Considering Cultural Differences and Social Determinants of Health in Feeding Therapy

Abstract: This session will discuss the impact cultural differences and social determinants of health have on access to care, therapy outcomes, and mealtimes in the home. This interactive presentation will utilize case studies to help therapists will feel confident in developing a plan for feeding intervention with cultural sensitivity that supports the needs of the child and family.

Description: Several factors must be taken into consideration when planning feeding therapy intervention. Cultural considerations and social determinants of health can greatly impact the mealtime dynamics in a home. It is vital therapists are aware of how mealtimes in other homes may differ from their own.

Our presentation will begin by discussing cultural differences in mealtime. The latest census bureau estimates suggest about 40% of Americans identify as racial or ethnic minorities (U.S. Census Bureau 2017) and according to ASHA’s membership demographics from 2018, 8.2% of ASHA members are from a racial minority. As speech language pathologists in the United States, it is likely that participants will treat patients with different cultural backgrounds than their own. Multicultural issues affecting service delivery of speech pathology services have been researched extensively regarding speech and language treatment, however it is also important to realize how a family’s cultural background affects almost every aspect of feeding and dysphagia therapy. Culture is the framework in which one processes and views the world around them. Culture can influence perspectives on healthcare, what and how information is shared with health care providers, how recommendations are interpreted, and the likelihood of carryover of skills into the home environment. The purpose of this presentation is not to educate about typical behaviors and beliefs of specific culture groups, but rather to provide insight into what could be potential cultural barriers when assessing and treating patients by utilizing data and specific examples collected from numerous different research articles and studies. After attending the session, participants will have the tools and ideas on how to approach feeding therapy with cultural humility and become a more culturally competent clinician.

A second part of our presentation will discuss social determinants of health. Social determinants of health (SDOH) are the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks (health.gov, 2023). These factors can have significant impact on a child’s growth, nutrition, development, and well-being (Goday, 2019). It is crucial feeding therapists understand the impact these factors play when planning for intervention and home programming. Considering strategies such as suggesting generic brands, helping families meal plan with economical food, and using nonperishable foods can help a family and child meet goals and progress in therapy.

Our presentation will include interactive elements and will conclude with a case study example to help support learning.

Supporting Research: Reference 1: Houston, Waldrop, & Mccarthy. (2011). Evidence to Guide Feeding Practices for Latino Children. The Journal for Nurse Practitioners, 7(4), 271-276.

Supporting Research: Reference 2: Jessri, M., Farmer, A., & Olson, K. (2015). A focused ethnographic assessment of Middle Eastern mothers’ infant feeding practices in Canada. Maternal & Child Nutrition, 11, 673-686.

Supporting Research: Reference 3: Dikeman, K. J., Riquelme, L. F. (2002). Food for thought: Ethnocultural concerns in dysphagia management. Perspectives on Swallowing and Swallowing Disorders (Dysphagia), 11(3), 31-35.

Supporting Research: Reference 4: Davis-McFarland, E. (2008). Family and Cultural Issues in a School Swallowing and Feeding Program. Language, Speech, and Hearing Services in Schools, 39(2), 199-213.

Supporting Research: Reference 5: Pak-Gorstein, S., Haq, A., Graham, E. (2009). Cultural Influences on Infant Feeding Practices. Pediatrics in Review, 30, e11-e21.