Cultural Broker

Who Is the Cultural Broker?

The characteristics, roles, and skills of cultural brokers are highly variable. Currently, the term cultural broker is used to denote a range of individuals from immigrant children who negotiate two or more cultures daily (Phillips & Crowell, 1994) to leaders in organizations who serve as catalysts for change (Heifetz & Laurie, 1997). The range and complexity of roles are equally varied. Cultural brokers may serve as intermediaries at the most basic level—bridging the cultural gap by communicating differences and similarities between cultures. They may also serve in more sophisticated roles—mediating and negotiating complex processes within organizations, government, communities, and between interest groups or countries.

One cultural broker may have extensive training and experience; another may have just been appointed to this role—for example, a parent in the community, or a support person in the organization—and wish to learn what is involved. In a broader sense, many staff working in health care settings or health education programs span the boundaries of the culture of health care and the cultures of the people they serve.

1. Cultural broker as a liaison
Cultural brokers are knowledgeable in two realms: (1) the health values, beliefs, and practices within their cultural group or community and (2) the health care system that they have learned to navigate effectively for themselves and their families. They serve as communicators and liaisons between the patients/consumers and the providers in the health care agency.
These personnel can play a critical and beneficial role—on a personal level, in the community in which they live, and on a professional level, in their respective agencies or practices. These personnel effectively bridge the two worlds. Similarly, NHSC scholars and clinicians in service, who come from diverse cultural backgrounds, also may be effective in assuming this role and function—particularly when housed in service areas where they have an understanding of the values, beliefs, and practices of the community.

2. Cultural broker as a cultural guide
Cultural brokers may serve as guides for health care settings that are in the process of incorporating culturally and linguistically competent principles, values, and practices. They not only understand the strengths and needs of the community, but also are cognizant of the structures and functions of the health care setting. These cultural brokers can assist in developing educational materials that will help patients/consumers to learn more about the health care setting and its functions. They also can provide guidance on implementing workforce diversity initiatives.
Some organizations that are well connected to the communities they serve use a community member as a cultural broker because of the member’s insight and experiences. A critical requisite for the cultural broker is having the respect and trust of the community. Using a community member as a cultural broker is acknowledgment that this expertise resides within the community. This approach also allows the health care setting to provide support for community development

3. Cultural broker as a mediator
Cultural brokers can help to ease the historical and inherent distrust that many racially, ethnically, and culturally diverse communities have toward health care organizations. Two elements are essential to the delivery of effective services: (1) the ability to establish and maintain trust and (2) the capacity to devote sufficient time to build a meaningful relationship between the provider and the patient/consumer. Cultural brokers employ these skills and promote increased use of health care services within their respective communities. For instance, cancer researchers have had to find ways to ease the concerns of the African American community about participating in clinical trials. For many African Americans, the Tuskegee study is a painful reminder of medical research gone wrong. In that study, conducted from 1932 to 1972, poor Black men were not fully informed about their participation in medical research on syphilis. They also were not given treatment for their disease, despite the eventual availability of drug treatment. Cultural brokers often can bridge this chasm of distrust that many cultural communities have toward researchers. Cultural brokers can be instrumental in reestablishing trust and reinforcing the importance of participating in research, particularly related to the elimination of racial and ethnic disparities in health.

4. Cultural broker as a catalyst for change
In many ways, cultural brokers are change agents because they can initiate the transformation of a health care setting by creating an inclusive and collaborative environment for providers and patients/consumers alike. They model and mentor behavioral change, which can break down bias, prejudice, and other institutional barriers that exist in health care settings. They work toward changing intergroup and interpersonal relationships, so that the organization can build capacity from within to adapt to the changing needs (Heifetz & &aurie, 1997) of the communities they serve.

Whatever their position or roles, cultural brokers must have the capacity to:

assess and understand their own cultural identities and value systems;
recognize the values that guide and mold attitudes and behaviors;
understand a community’s traditional health beliefs, values, and practices and changes that occur through acculturation;

understand and practice the tenets of effective cross-cultural communication, including the cultural nuances of both verbal and non-verbal communication; and
advocate for the patient, to ensure the delivery of effective health services.
Who can fulfill the role of cultural brokers in health care settings?
Almost anyone can fulfill the role of a cultural broker. Most cultural brokers assume multiple roles within health care and other settings and their respective communities. Although cultural brokers serve the same function, they come with different expectations and have divergent experiences, yet aim to create a cultural connection.

Cultural brokers may be any of the following:

outreach and lay health worker
peer mentor
community member (family member, patient)
administrative leader
nurse, physician, physical therapist,
or health care provider
social worker
interpreter
program manager
health educator
board member
program support personnel

Cultural brokers may work in these settings:

community health centers
community-based organizations
government offices
churches, mosque, kivas, plazas, temples, and other places of worship
schools
universities
hospitals
faith-based organizations
migrant communities

Whatever their position, cultural brokers aim to build an awareness and understanding of the cultural factors of the diverse communities they serve and of the ways in which such factors influence communities. Cultural brokers may not necessarily be members of a particular cultural group or community. However, they must have a history and experience with cultural groups for which they serve as broker including:

the trust and respect of the community;
knowledge of values, beliefs, and health practices of cultural groups; an understanding of traditional and indigenous wellness and healing networks
within diverse communities; and
experience navigating health care delivery and supportive systems within communities.

by ebased treatment org.