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Date of Award


Document Type

Thesis - Pacific Access Restricted

Degree Name

Master of Arts (M.A.)


Intercultural Relations

First Advisor

Kent Warren

First Committee Member

Janet M. Bennett

Second Committee Member

Anita Rowe


Public health nurses are required to communicate important communicable disease and preventative health information to an increasing number of immigrants and refugees accessing the American public health system. They must also obtain information on a broad scope of topics about clients and/or their children. Little attention has been paid to the study of intercultural communication between public health nurses and their diverse clientele. The purpose of this study was to identify barriers affecting communication between public health nurses and their immigrant and refugee clients. The Developmental Model of Intercultural Sensitivity developed by Milton Bennett provided a conceptual framework for review and analysis of study results. Data were collected using semi-structured formal interviews with a network sample of 17 nurses. Analysis of the data indicated four major themes: (1) common use of a Western- European, ethnocentric communication style; (2) insufficient recognition of how the dominant culture's values, beliefs, and behaviors affect those from non-dominant cultures; (3) inadequate or irrelevant prior diversity training; and ( 4) lack of available and competent interpreters necessary for translation of information during interviews. These categories capture the essential barriers preventing effective communication with culturally diverse clients.

From the perspective of the nurses, communication barriers due to cultural or language differences result in difficulty obtaining compliance with public health mandates such as childhood immunization and medication regimens, and limit understanding of preventative healthcare practices. The results of this study provide information and insight for the development of intercultural sensitivity training for public health nurses. A training program that demonstrates cultural training theory, methods, and suggested sequencing is included. An additional sample training outline follows that offers public health nurses culture specific information regarding Hmong refugees.



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