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Many health concerns in the United States (e.g., diabetes) are routinely managed in primary care settings. Regardless of the medical condition, patients' health is directly influenced by factors such as healthcare providers and cultural background. Training related to how behaviors influence health, coupled with training on how cultural diversity intersects with mental health, allows psychologists to have the relevant expertise to assist in the development of primary care behavioral health interventions. However, many psychologists in primary care struggle with how to integrate a culture-centered paradigm into their roles as behavioral health providers. This paper provides an introduction on how three culture-centered concepts (providers' cultural sensitivity, patient-provider cultural congruency, and patients' health literacy) can be applied in primary care using the Five A's Organizational Construct and a model of cultural competence. In addition, the paper includes a section on integration of cultural considerations into consultation and training and concludes with a discussion of how the three culture-centered concepts have implications for health equity.

American Indians/Alaska Natives (AI/ANs) suffer disproportionate rates of substance use disorders compared to Americans overall. Providers serving AI/AN communities are drawing from a diverse toolkit of treatment strategies that incorporate Native worldviews and community-shared values in order to improve outcomes. This paper describes findings from interviews with 22 program directors and 18 representatives from Single State Authorities on substance abuse. Interviews assessed provider and state efforts to increase AI/AN client engagement and to improve the quality of care through culturally relevant interventions. Results suggested that providers employed flexibility and originality to cultural-based programs by broadening established practices, adopting outside traditions, and creating new ones to fit client needs. However, gaps in state-tribal collaborations and inter-group complexities such as staff-based tensions, a widening generational divide, and blurred consensus of "tradition" affect service delivery. Overall, respondents underlined the critical role culturally relevant care plays in individual and community healing.

Over the centuries, slavery has become embedded into the social fabric of Mauritania with generations of abid and bizan (Mauritanian slaves and slave masters, respectively) born and raised knowing nothing but the institution of chattel slavery. Abid fleeing their station in Mauritania come to the USA with unique psychological needs that will affect all of their interactions with the medical community. This paper aims to assist health professionals and others concerned with the welfare of former chattel slaves in competently serving this vulnerable population. Discussion includes an overview of Mauritanian chattel slavery, deduced sequelae of chattel slavery, preliminary recommendations for mental health and medical treatment protocols, and suggestions for future research. A confidential Institutional Review Board (IRB)-approved case report will be used to illustrate these objectives.

The absence of universally available language services is a national healthcare system failure, the burden of which is suffered by patients with limited English proficiency and their healthcare providers. Conceptualizing mandatory provision of language access as an unfair, unfunded mandate ignores massive and fundamental social changes taking place. Overcoming language barriers is essential to safe, quality health care. This paper, informed by the experience of Hablamos Juntos, a national demonstration project funded by the Robert Wood Johnson Foundation, argues that national and health industry investments are needed to develop population-based approaches supported by communication and information technology, and that these investments may prove useful to improving healthcare communication for English-speaking patients as well.