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Universal Understanding
This primer will help you address cultural competency and fitting specifics to grow your practice base
By Karlen McLean

The African American market has a great need for optical care. Shown: Essence style ES249 from Lantis

Many people in the retail marketplace today have lots to learn when it comes to cultural competency.

For optical, Derrick L. Artis, OD, MBA, defines cultural competency as "acquiring knowledge of, and sensitivity toward, a patient's culture and applying this information to your practice to provide the best health care possible."

Artis is the director of professional affairs at Vistakon, a division of Johnson & Johnson Vision Care, Inc. He has addressed cultural competency issues within Vistakon and the optical community and was a key source for the following guide to multicultural success.

AFRICAN AMERICANS

■Demographics: This group experiences higher rates of glaucoma, diabetic eye disease, and hypertensive retinopathy than the general population, and 59 percent report annual eye exams versus 48 percent of the majority.

■Interaction: When meeting for the first time, use formal addresses—Mr., Mrs., or professional title and last name. Then let them take the lead in how they'd like to be addressed.

Top to bottom: Carolina Herrera style H304 by Base Curve; Prada style VPR 09H from Luxottica; Thalia style Federica from Kenmark; Gucci style GG 2730 from Sàfilo; Missoni style MI04103 from Allison

■Staffing: Hire staff members who reflect the ethnicity of the community. Involve staff with the community by conducting visual screenings and community outreach projects.

■Practice Tips: Research shows that some African Americans look to eyecare sources for exams required for a driver's license or employment and may bypass traditional medical doctors. ECPs may be the first to diagnose systemic diseases. African Americans prefer specific instructions and recommendations from doctors. Lastly, it's essential to build a reputation of respect to gain trust to work effectively with this group.

ASIAN AMERICANS

■Demographics: The second-fastest growing minority group in the U.S., Asian Americans exhibit a high rate of myopia and 7.3 million people in this group require some type of vision correction. While understanding key subcultures, such as Japanese, Chinese, or Korean, in your community is recommended, there are some common attitudes and customs.

■Interaction: Some Asian Americans have longer periods of silence during conversations. Pause during discussions to give patients time to talk and ask patients to repeat instructions. A smile and nod can express a variety of reactions including happiness, embarrassment, or discomfort. Also, touching may be considered offensive. A verbal greeting is the best approach. Patients expect to leave the exam room with written product recommendations and a prescription.

■Staff: Hire staff members proficient in the Asian subcultures in your area or hire a translator.

■Practice tips: In Asia, eyewear is typically purchased from a merchant who refracts and prescribes eyewear without an eye health examination. Explaining your practice capabilities, qualifications, and services is key to building this patient base.

In traditional Asian eyecare they under-correct, so some patients may have less than a full Rx.

LATIN AMERICANS

■Demographics: Latin Americans are the largest minority group in the U.S. In 2004, over 14 percent of the U.S. population was Latin American. Half of this population is under age 27, and one in every five Americans under 18 is Latin American.

■Interaction: Set up flexible payment plans and offer incentives for full payment for these patients, who often prefer to pay by cash. Welcome walk-ins and let them know you will see them, but they may have to wait. Family members and friends may accompany the patient, so have a reception area with sufficient seating

■Staff: Hire bilingual staff members and learn some Spanish, particularly optical terminology.

■Practice tips: Be aware that Latin Americans have a higher rate of ptyerigium and exhibit a high incidence of hypertension and diabetes.

Feature Spanish language periodicals, P.O.P., and patient forms. Advertise in Spanish language newspapers and magazines, and on strategically placed posters and billboards.

Baby Phat style MOD 215 by MODO

Entertain and educate those waiting with bilingual reading materials and videos on the importance of eyecare and eyewear, and the fashion statement that eyewear and CLs can make.

Latin Americans are highly tuned into style. It's important to have up-to-date office décor and up-to-the-minute technology. Be well stocked with current products aimed at improving appearance, such as high-fashion frames and lenses, hip sunwear, and cosmetic/ color contact lenses, since color CLs are more popular with Latin Americans than any other group.

Cultural competency is based on ongoing respect and trust. By avoiding stereotypes, making your practice more attractive based on client culture, maintaining an involvement with your community, and finding creative ways to communicate with diverse population groups, you can grow your success.

Fitting Focus: HISPANIC

■Facial Factors: High cheekbones and dark eyebrows.

■Frame options: Select frames that follow the brow line to avoid the appearance of a double brow.

Top to bottom: Daniel Swarovski style S143 by Silhouette; Toki style TK-5504; Shiseido style SH-5013 from Aoyama; Konishi style C212 by Clariti Eyewear; Stark Eyes style P0522

■Color palette: Cool skin tones and hair color are typical among Hispanics. Opt for pinks, blues, taupes, reds, and gold.

Fitting Focus: AFRICAN AMERICAN

Some typical fitting characteristics for this market are:

■Facial Factors: Flat bridges and high cheekbones. Deep faces are also common.

■ Frame options: Adjustable nosepads provide the best fit, while saddle and keyhole styles may slide down flat bridges and rest on the end of the nose or cheekbone. Longer temples may be important for proper fit.

■Color palette: The majority of African Americans have cool-based skin tones and hair, while about 30 percent are warm-based.

Fitting Focus: ASIAN AMERICAN

■Facial Factors: Broad faces with flat planes and few angles. Rounder, shorter noses and low, flat bridges are typical.

■Frame options: Select styles with Asian-specific bridges or those with adjustable nosepads and shallow vertical measurement to accommodate high cheekbones. Simple, high temples help lengthen broad faces.

■Color palette: Blue-based colors such as magenta, cool tortoise, and pewter, as well as gold metal with black or tortoise works for the 60 percent of Asians with cool coloring.