As the population becomes more racially and ethnically diverse, health care providers will continue to care for more patients from different cultures and backgrounds. One of the biggest challenges will be communication across cultures. CDI has developed several cross-cultural initiatives including courses, medical grand rounds and a film series. CDI is also partnering with several MGH departments in education and training initiatives centered toward improving the work environment for physicians and nurses, and the quality of patient care

Cross-cultural education

Joseph Betancourt, MD, MPH, CDI's program director for cross-cultural education, has worked with a team* to develop online courses that help health care providers and staff interact with patients from different cultures. These “Quality Interactions” courses are designed to quickly teach clinicians how to:

  • identify cross-cultural issues
  • conduct a culturally-competent history and medical exam
  • work with Interpreters Service staff
  • identify the impact of cultural issues on medical decision making
  • explain a patient’s diagnosis and management options
  • negotiate a treatment plan that improves patient cooperation

There are two versions of the clinician course --- one tailored specifically for physicians, the other for nurses and case managers. Department of Medicine residents are required to complete the physician course during their ambulatory care training unit.

There is also a health care staff version of the “Quality Interactions” course, which is appropriate for administrators, billing staff, lab technicians and others who interact with patients in a nonclinical setting. This course is designed to teach health care staff how to:

  • respect and value cultural diversity
  • communicate clearly in cross-cultural interactions
  • understand and explore cultural differences


* Joseph R. Betancourt, MD, MPH, Director, The Disparities Solutions Center; Alexander R. Green, MD, MPH Senior Faculty, The Disparities Solutions Center; and J. Emilio Carrillo, MD, MPH, Vice President of Community Health Programs at New York Presbyterian Hospital



Cross-Cultural Film Series

Film Series

The goal of the Cross-Cultural Film Series, co-sponsored by the Center for Diversity and Inclusion, the Schwartz Center and the Disparities Solutions Center, is to use film –  popular and documentary – to present themes related to cross-cultural health care and racial/ethnic disparities to a broad audience of health care professionals. The series also includes discussions with experts and in some cases, the filmmakers.
DSC/CDI Film Series:

From the Rural to the Nation: The Origin of the Community Health Center Model and the Roots of Cross-Cultural Care

On Wednesday, April 7th at Harvard Medical School, the Disparities Solutions Center (DSC) and the MGH Multicultural Affairs Office co-hosted a film series that focused on the role of community health centers in providing care to diverse and underserved populations. We featured the documentary Out in the Rural: A Health Center in Mississippi (1969) about the Delta Health Center in Bolivar County, Mississippi. This film focuses on the use of health services to address the social determinants of health and developing community empowerment, while combining primary care with public health interventions. The keynote speaker was Jack Geiger, MD, M.Sci.Hyg, Arthur C. Logan Professor of Community Medicine Emeritus at the City University of New York Medical School. Dr. Geiger initiated the community health center model in the USA, founding and directing the nation's first two community health centers in the Mississippi Delta and in Columbia Point Boston. These centers became models for what is now a national network of more than 1000 community health centers serving some 17 million low-income and minority patients. In Massachusetts, 52 community health centers provide high quality health care to more than 760,000 state residents through 285 sites statewide.

Environment, Education and Empowerment: Improving Nutrition and Addressing Obesity in Vulnerable Communities

On Wednesday, December 16th, 2009, the Disparities Solutions Center, the MGH Multicultural Affairs Office and the Schwartz Center co-hosted a film series on the growing obesity rates among children, in particular among African American and Latino children. We featured the documentary Nourishing the Kids of Katrina: the Edible School Yard which follows renowned chef Alice Waters' Berkeley "Edible Schoolyard" program as it contributes to the rebirth of the New Orleans uptown Green Charter School after its devastation from Hurricane Katrina. Speakers included, Robert Lee Grant, film maker and director, Sylvia R. Chiang-Raposo, MD, MPH, Manager of the Food and Fitness Initiative at MGH’s Revere CARES, and Kathy Cunningham, M.Ed, RD, LDN, Senior Program Manager/ Dietitian for the Chronic Disease Prevention and Control Unit at the Boston Public Health Commission.


"Stanley" part of the three-part Caring at the End of Life series

The fifth event in this series was held on October 28, 2009 in the O'Keeffe Auditorium. The film presents a comatose patient whose family and healthcare team are in conflict over how long to continue with the treatments that are keeping him alive. They confront difficult ethical questions about patient autonomy versus the needs of the family, about who is in a position to judge what another person would want, about the role and impact of religious faith. Following the film, there was an interactive discussion led by experts in the field. The goal of this program is to improve health care providers' ability to understand and communicate with diverse patient populations, and be more skilled in cross-cultural communication as it pertains to end of life.

Return to the Killing Fields: Cross Cultural Care and the Cambodian Experience

The fourth event in this series was held on April 14, 2009, in the Amphitheater at the Joseph B. Martin Conference at Harvard Medical School.  Selections from two documentaries were shown: “Return to the Killing Fields”, which provides an overview and history of the Khmer Rouge regime, and the award-winning “S21: The Khmer Rouge Killing Machine”, which documents the reunion of 2 survivors of the Khmer Rouge’s Tuol Sleng Prison and the former prison guards when they return to the site. Dr. Richard Miller, Medical Director of Khmer Health Advocates, and Chhan Touch, Family Nurse Practitioner at Metta Health Center in Lowell, MA commented on the subject.


"Becoming American” part of UNNATURAL CAUSES: Is Inequality Making us Sick?
The 3rd DSC/MAO Film series: Becoming American was held on October 7th in celebration of Latino Heritage. The featured film “Becoming American” part of the PBS documentary series Unnatural Causes: Is Inequality Making us Sick? highlighted the positive aspects of health and culture that newly arriving Latino immigrants bring to the US. Drs. Byron Garcia and Enrique Caballero commented on the issues depicted in the film.

La Ciudad (the City)
"La Ciudad" held on May 5th, 2008. This film was followed by a panel discussion and a question and answer period with director David Riker and Drs. Jim O’Connell and Elizabeth Barnett.

Miss Evers’ Boys
"Miss Evers' Boys" held on January 17th, 2008. This film is based on the true story of the US Government's 1932 Tuskegee Syphilis Experiments. Dr. Valerie Stone, Director of the Women's HIV/AIDS Program and the Primary Care Residency Program at MGH and Dr. Michael Byrd, medical historian from the Harvard School of Public Health and a physician at Beth Israel Deaconess Medical Center commented on the historical context of this study, and how it fits in with African-American health care in the US.

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