Home sweet home....it is one of the many expressions that exist around the world to address the importance of comfort and security of a home. Yet, for many people home is a place of pain, humiliation and fear, such as in the case of women who are victim of domestic violence and abuse by an intimate partner. Violence against women causes and is caused by some level of gender inequality. Sexual Violence or Sexual Assault is merely one type of violence against women, and it can include both an intimate partner or a non-partner. 
Because culture and behaviors cannot be separated, it is important to raise awareness about how women around the world may respond differently against sexual violence, especially by an intimate partner, based on cultural norms and expectations. These can have a direct impact on how much is "normal, "acceptable' or "unacceptable" at it relates to acknowledging the existence of a problem, placing responsibility, and disclosing information.
In the early 2000s, the World Health Organization (WHO) conducted a study on Women’s Health and Domestic Violence against Women in ten countries where data was still scarce on this issue- Bangladesh, Brazil, Ethiopia, Japan, Peru, Namibia, Samoa, Serbia and Montenegro, Thailand, and the United Republic of Tanzania.
As the study clearly demonstrates, violence against women is widespread and deeply ingrained in social norms, and has serious impacts on women’s health and well-being. The data collected from all ten countries was eye-opening and pointed to the important role that political, religious, and traditional leaders can play in raising awareness about the problem of violence against women, challenging commonly held misconceptions and cultural norms, by promoting advocacy, especially in areas where violence against women is higher, such as provincial areas, or where violence at home is seen as inconsequential.
REACH-reaching diversity has started to offer a 3 hour women's violence workshop - In Her Shoes- with the objective to: increase awareness of, and empathy for the difficulties women who experience violence face when seeking support; demonstrate that all women can become victims of violence no matter their circumstances; encourage participants to actively think about what they can do in their personal and/or professional lives to help prevent violence against women; and begin a rights-based discussion and analysis of common perceptions about violence against women.
If your organization is interested in making this workshop available to people in your workforce or community, you can contact TrainingLounge@reach-diversity.com.
You can learn more about In Her Show, a women's violence workshop, by clicking the following link, https://reach-diversity.com/in-her-shoes---a-women-violence-workshop.html

You can learn more about the WHO "Multi-country study on women’s health and domestic violence against women : initial results on prevalence, health outcomes and women’s responses"authored by Claudia García-Moreno, et al. by clicking on the following link, https://www.who.int/reproductivehealth/publications/violence/24159358X/en/

This year more than ever, REACH-reaching diversity has presented a lot about the importance of self-care and ways to boost brain power and emotional fitness to help reduce stress, especially when dealing with taxing personal and workplace relationships and situations.
In the wake of Thanksgiving Day, a pioneering study from 2009 looked at whether a Thanksgiving staple could benefit sleep - gratitude. 400 people participated in the study to look at the effects of gratitude on sleep.
Here is what the study found...
Participants with more gratitude reported better quality & longer-lasting sleep and less time to fall asleep. In addition, gratitude appeared to decrease irritability, fatigue, and inability to concentrate on tasks. The study was published in the Journal of Psychosomatic Research, volume 66, pp. 43-48, if you'd like to read it yourself.
We, at REACH-reaching diversity, are very grateful for your trust in our services, your partnership, collaboration, and support.
We wish you all a Thanksgiving Day full of gratitude that will impact your life in a positive way.
Happy Thanksgiving Day!

– Anyone entering a new community unable to speak the language knows the struggles of language barrier when doing everyday things like interacting with healthcare providers, or teachers in their children’s schools, setting up banking or even buying groceries. Now there is an opportunity for those who have gained strong proficiency in English and another language to help others through the same struggles they experienced.
REACH- reaching diversity, in sponsorship with Champions for Health, the non-profit foundation of the San Diego County Medical Society, is inviting those with strong bilingual skills to register for The Community Interpreter® course, an interactive, skills-based training program. The program will be held at Champions for Health, 5575 Ruffin Rd., Suite 250, in San Diego, on Sept 4, 7, 10, 13 & 18, 2018, from 8:30 AM to 5:00 PM.
Conducted in a classroom over five days, The Community Interpreter® sessions teach participants what they need to know to work as a professional interpreter in settings such as medical facilities, schools, and government or nonprofit service settings. Completing the course provides the classroom-hours prerequisite for those wishing to take the examination for national medical interpreting certification.
Adama Dyoniziak, Executive Director for Champions For Health, stated, “We are excited to have this professional interpreter training available for our community. I am bilingual Polish-English, and I interpreted for my parents during medical appointments. It was very empowering to know that I was making a short time slot productive for both the provider and the client by increasing understanding during an important interaction. We welcome people who are kindred spirits in this endeavor.”
Rosanna Balistreri, Founder of REACH-reaching diversity and instructor for the course, stated, “Interpreters bridge the language gap between people and assist in providing meaningful access to much needed services. This course is very interactive, fast-paced and fun. We invite anyone who wishes to help others to join us!”
Registration is now open and closes August 15. The course is being limited to 20 participants. The cost is $750, which includes books. To register email: Traininglounge@reach-diversity.com, or more information can be obtained by calling (619) 630-0310.

One of the most difficult skills of healthcare interpreters is to successfully convey meaning about symptoms, medical conditions, diagnostic and therapeutic information from one language into another. The role of an interpreter is not to interpret word for word, but rather to convey the same meaning in an intelligible and authentic way that fits the context of the target language. One key aspect of interpreting in healthcare is developing the skills to maintain the integrity of the patient's original message, including the para-linguistic elements that align meaning to the uttered words such as, intonation, pitch, and speed.

Most patients come to see a physician with some sort of medical problem; it is the primary goal of a medical doctor to understand and resolve it using the following four steps: collect information based on patient's medical history and symptoms; recognize all possible clues and decide what possible diagnoses to pursue further; use evidence-based knowledge that can provide a possible solution; and follow through with a decision or a recommendation.
When looking at this process in more depth, it is clear that the step of collecting information, including patient's illness history, cannot take place without an open engagement and a clear communication with the patient. A medical provider needs to ask questions and fully comprehend each response, taking into account the idiosyncrasies that surround the patient's perception of the problem by the manner in which he/she explains symptoms and their chronology. Having a clear understanding of all clues is, therefore, key to getting closer to an accurate diagnosis.
For this reason, we can conclude that communication is the first and foremost diagnostic tool and platform for medical providers. And with such premise in mind, "effective communication" is pivotal to the diagnostic process, thus making the task of interpreting accurately and completely one that can have a profound effect for the patient.
Let's take a closer look at the importance of preserving patient's language when describing symptoms. In a medical scenario where the patient complains of chest pain, if the patient says, "the pain feels like a pressure" and the interpreter relays it as, "the pain feels like burning", the distortion of pain description can be significant enough to mislead the medical doctor to possibly follow with a question that may be related to heartburn or indigestion, rather than to difficulty breathing under physical exertion, especially when the patient's medical history can also be misleading.
Recognizing the great value of communication in health care is crucial to reduce the risk of errors and adverse events. When delivering services to a patient with Limited English Proficiency, no organization should risk the chance of error by allowing a family member or non-qualified and un-vetted staff members to relay information between patient and provider. Preserve your patient's language and maintain the highest standards of quality on the delivery of sensitive information for all your patients. You have already invested in the best medical specialists and state of the art technology to distinguish your excellence - don't compromise your investment. Trained interpreters and bilingual staff, whose interpreting competencies have been vetted, will help accomplish that mission.

Rosanna Balistreri, MA
Founder, REACH-reaching diversity

On February 23 and 24 Rosanna Balistreri, REACH-reaching diversity's founder and cultural & linguistic trainer, facilitated a two-day training to help individuals in the community become helpers with people at risk of suicide. 

The Applied Suicide Intervention Skills Training (ASIST)  - organized by the Community Health Improvement Partners in collaboration with representatives from REACH-reaching diversity, Cal State University San Marcos, Mental Health America and OptumHealth Access and Crisis Line - was facilitated to a group of Native Americans residing in San Diego East County

Taboos and stigma about suicide coexist with the increasing numbers of completed suicides and attempted suicides among Native Americans.  In addition to giving the tools for first-aid assistance to people at risk of suicide, the training also provided a unique opportunity to address the cultural barriers that prevent open communication on need for assistance by those people at risk, regardless of their age, gender and socioeconomic status.

"I feel very privileged to have been a part of a team of four trainers selected to empower this group of individuals in becoming helpers in their community.  It is a shame that people who look at death as a solution cannot be helped early on, especially when we know that, if given the choice of life over death, most of them would choose to live", stated Miss Balistreri.

Congratulations to everyone who participated in this wonderful effort!

REACH-reaching diversity

Dear Colleague,

It's been a wonderful year full of professional and cultural training development and facilitation, but we couldn't have done it without you, our loyal supporter and/or interpreter. 

I am truly grateful of all the support REACH has received by individuals who were seeking professional training to be able to certify as medical interpreters or healthcare interpreters.  Likewise, many certified interpreters have given REACH the privilege to be their choice for continuing education.  We work very hard to create training material that is educational, stimulating and fun, and we are committed to your ongoing feedback to improve our process and content.

On the same token, we are truly grateful to all of you who may not be interpreters, but have supported REACH thanks to your commitment to equal quality care.  Many of you have made possible for our training and presentations to have a venue or have helped promote our work and services in the areas of effective patient-centered communication and compassionate care-thank you for that.

As we enter into the Holiday Season once again, keeping an eye toward all things related to language access, cultural competence, literacy, equity and equality in healthcare, I would like to extend warm wishes to all of you and your families.  Please make the most of the holiday season and I hope you look forward to more training and collaboration with REACH-reaching diversity in the new year.

Happy Holidays,

Rosanna Balistreri

1. Recognizing high-risk patients: To effectively reduce readmission rates, hospitals need to recognize high-risk patients as soon as they are admitted.  This recognition requires extensive work and partnership with both patients and family members.

2.  Communicating effectively among providers and care teams:  The healthcare team must communicate appropriately, clearly and in a timely manner with one another.  A multidisciplinary bedside rounding requires all caregivers — physicians, nurses, specialists, case managers — to visit the patient at the same time and discuss the patient's care plan together, along with the patient.  

3.  Educating patients: Patient education involves patients and their families in the care process and it helps ensure they have a clear understanding of patient's condition and treatment plan.

4. Following up post-discharge: With a call- back system, following up with patients after they leave to see how they are doing, if they are following the discharge instructions and if they have any questions is a proven method of reducing re-admissions.  It is a very important step to assess new symptoms that indicate if necessary readmission needs to happen.

5. Improving the medication reconciliation process: This process is frequently a source of confusion for patients.  Medication reconciliation simply refers to a review of all medications and dosages of medicine that a patient is taking.   Hospital clinicians need to make sure patients are taking the necessary medications in the correct dosage while they are in the hospital, but they also need to ensure that patients and their care takers know what medication is needed to be taken and how once they go home.

Furthermore, hospitals also need to communicate the patients' medication requirements to outpatient providers to reduce to the risk of errors and the latter need to ensure patient's understanding as well.

If you are familiar with the National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care and The Joint Commission Hospital Accreditation Standards on Patient-Centered Communication, then you already know that as a healthcare organization you need to deem your bilingual qualified to interpret to ensure effective communication is taking place.  "Qualifications for language interpreters and translators may be met through language proficiency, assessment, education, training, and experience " (Joint Commission Standard HR.01.02.01).  Also, CLAS Standard #3 states the importance to "recruit, promote, and support a culturally and linguistically diverse governance, leadership, and workforce that are responsive to the population in the service area".

And let's not forget that the use of qualified interpreters and translators is supported by the Americans with Disabilities Act, Section 504 of the Rehabilitation Act of 1973, and Title VI of the Civil Rights Act of 1964!

To help you qualify your bilingual staff, REACH-reaching diversity will be offering a 40 hour online training that will cover Interpreter Standards of Practice, Code of Ethics and fundamentals of medical terminology.  

By preparing your bilingual staff on how to implement best practices when facilitating communication between your clinicians and Limited English Proficiency Patients, not only this training will help your organization reduce patient's unnecessary readmission by improving effective communication, but it will also help your organization:

* Reduce medical errors
* Increase patient satisfaction scores
* Help save costs by reducing the amount of unnecessary testing (when unclear on     symptoms, doctors tend to run more tests to confirm or dismiss possible diagnosis)
* Increase patient flow in and out of hospitals
* Become the preferred choice among non-English speaking communities

All information about the 40-hour online training is available here

Thanksgiving is just around the corner and I do not want to miss the opportunity to say 'thank you" to all of you who continue to support REACH-reaching diversity through your patronage and word of mouth referrals. 

To interpreters, whether certified or just joining the field, and to all health organizations, professional associations and language service providers who have hosted or sponsored us during this year, THANK YOU for giving REACH the opportunity to provide educational workshops and seminars!

Have a blessed and safe Thanksgiving Day with your loved ones!

Rosanna Balistreri
Founder, REACH-reaching diversity