Outcomes: The Recruitment Enhancement Cultural Affirmation Project

Abstract

Abstract: The purpose of this Recruitment Enhancement Cultural Affirmation Project (RECAP) for culturally diverse students was to improve access to quality health care for culturally diverse populations in Oklahoma. Project objectives were: 1) increase the number of African American, Hispanic American Indian, Asian underrepresented (Vietnamese) and educationally disadvantaged white BSN graduates by 5% each project year, and 2) improve the health care of minority and underserved vulnerable populations by increasing the theoretical knowledge base about low-income vulnerable populations and improve cultural competency of BSN nursing students and faculty. The project findings indicate that objectives 1 and 2 were highly successful. In the prior year of the project initiation, 45 minority students graduated. At the completion of the second year of the project, 70 minority students graduated. All undergraduate BSN courses were evaluated for content and clinical practicum for cultural competency, poverty, and vulnerability. In areas of deficiencies, faculty made appropriate adjustments. Key Words: Recruitment, Retention, Minority, Nursing Students, Cultural Affirmation, Teaching Innovation BACKGROUND Over the past decade, there have been three emerging trends in the United States in general and Oklahoma in particular. First, the minority population in the state is increasing at higher rates than the white population. For example, the Hispanic population increased more than 1 08 percent. Oklahoma has the second largest population of Native American Indians in the United States (U.S. Census Bureau, 2008). In addition, African Americans and Asian Americans represent significant increases in Oklahoma's population growth (OSBH, 2002). This trend is also reflected at the national level. For example, according to the U.S. Census Bureau (2008), the aggregate ethnic racial minority population was approximately 102.5 million in 2007 and represented 34 percent of the total U.S. population. When demographic data are linked to health indicators, minorities are worse off in Oklahoma than they are in the nation as a whole. For example, African Americans in Oklahoma have higher rates of mortality for heart disease than the national rate for African Americans. Moreover, Asian Americans, African Americans, and Hispanics have a disproportionate burden for cancer deaths compared to these racial minority populations in the rest of the nation. With prevalence rates of 50 percent for women over the age of 40, diabetes is at epidemic proportions among American Indians and African Americans. A key component that affects health disparities is cultural competency (OSBH, 2002; IOM, 2002, Sullivan Commission, 2004). Being culturally competent potentially improves care and may aid in reducing the burden of health disparities. Implementing fundamental change requires that nurses and other health care professionals understand these disparities. According to the Institute of Medicine, cultural competency is directly linked to the goal of reducing health disparities (Smedley, Butler & Bristow 2004). A second trend in Oklahoma is an increasing rate of poverty among its people. Oklahoma is ranked 8th in the nation in childhood poverty. Approximately 20.3% of Oklahoma's children live in poverty (OSBH, 2003). Oklahoma's per capita income lags behind the rest of the nation. An additional burden is the high rate of uninsured families with children. This factor makes access to care a significant problem for low-income populations and contributes to disparities in health for this population. Providing health care to Oklahoma's low-income and minority populations is hampered by both a significant nursing shortage that has had a substantial impact on the ability of health service agencies to care for Oklahoma's low-income underserved populations. The third trend is the under representation of minorities in professional nursing and nursing education programs. …