewarded for my professional and research activiities with a lifetime achievement award at the 2010 annual meeting of APHA.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.