Institutional Level Strategies

There are several institutional strategies that can be used to increase health care and rehabilitation utilization among African Americans. Rehabilitation and medical professionals should be sensitized to cultural issues that impact African Americans' utilization of health and rehabilitation services. For example, as noted earlier, among African Americans, it is important to establish a sincere relationship and to be able to connect to the consumer at an interpersonal level. Accordingly, programs need to be developed to train individuals in these areas.

Another way to increase beliefs about one's ability to access and receive appropriate services is by having appropriate role models at the facility. Making sure that the staff is ethnically and culturally diverse is another way to show sensitivity to culturally diverse consumers. Programs aimed at training and recruiting African Americans in health, medical, and rehabilitation careers should be implemented at the high school and college levels.

A consumer advocate (an African American with a disability) would be a good staff member to have at a treatment facility. This individual could bridge the gap between the consumer and the institutional staff. The consumer advocate could inform the consumer of how to negotiate to get the services they need. This consumer advocate could also help the treatment staff become more sensitive to the needs of consumers.

Finally the facility must be accessible. Hours of operation should be flexible. Perhaps the facility could stay open late one evening a week. Child care may be necessary for parents who have to bring their children with them to appointments. Transportation needs should be considered a necessary aspect of medical services. When possible, services should be located within the community in which consumers reside. Friendly reminders of appointments may also be helpful and convey to the consumer that his or her attendance is important.

Rehabilitation professionals also need to be aware of and ready to address core problems that impact the consumer, such as lack of adequate housing, employment, and food. It is unlikely that one institution or agency could take care of all of these problems, so services must be coordinated to avoid duplication.

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