Please respond to each discussion post with at least 150 words.
You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.)
All replies must be constructive and use literature where possible.
Please post your initial response by 11:59 PM ET Thursday, and comment on the posts of two classmates by 11:59 PM ET Sunday.
You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date.
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Discussion 1
According to Harder 2021, the Amish are the fastest-growing subgroup in the United States and are increasingly coming into contact with child welfare and other professional systems. As of 2020, there were over 340,000 Amish in the United States, 5,995 in Canada, and 210 in South America. Th e Amish are growing faster than almost any other subculture, religious or non-religious, in North America (Donnermeyer et al., 2013, p. 74). Due to large family sizes and at least 85% of its members remaining in the faith, the Amish population doubles about every 20 years. Amish now live in at least 31 states, four Canadian provinces, and two countries in South America (Amish Population Project, 2020). They are a close people and will actively resist any efforts by outside entities to sway them from their chosen way of life. In particular, a total of 17,020 Amish individuals resided in the Geauga Settlement in 2015 (Miller-Fellows et al., 2018)
If there is need to interview a child or parent, a church leader should be present as well to provide a necessary conduit to the family, including language translation and follow-up. (Harder, 2021) This will be very helpful in the case of Mary and Elmer because it will help them open up. It is also good to note that the Amish religion does not restrict people from seeking modern medical care, for the most part as it relates to the use of local doctors, dentists and hospitals They pay for most of their medical procedures out-of-pocket and in cash, so when talking to them it will be a bright idea to have this at the back of one’s mind. Prenatal care is provided to this population by the midwives either at their offices, located at the center or in the homes of the patients. This will be where my meetings with Mary and Elmer will be taking place.
When preparing to do prenatal education classes with Amish patients such as Mary and Elmer, the three main beliefs and/or practices that come to my mind for the purpose of this discussion are:
Faith -based social structure
Amish religious beliefs
The value of children in the Amish Culture.
Faith-based Social Structure:
A research carried out by Kraybill (1989), revealed that a culturally congruent education group can potentially improve prenatal care utilization when embedded within a population’s faith-based social structure. This same platform can also be utilized to carry out classes or teaching sessions with Mary and Elmer. A better feel of the population is enhanced when the educator is embedded in the Amish population. According to Katz et al., 2013 twelve percent of Amish participants read at or lower than a 6th grade level compared to 2.6 % of non-Amish participants, and many Amish participants have limited or marginal health literacy. Preparing teaching material has to be with tact and using one of theirs will be very helpful.
For example, on the topic of nutrition I could have an educated and open-minded Amish woman discuss the role of nutrition, the importance of a healthy diet even prior to pregnancy, and the benefits of vitamins, minerals, calcium and folic acid for fetal development. She could prepare smoothies with spinach and other fruits and vegetables and make “sushi” with brown and white rice and other healthy condiments. She can then discuss the importance of appropriate weight gain during pregnancy and the recommended weight gain of 25-35 pounds. She could also teach with my guidance the alternatives to high caloric food and condiments which have high sodium content, e.g., soy sauce, used frequently by the Amish people.
Amish Religious Beliefs:
The Amish religion forbids the use of technological advances. They do not use electricity nor drive motor vehicles. They do not have telephones in their houses but may have one in the barn or dairy for business purposes; if possible, they try to have a non-Amish person do the calling for them. They have managed to stay insulated, not isolated, and to maintain what is meaningful to them (Kraybill, 1989). The avoidance of modern-day electrical devices including communication devices such as the television, radio, and computers has only made it more difficult to teach this population. Their chosen lifestyle may have implications for health literacy as well as poorer health behaviors and outcomes. Hence for Mary and Elmer I will have to make sure that they have someone who has a cellphone to make a call for them (in case of emergency) to be in conformity with their religious believe.
The Value of Children in the Amish Culture
The Amish place a high value on children as gifts from God and foster a close bond with their children; however, they are not likely to evidence this through displays of affection or emotion toward their children in the presence of non-Amish as would other cultures (Kraybill et al., 2018). Consequently, if Mary and Elmer do not show as much interest as expected from a non-Amish couple, it does not mean that they are not interested. It is paramount that child welfare professionals at all levels come to understand these values in order to deliver culturally competent services to this unique population. (Harder, 2021). Child welfare and other professionals will be more effective in outreach to these communities by embracing a stance of curiosity about their faith, values, and way of life. Rather than being afraid to offend, the healthcare provider should be nonjudgmental and open in asking the Amish questions and listening to their answers (Kraybill et al., 2018). It is with these church leaders that child welfare workers should take the time to build relationships. When needing to interview a child or parent, a church leader can provide a necessary conduit to the family, including language translation and follow-up. (Harder, 2021). This is how you can penetrate them to get an inside of their culture and tailor any form of health education specific for this population. In other words, implementing a culturally congruent care approach for Mary and Elmer.
Conclusion
Health behavior is intrinsic and culturally based, making it difficult to change health practices that lead to negative outcomes. Having the notion that one can penetrate and change the beliefs of this population will be a simple fantasy It is therefore crucial to implement culturally congruent healthcare strategies not only for individuals and families, but also for population-based health initiatives. Doing so will preserve the cultural identity of the Amish population while respecting their cultural beliefs.
References:
Amish Population Project. (2020). Young Center for Anabaptist and Pietist Studies, Elizabethtown College. http://groups.etown.edu/amishstudies/statistics/ amish-population-profi le-2020/
Donnermeyer, J. F., Anderson, C., & Cooksey, E. (2013). Th e Amish population: County estimates and settlement patterns. Journal of Amish and Plain Anabaptist Studies, 1, 72–109. https://doi.org/10.18061/1811/54896
Harder, J. (2021). Understanding and Partnering with Amish Communities to Keep Children Safe. Child Welfare, 99(1), 69–91.
Katz, M., Ferketich, A., Paskett, E., & Bloomfield, C. (2013). Health Literacy Among the Amish: Measuring a Complex Concept Among a Unique Population. Journal of Community Health, 38(4), 753–758. https://doi.org/10.1007/s10900-013-9675-z
Kraybill, D.B. (1989). The riddle of Amish culture. Baltimore: The Johns Hopkins University Press
Miller-Fellows, S. C., Adams, J., Korbin, J. E., & Greksa, L. P. (2018). Creating Culturally Competent and Responsive Mental Health Services: A Case Study Among the Amish Population of Geauga County, Ohio. Journal of Behavioral Health Services & Research, 45(4), 627–639. https://doi.org/10.1007/s11414-018-9612-0
Discussion 2
The Amish
As healthcare providers, our responsibilities are to provide the best, highest quality care to every patient we encounter. To do so, we must have cultural competence; culture-informed medical practice is vital to providing patients of varied backgrounds the care with the best outcomes and patient satisfaction. The Amish have unique characteristics that make healthcare services delivery challenging (Rohr et al., 2019). Seeking help from healthcare providers requires them to go outside their people. To help Mary with prenatal care, I would include education on the use of CAM therapy, promoting midwifery services, and home deliveries. When preparing to do prenatal education classes with Amish patients, show respect for Amish healthcare practices, refrain from using technology such as videos, encourage family involvement in perinatal care (Purnell, 2013).
The Amish consider that children are a gift from God. Many do not own or operate automobiles; education among the Amish is distinct. Formal, classroom-based education lasts until the eighth grade. The class focuses on aspects of religion and agriculture, with minimal concepts of public-school health class. Health literacy is much lower, and Amish health attitudes are characterized by a mistrust of vaccination and lack of medical insurance. The Amish community’s origin is relevant to health care discussion because individual settlements have vastly different governing rules (called Ordnung) about what behaviors and technology in daily life are allowable (Rohr et al., 2019). In general, The Amish tend not to access preventive services when they are experiencing good health. When they do, inconsistent use of types of preventive healthcare services such as immunizations, cardiovascular health screenings, and prenatal/perinatal health education programs. Most health services that they seek are for occupational injuries associated with farm labor, such as traumatic loss of limb, burns, and muscle and joint strains. When they do, studies suggest that the Amish prefer providers who exhibit personal concern, are respectful of their cultural value of isolation, offer to make home visits, try to prevent hospitalization when possible, and include the use of CAM in treatment discussions (Farrar, Kulig & Sullivan-Wilson, 2018).
When working with the Amish, healthcare providers should recognize that every interaction represents an opportunity to gain or lose trust through subsequent word-of-mouth conversations about the interaction, assessment of acknowledgment of the community hierarchy, and working alongside the community bishop. A nonjudgmental attitude regarding the use of CAM and a recognition that the Amish value humility, simple living, and obedience to God’s will facilitate trust. Healthcare providers are advised to appreciate the Amish value of caring for older adults in a home environment free of advanced technology. Paying for health care and ensuring the financial security are concerns within Amish society. Amish prepare for their financial security by accumulating savings and contributing to an Amish system of health insurance called the Mutual Health Aid program (Farrar, Kulig & Sullivan-Wilson, 2018).
References
Farrar, H. M., Kulig, J. C., & Sullivan-Wilson, J. (2018). Older Adult Caregiving in the Amish: A N Integrative Review. Journal of Cultural Diversity, 25(2), 54–65.
Purnell, L. (2013). Transcultural health care: A Culturally Competent Approach (4 Ed) Philadelphia: F.A. Davis.
Rohr, J. M., Spears, K. L., Geske, J., Khandalavala, B., & Lacey, M. J. (2019). Utilization of Health Care Resources by the Amish of a Rural County in Nebraska. Journal of Community Health, 44(6), 1090–1097.
Grading Rubric
Your assignment will be graded according to the grading rubric.
Discussion Rubric
Criteria Ratings Points
Identification of Main Issues, Problems, and Concepts
Distinguished – 5 points
Identify and demonstrate a sophisticated understanding of the issues, problems, and concepts.
Excellent – 4 points
Identifies and demonstrate an accomplished understanding of most of issues, problems, and concepts.
Fair – 2 points
Identifies and demonstrate an acceptable understanding of most of issues, problems, and concepts.
Poor – 1 point
Identifies and demonstrate an unacceptable understanding of most of issues, problems, and concepts.
5 points
Use of Citations, Writing Mechanics and APA Formatting Guidelines
Distinguished – 3 points
Effectively uses the literature and other resources to inform their work. Exceptional use of citations and extended referencing. High level of APA precision and free of grammar and spelling errors.
Excellent – 2 points
Effectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. Moderate level of APA precision and free of grammar and spelling errors.
Fair – 1 point
Ineffectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. APA style and writing mechanics need more precision and attention to detail.
Poor – 0 points
Ineffectively uses the literature and other resources to inform their work. An unacceptable use of citations and extended referencing. APA style and writing mechanics need serious attention.
3 points
Response to Posts of Peers
Distinguished – 2 points
Student constructively responded to two other posts and either extended, expanded or provided a rebuttal to each.
Fair – 1 point
Student constructively responded to one other post and either extended, expanded or provided a rebuttal.
Poor – 0 points
Student provided no response to a peer’s post.
2 points
Total Points 10
Last Completed Projects
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