Best Practice Guide For Providers

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• Language Justice

• How to create & maintain connection with people with or at risk of HIV

Shekinah Rose (She/Her/Hers)�Positive Women’s Network USA�2023-2024 Policy Fellow – Policy Practicum�email: shekinahrose99@gmail.com

Learning Objective

• The Platinum Rule

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• Many learn as children that the best way to respect others is to follow the Golden Rule: “Treat others as you wish to be treated.” Many advocates in the HIV community promote the Platinum Rule: “Treat others as they wish to be treated.”

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• This guide aims to help providers, scientists and administrators use fair, accurate and respectful language, but preferences can change and vary across groups and individuals. They can also evolve overtime.

• When providers, scientists and administrators write or speak about HIV, the words they choose have the power to passively perpetuate ignorance and bias. Conversely, they have the power to respectfully and accurately represent people and ideas.

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• The NIAID Language Guide was designed to help those at NIAID communicate about their work using empowering rather than stigmatizing language, especially as it relates to HIV. Since a group of people with AIDS wrote the self empowerment manifesto known as The Denver Principles in 1983, language has been a central theme in efforts to dismantle stigma around HIV.

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• Many HIV advocacy groups and media outlets embrace slogans such as “language matters” and promote primers on using empowering language, as do other organizations that advocate for other health conditions and marginalized groups. Conversations about language choice frequently come up during demonstrations, conferences and listening sessions.

• Empowering language remains an important focus for such organizations because language perpetuates stigma, and as studies continue to bear out, stigma helps perpetuate the HIV epidemic.

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• While many factors that contribute to health-related and societal stigmas are entrenched and systemic, NIAID officials have the immediate power and opportunity to improve language and lead by example.

Nothing about us, without us

Three Keys to Inclusive Health Content: Plain Language, Transcreation and Cultural Nuances

Overcoming language and Cultural Barriers in Healthcare Communication

• Utilizing technology to overcome language barriers

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• The consequences of poor communication

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• Encouraging a culture of openness

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• The role of technology in enhancing communication

How to Build Trust with Cultural Competency

• Promote Cultural Training Sessions
• Use Plain Language and Respectful Body Language
• Offer Comprehensive Language Services

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Language Services = Quality Patient Care

• Inclusive language puts our humanity at the center; it allows everyone to feel recognized, valued, invited and motivated to contribute at their highest level.

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• To become an anti-racist institution, take concrete action to change your culture and the experiences of healthcare members and stakeholders.

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• If our words but not our deeds change, we have failed.

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• Yet learning about and using respectful, identity-affirming language is key to creating a welcoming environment that is antiracist and embraces diversity as a whole.

• Inclusive language promotes diversity, inclusion, equity, and equality.

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• Diversity includes all the ways in which people differ, encompassing the variety of skills, abilities, experiences, and cultural backgrounds. Inclusion goes one step further by creating an environment where individuals or groups can be and feel welcomed, respected, supported, and valued.

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• Equality is giving individual or groups the same resources or opportunities.

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• Equity recognizes that individuals or groups have different circumstances, starting points, and opportunities, and therefore, provides necessary resources to reach an equal outcome.

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• Unlike biased language, inclusive language acknowledges diversity; conveys respect to all people; is sensitive to differences; promotes equal opportunities; and is free from stereotypes, subtle discrimination, and negative messages.

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• The benefits of inclusive language include allowing people to be their authentic selves; promoting effective communication; fostering a common understanding; and getting us closer to inclusion and equity.

Best Practices and General Guidelines for Using Inclusive Language for Race and Ethnicity

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• Using inclusive language is important, particularly to people who have historically been excluded and marginalized.

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• It is not the same thing as political correctness.

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• Whereas political correctness focuses on not offending, inclusive language focuses on flexibility and connectedness while also honoring people’s identities.

• General guidelines for using inclusive language for race and ethnicity are included below.

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• •Focus on the person, not their characteristics (person first language)

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• • Do not hyphenate nation origins (ex: African American not African-American); use of the hyphen was used in the late 19th to early 20th centuries to ridicule those who were not born in America

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• • Do not use adjectives as nouns (ex: Asian people not Asians or the Asians)

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• • Be sensitive to self-identification

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• • When in doubt, ASK

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• • Use universal phrases instead of idioms, industry jargon, and acronyms

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• • Ask yourself if race/ethnicity descriptor is necessary

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• • Be specific; do not hide behind vague words or generalizations

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• • Focus on strengths rather than deficits (ex: amplify voices rather than give voices)

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• • Be thoughtful about the imagery you use (ex: lazy, dirty, primitive, etc.)

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Some Principles

• Identity is personal
• Respect
• Ask
• Be Specific
• Be thoughtful and intentional

Be kind and affirming

• People-first language
• Avoid labels
• Use asset-not-deficit-based language
• Intellectual humility
• Gender neutral language
• Capitalization
• Black, Indigenous, brown, white

Best practices

Respectful Language�Ability, physical, mental and chronological attributes��Following is a glossary promoting language around ability and physical, mental and chronological attributes.

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• Ableism
• Able-bodied
• Ageism
• Autism spectrum disorder
• Body weight
• Deaf person
• Hard of hearing
• Sanism (mentalism)
• Substance use disorder

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• Neurodiverse
• Neurotypical
• Obvious disability
• Hidden/invisible disability
• Person with a disability/people with disabilities

Best practices�

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• If you’re unsure what name or pronoun someone uses, politely ask. It’s usually OK to ask: “What pronouns do you use?” Remember, it’s not what pronouns they “prefer.”
• Do your best to use someone’s name and pronouns consistently, even if you knew the person by another name.
• Acknowledge any language mistakes you make and how it may make the person feel.
• Talking about a transgender person’s previous identity is called deadnaming. It’s disrespectful. If you don’t know how to refer to someone in the past, ask. If the person doesn’t want to discuss it, respect that.

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Presenting complaint: Use of language that disempowers patients

What’s in a word?

• Because changing language can act as a catalyst for changing the way doctors think or approach patient care, reflecting on and updating the words we use might be considered part of a broader movement to support and promote a collaborative doctor-patient relationship.³²

Key Messages

7 Ways to Build Rapport with Patients

Shekinah Rose

• Positive Women’s Network USA
• 2023-2024 Policy Fellow - Best Practice Guide for Providers – Language Justice
• shekinahrose99@gmail.com

References:

• https://www.nih.gov/nih-style-guide/person-first-destigmatizing-language
• https://www.niaid.nih.gov/sites/default/files/NIAID%20HIV%20Language%20Guide%20071520%20revised_%20updated.pdf
• https://careful.online/overcoming-language-and-cultural-barriers-in-healthcare-communication/
• https://careful.online/the-impact-of-communication-on-patient-safety/
• https://review.content-science.com/three-keys-to-inclusive-health-content-plain-language-transcreation-and-cultural-nuances/

References:

• https://www.shpep.org/newsletter/diverse-languages-in-the-health-professions/
• https://www.helloglobo.com/blog/how-to-build-trust-with-patients-from-diverse-cultural-backgrounds
• https://www.ohsu.edu/inclusive-language-guide
• https://ncbi.nlm.nih.gov/pmc/articles/PMC9273034/
• https://journals.sagepub.com/doi/10.1177/10946705231190018
• https://www.amnhealthcare.com/blog/nursing/travel/how-to-build-rapport-with-patients/
• https://ohr.dc.gov/sites/default/files/dc/sites/ohr/page_content/attachments/OHR_ILG_RaceEthnicity_FINAL%20%281%29.pdf

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References:

32. Lala A, Mentz RJ. Language matters: understanding barriers to medication adherence to better tailor heart failure care. J Card Fail 2021;27:825. 10.1016/j.cardfail.2021.07.001 [PubMed] [CrossRef] [Google Scholar] [Ref list]