Transcript Low Vision Solutions For Service Providers

El Poder Sin Ver:
Ability Without Sight
Initiatives to reach
Latino People
with low vision
Presented By:
•
Adama Dyoniziak, MPH, CPH
Director of Strategic Programs, Braille Institute, Los Angeles
•
Lynn Dubinsky, MA
Adult Programs Manager, Braille Institute, Santa Barbara
•
Rosie Rascon, BS
Independent Living Skills Instructor, Braille Institute, San Diego
Learning Objectives
 Learn
steps to success in working
with the visually impaired Latino
population in urban, suburban, and
rural areas
 Gain
cultural competencies with
regards to working with the Latino
population
Braille Institute Latino Initiative

Braille Institute is a private, non-profit organization
whose mission is to eliminate barriers to a fulfilling
life caused by blindness and severe sight loss

Strategic Plan: Focus new services to the
underserved segments of the population, particularly
the Latino communities using a public health model

Five centers in Southern California – each has its
specific population and needs
California
Statistics: Diabetes

Diabetes 7th leading cause of death in general US
population; 5th leading cause of death in Latino population,
and leading cause of vision loss

US population 65 years+ expected to increase 93% over
the next 3 decades; US Latino elderly population will
increase by 555% (2001, Health Issues in the Latino Community)

Estimated prevalence of Diabetic Retinopathy for people
65+years in the US is 11% (2004, Archives of Opthalmology, Vol 122)

Total prevalence of diagnosed & undiagnosed diabetes
among Mexican Americans is 23.9% (vs Whites 12%)

7.8% of all adults in California have diabetes; 9.2% of
Latino adults in California have diabetes (2010, UCLA Center for Health
Policy Research)
Collaborative Approaches
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Partnership development builds infrastructure
Build trust…warm up the crowd…get
commitments
One legitimate contact gets your foot in the
door
Build momentum through a community
outreach process
Consistent follow-up to maintain credibility &
program viability
Urban Areas: East Los Angeles
• Los Angeles’ Latino
population increased 11%
in the past decade
• 48-97% geographically
dense Latino enclaves
• Los Angeles has the
largest number of people
with diabetes in California:
642,000 residents
Urban Areas: East Los Angeles

Partners: Vision y
Compromiso, American
Diabetes Association

Contracts: AltaMed Health
Care Services, Harder+Co
Community Research, RL
Public Relations

Clinics, evaluation, public
education campaign
Instituto Braille website
Promotoras, or Health Promoters

Grass roots health educators used in
Latino countries for a myriad of health
and community interventions

Add a personal and informal style to
health care

Bridge the gap between providers and
the community
Promotoras in Action
Promotoras
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known grass roots leaders in their
communities
majority are members of the target
population
culturally competent: language, customs,
understand and live the values of the
community they serve
trained to facilitate individual, family or small
group health education
work in a multidisciplinary approach
El Poder Sin Ver In Action
Suburban, Urban, & Rural Areas:
California South Central Coast
Suburban, Urban, & Rural Areas:
California South Central Coast

Santa Barbara (43.4%), Ventura
(40.9%), & San Luis Obispo (21.3%)
Counties
(2010 Census)

Sansum Diabetes Research Institute
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La Casa de la Raza: Latino Community
Center

Neighborhood clinics & farmers’ markets
Sansum Diabetes Research Institute
La Casa de la Raza
Suburban & Urban Areas- San Diego

113,000+ San Diegans have diabetes; over half are Latino (National
Diabetes Stats)

28.8% (376,000) of San Diegans are Latino (City-data.com)
Suburban & Urban Areas: San Diego

Partners: La Maestra Clinic, Family Health
Centers
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Gap in Diabetic education: eye component
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Outcomes: retinal exam grant funding,
systems change
Culturally Appropriate
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Culture is more than race and ethnicity
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Socioeconomic status or class
Urban, suburban, or rural community
Religious traditions and beliefs
Parents’ level of education
Length of residency in the US assimilation level
Language and traditions of their country of origin
Culturally appropriate means considering how all of
these factors will affect participants’ experiences in the
program or curriculum.
Culturally Sensitive

Culturally sensitive care targets the entire
person not just his or her physical ailment
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Recognize, understand, respect, and respond
to the client’s cultural convictions.
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Success requires patience, a willingness to
listen carefully, and a respect for cultural
diversity
Culturally Competent
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Awareness of one's own cultural worldview
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Personal Attitude towards cultural differences
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Knowledge of different cultural practices and
worldviews
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Cross-cultural Skills
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The culturally competent organization fosters a culture
of openness and respect, and is committed to:
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serving diverse clients,
hiring diverse staff, and
establishing programs that address the needs of different
client populations.
Cultural Values
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The Latino family is an interdependent
and interactive kin network that allows
for mutual and reciprocal help among its
members
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Some relevant values include:
colectivismo, familismo, simpatía,
respeto y confianza, machismo,
presentismo, amistad
Colectivismo, or Collectivism
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The emphasis is on the needs,
objectives, and points of view of the
group vs the individual
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Interdependence within a group has
higher priority than independence of the
individual
Colectivismo, or Collectivism
Familismo, or Familialism
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This value fosters strong identification
with and attachment to the nuclear and
extended families and feelings of loyalty,
reciprocity, and solidarity among family
members
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Value facilitates a natural network of
support and a structure for sharing
successes and failures
Familialism
Simpatía, or Avoiding Conflict
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This value stresses the importance of avoiding
conflicts and promoting behaviors that foster pleasant
social interactions
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People may agree to participate in workshops and
never attend because initially saying no would create a
conflict
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Participants want to comply with provider suggestions
so they will agree with a provider - but the suggestions
may not be compatible with what the participant
believes or what they are able to do
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Providers who form relationships with participants
need to converse about topics important to
participants, although this may be unrelated to the
services
Simpatía
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Participating in nontraditional activities
ie., Zumba, eating
Three Kings Bread
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No shows for
workshops or
events
Respeto (Respect) y Confianza (Trust)
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Latinos are high power-distance individuals in
that they value conformity and obedience and
support authoritarian attitudes
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These individuals include those with more
education and greater wealth, or greater
experience
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The cultural tendency to encourage respect for
authority and to discourage disagreement is
even more pronounced if a provider is
perceived as more powerful
Respect and Trust
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Instructors or other
professionals are
referred to as Doctora
or Maestra
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Can lead to fear of
authority, especially
institutes or
governmental-like
organizations
Machismo, or Gender Roles
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Traditionally, Latino men are more
dominant and are more likely to assume
financial responsibility for elderly
parents, and other family members
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Latino women are expected to be
submissive, passive, selfless and home
centered and are more likely to assume
caretaking roles for the extended family
Machismo
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Males are less likely
to ask for help
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Latino men may
avoid “learning”
activities if they
perceive it as
threatening their
control or dignity, or
indicates that they
have flaws or
weaknesses.
Presentismo, or Time Orientation
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Future oriented: planning, delayed gratification,
punctuality, efficiency
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Present oriented: less able to delay gratification, less
able to plan for the future, place less emphasis on
punctuality and efficiency
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Latinos are more likely to be present oriented, valuing
the quality of their interpersonal relationships rather
than the length of time of an interaction
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Latinos may be dissatisfied with the inflexibility and
rigidity of time devoted to issues based on efficiency;
providers may be frustrated with the inability to provide
a complete service because of less planning by the
participant
Time Orientation
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Being late as rude
vs handling
practical matters
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Have a time
cushion
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Take time to warm
up the group
Amistad or Social Warmth
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Latinos need less physical space when
interacting socially, and is a sign of being
demonstrative and responsive with the
person you are interacting
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Latinos may view providers of other
ethnic groups as impersonal or distant
when they need more space; while nonLatinos may view Latinos as emotional
or too personal in a professional setting
Social Warmth
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When teaching a
class, students
often socially
embrace the
instructor or offer
food
In Conclusion

Your agency cannot be “outside” the
community trying to get “in” and provide
services.
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Be a legitimate part of the community with
people and organizations being aware, taking
part in, and referring to your services.

Be integral to the community’s success
because they are integral to your success.
For More Information
 1-800-BRAILLE
(1-800-272-4553)
Monday - Friday, 8:30am - 5 pm
 access
our website
http://www.brailleinstitute.org
 Se
habla español