Accent on Taste: An Applied Approach to Multicultural Competency

Abstract

“Multicultural competency is not a luxury or a specialty, but a requirement for every registered dietitian,” according to the American Dietetic Association.1 Practitioners who primarily treat clients with type 2 diabetes are familiar with the challenges of intercultural counseling. The prevalence of type 2 diabetes among African Americans, Asians/Pacific Islanders, Latinos, and American Indians/Alaska Natives is disproportionately high; it is 1.5–2 times greater than in the white population of the United States, with even higher rates in some subgroups.2 Similar trends are seen internationally, with prevalence rates in Russia and Japan exceeding those in the United States. The countries with the highest number of people with type 2 diabetes are India (35.5 million) and China (23.8 million).3 Today, diabetes specialists most likely work with at least some clients with backgrounds different from their own. In the near future, even more client-practitioner relationships may be intercultural. Type 2 diabetes is increasing worldwide, as is the need for multicultural competency. We have identified three key proficiencies in multicultural competency. First, there is an attitude of acceptance. This includes respect for cultural differences, a tolerance for the ambiguities inherent in intercultural communication, and patience for the additional time and effort necessary for effective counseling. Second, there is culture-specific knowledge of clients' diets and traditional health beliefs and practices. This includes information on typical foods and meal patterns, special-occasion customs, food avoidances/additions necessary to well-being, common botanical remedies, and acculturation norms. Finally, intercultural counseling skills are necessary. These include verbal and nonverbal communication abilities and practical approaches to diet modification. Discussion of these three complex proficiencies is beyond the scope of a single article, and other resources addressing them are available.4 In this overview, we instead address hands-on practice, with the assumption that diabetes specialists are familiar with the three …