Abstract
This pilot case study describes foreign-trained former Montagnard refugee physicians’ practice experiences in Vietnam and their current community health worker and “ally” roles within the Montagnard refugee community. It highlights key features that facilitate cross-culturally responsive health care. We interviewed five Vietnam-trained former Montagnard refugee physicians using an open-ended interview format during March, 2012. We used content analysis procedures to identify key themes characterizing Montagnard physicians’ former and current practice experiences and emphasizing the roles they currently play in their new homeland. Montagnard physicians were fighting infectious diseases in homeland Vietnamese communities. Since coming to the U.S., Montagnard physicians have reoriented their competencies to fit within a community health workers model, and have shifted practice to fighting chronic disease in this refugee community. Tasks now include describing and contextualizing unique characteristics of the Montagnard languages and cultures to outside constituents. They become cross-cultural allies to the U.S. health care and facilitate individuals’ medical adherence with mainstream physicians’ orders. They ensure accuracy of interpretation of Montagnard patients’ medical complaints during a medical visit. Our findings reveal the potential roles that can be ascribed to a cross-cultural ally and can be built into practice to fulfill the Montagnard community’s unmet health needs: oral historian, mediator, facilitator/negotiator, quality assurer, psychosocial confidant, and health advocate.
Highlights
Use of the Community Health Workers (CHWs) model to improve community health has existed for more than a half century (World Health Organization, 2007)
Montagnard refugees who are Foreign-Trained Medical Graduates from Vietnam have had to redirect their experiences and skills to address unmet health needs in the U.S based Montagnard community
They function as community health workers who manage medical adherence issues and cross-cultural allies who contextualize the cross-cultural differences among the tribal groups
Summary
Use of the Community Health Workers (CHWs) model to improve community health has existed for more than a half century (World Health Organization, 2007). This model involves the dynamic use of paraprofessionals to “assist individuals and communities to adopt healthy behaviors” through community outreach and implementation of health interventions (U.S Department of Labor, 2012). CHWs have been instrumental in bringing about favorable changes in participants’ life styles and physiological measures, and reduced utilization of unnecessary diabetic health care among diabetes patients (Brownstein et al, 2007). CHWs played significantly positive roles in the improvement of medical compliance (e.g., helping clients follow through with medical appointments and adhere to medications) and reduced medical expenditures among hypertension patients (2007)
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