PM3018: Assessing Teacher Cultural Competency During Implementation of the Y-HEALAR Health Education Curriculum for Afghani Refugee Families

Background: There are known disparities in healthcare access and education for impoverished and migrant populations. Research has shown cultural competency of providers may reduce health disparities and play an in important role in quality of minority healthcare. Yale Health Education and Literacy for Asylees and Refugees (Y-HEALAR) an existing partnership between medical professionals at Yale and two New Haven-based refugee resettlement agencies, aimed to assess teacher cultural competency during implementation of an interactive, virtual health education curriculum targeted for Afghani refugees to improve refugee healthcare knowledge.

Methods: Using the Kern approach for curricular development, seven two-hour virtual classes were developed and taught by pediatric residents and medical students with faculty input from June 2021-March 2022. Pediatric residents and medical students were recruited to teach by email and in-person residency staff meetings. Topics were chosen in collaboration with community organizations and included nutrition, COVID19 Safety and Vaccines, common childhood illnesses, mental health, navigating the school system, and navigating the healthcare system. PowerPoint slides were used as visual aids; real-time translation was provided by interpreters in Pashto or Dari. Teacher cultural competency—specifically cultural knowledge, awareness, and skill—was assessed by refugee participants using a 9-item previously validated questionnaire (Lucas et al, 2008) with a 7-point Likert scale in which greater scores correlate with higher perceived cultural competency. The questions were administered by phone within 10 days of the class. Numerical responses were converted to percentages and analyzed using descriptive statistics.

Results: There were 27 teachers for 7 classes (average 2.8±1.6, range 1-6); 5 teachers taught in two different classes. 56% were pediatric residents or fellows, 81% were female (Table 1). The classes were attended by an average of 6 refugee participants (range=3-9). Of 36 total refugee participant respondents (80% response rate), 100% were female, 53% had no formal schooling and 100% were Medicaid recipients. Participants arrived in the US an average of 5±3 years ago. Refugee participants rated the teachers’ cultural knowledge, awareness, and skill with an average of 81%±13, 83%±17, and 89%±9 out of 100%, respectively (Figure 1). 100% of respondents would recommend the class to a friend.

Conclusion: Perceived cultural competency of trainee providers teaching virtual health education classes, as reported by Afghani refugee participants, was highly rated. In previously validated studies, highly rated cultural competency was correlated positively with trust and satisfaction and negatively correlated with perceived discrimination. Our results demonstrate that an academic-community partnership between healthcare providers and community refugee organizations can provide culturally sensitive health education for refugee families.