News
Comment: Achieving culturally competent care
Gloria Kolb, co-founder and CEO of Elitone on addressing the unique needs of women from diverse backgrounds

Personalised medicine has gained a lot of attention as of late. It can mean suiting a treatment to the genetic makeup of the patient. In a broader sense, it means competent care that is not one-size-fits-all and more than acknowledges a patient’s background, but care that takes into account cultural identity, values, and health beliefs.
Especially in women’s health, women from different cultural, ethnic, and socioeconomic backgrounds often face unique health challenges and additional barriers that require culturally competent care.
In this ever-evolving field, and as medical innovations advance, practitioners must take the time to understand and respect each woman’s cultural differences that influence health behaviors, perceptions, and communication. This approach fosters trust and improves health outcomes by improving understanding and compliance with treatments. As we continue to innovate in women’s health, addressing these differences is crucial to bridging the gap between access and outcome disparities that have disproportionately affected women from diverse communities.
Understanding the unique needs of diverse women
Women from different cultural backgrounds often face distinct health challenges that are shaped by factors such as genetics, lifestyle, and societal expectations. These disparities highlight the importance of tailoring healthcare to meet the specific needs of each group.
The traditional “one-size-fits-all” approach in medicine does not account for the significant differences in how certain conditions manifest across various populations. Cultural identity is just one of many factors that shape an individual’s health needs and experiences. Within any given ethnic group, there is significant diversity in terms of lifestyle, socioeconomic status, education, and personal health beliefs.
Assumptions based solely on ethnicity can lead to stereotyping and the risk of overlooking personal nuances that are critical to effective healthcare. For example, while a Latina woman may statistically be at higher risk for diabetes, assuming that every Latina shares the same risk profile ignores the reality that individual behaviors, family history, and access to resources play crucial roles.
In another example, black women at one time were thought to have lower incidences of incontinence. Only after further research was conducted did it show that black women under-reported their conditions more than other races, and when black women did present with incontinence, their conditions were already much worse.
Regarding certain socio-economic statuses, prescribing weekly pelvic floor physical therapy or neurostimulation office visits has led to poor compliance. Often, these women can’t hire a babysitter for every office visit or take time off from work in the middle of the day. Poor compliance is often simply due to a lack of transportation.
Healthcare providers must balance recognising common trends within ethnic groups and treating each patient as an individual with unique circumstances. This approach not only builds trust but also allows for more effective diagnosis and treatment, as patients are more likely to feel heard, engage in open communication, and collaborate in their healthcare when they feel understood on a personal level.
The role of healthcare providers in culturally competent care
Healthcare providers play a crucial role in delivering culturally competent care by actively educating themselves about the communities they serve. This includes being aware of the social determinants of health — factors such as income, education, and environment — that disproportionately affect women from marginalized communities.
It’s understood that healthcare providers are woefully busy. On average, OBGYNs spend about 13 minutes with each patient to understand issues, examine them, and give diagnoses and treatments. During this time, women, as family health caretakers, may bring up issues other than their own.
Cultural differences can influence their perceptions of illness and treatment, delay decisions until the family is included, or avoid needed taboo topics such as pelvic, mental, and sexual health. Providers who are sensitive to these nuances can navigate conversations with empathy and respect, leading to better communication and patient adherence to treatment plans.
Innovative approaches to culturally competent care
Innovation in healthcare is not only about developing new treatments or technologies but also about rethinking how care is delivered to ensure it meets the needs of diverse populations. One promising approach is integrating community health workers (CHWs) into healthcare teams. CHWs are often members of the communities they serve, making them well-positioned to provide culturally relevant health education, support, and advocacy.
Another innovative solution is using telemedicine to reach women in underserved areas. Telemedicine allows healthcare providers to connect with patients who may face geographical, financial, or even social barriers to in-person, mid-day care.
For women from rural or immigrant communities, telemedicine offers a way to access culturally competent care from providers who may not be physically accessible. Lower-paid workers often have jobs that are more inflexible regarding taking time off during work time. By breaking down these barriers, telemedicine can help bridge the gap between diverse populations and quality healthcare.
Additionally, healthcare institutions can leverage technology to create tailored health education materials in multiple languages and formats. Digital platforms that deliver culturally specific content about preventive care, maternal health, and chronic disease management can empower women from different backgrounds to take control of their health.
Similarly, at-home treatments can allow for easier treatments on your own time without taking transportation time or time off from work.
The future of culturally competent care in women’s health
The demand for culturally competent care in women’s health will only grow as the population does. Yet, the future of healthcare cannot rest solely on broad generalizations about ethnicity or culture.
Ultimately, the future of culturally competent care in women’s health lies in moving away from a one-size-fits-all model and embracing a patient-centered approach that respects each woman’s unique combination of cultural, social, and personal factors.
By doing so, healthcare providers can ensure that women from all backgrounds receive the quality care they deserve, leading to improved health outcomes and a more equitable healthcare system.
Gloria Kolb is the CEO and co-founder of Elitone, the first non-invasive, FDA-cleared, wearable treatment for women with urinary incontinence. Elitone’s accolades include winning Best New Product by My Face My Body, Sling Shot 2020, finalist in the Women Startup Challenge, and many startup pitch competitions. As an inventor with 30+ patents, Gloria has been featured in Forbes as a Top Scientist Driving Innovation in Women’s Health. Her creative designs and problem-solving abilities have earned her recognition, such as Boston’s “40 Under 40” and MIT Review’s “World’s Top Innovators under 35.” She has engineering degrees from MIT and Stanford, as well as an MBA in entrepreneurship from Babson College.
Mental health
Cosmetic procedures may become addictive for some women, researchers say

Cosmetic procedures may become addiction-like for some women, with low body esteem and problematic social media use linked to higher risk, new research suggests.
A study of 1,614 women aged 25 to 71 found that one in five who had undergone treatments met the threshold for moderate to severe risk of addictive cosmetic procedure use.
Low body esteem and problematic social media use emerged as the strongest risk factors.
Researchers from the Hebrew University of Jerusalem and the Israel Center for Addiction and Mental Health examined what they described as addictive cosmetic procedure use, or ACPU, among Jewish Israeli women.
ACPU refers to repeated cosmetic treatment behaviour that may resemble addiction, including feeling unable to stop, continuing despite negative effects or craving further procedures.
The study was led by Vera Skvirsky alongside Uri Lifshin, Dvora Shmulewitz and Mario Mikulincer, from the department of psychology at the Hebrew University of Jerusalem and the Israel Center for Addiction and Mental Health.
The researchers surveyed women from the general population rather than focusing only on patients at cosmetic clinics.
Among women who had undergone cosmetic procedures, 20 per cent met the threshold for moderate to severe lifetime risk, while more than 15 per cent reported symptoms within the previous year.
Across the full sample, nearly nine per cent of women showed moderate to severe signs of problematic cosmetic procedure use.
The researchers adapted questions based on mental health criteria used to assess substance-related disorders.
Participants were asked whether they had tried unsuccessfully to stop having cosmetic procedures, felt compelled to continue despite negative consequences or experienced cravings linked to treatment.
Previous research has linked cosmetic procedures with body-image concerns and body dysmorphic disorder.
Body dysmorphic disorder is a mental health condition in which a person becomes highly distressed by perceived flaws in their appearance, often flaws that others may not notice.
The new study examined whether repeated cosmetic procedures may, in some cases, resemble a behavioural addiction.
Women with lower body esteem were more likely to report addiction-like patterns, particularly when this was combined with high levels of problematic social media use.
Participants who reported problematic or excessive social media behaviour appeared especially vulnerable when they also felt dissatisfied with their appearance.
The researchers also found smaller links between addictive cosmetic procedure use and lower feminist attitudes, lower attachment security and more negative attitudes towards ageing.
However, those links were less consistent when several factors were analysed together.
The findings come amid a sharp global rise in cosmetic procedures, with international estimates cited by the researchers suggesting interventions increased by around 40 per cent between 2019 and 2023.
The researchers stressed that the study does not suggest cosmetic procedures are inherently harmful.
Instead, they said repeated engagement may, for some people, take on characteristics similar to behavioural addictions already recognised in mental health research.
The researchers said: “Cosmetic procedures have become deeply normalised in many societies, and for many people they may be a positive experience.
“But our findings suggest that for a meaningful minority, the behaviour may begin to resemble other compulsive patterns we see in addiction research, especially when low body esteem and problematic social media use are involved.”
The study was cross-sectional, meaning it captured a single point in time and cannot prove cause and effect.
Researchers said it remains unclear whether problematic social media use contributes to addiction-like cosmetic procedure behaviour, whether treatments influence body image and online engagement, or whether other psychological factors drive both.
Insight
New pregnancy treatment shows promise for at-risk twins

A high-powered ultrasound treatment could help identical twins affected by a rare and serious condition during early pregnancy, an initial study suggests.
Twin-to-twin transfusion syndrome, or TTTS, causes uneven blood flow between identical twins who share a placenta.
The imbalance can leave one baby dangerously small and the other too large, putting both babies’ survival at risk.
Brioney Garrett’s daughters were in danger before doctors used the world-first treatment to seal the blood vessels causing the problem without an operation.
Nancy and Margo were born healthy and, now aged four, are due to start school.
Researchers from Queen Charlotte’s and Chelsea Hospital tested the non-invasive procedure in 10 women from the UK and elsewhere in Europe after scans detected TTTS during early pregnancy.
Five women needed further treatment, while 12 of the 20 babies survived following the procedure.
The researchers described having a treatment that did not require a needle or telescope to be inserted into the mother’s abdomen as “extremely exciting”.
However, they said larger studies involving more pregnant women were needed before the procedure could be offered more widely.
Garrett described her daughters as “my miracle twins”.
She said: “We were in a very dire situation and I don’t forget that.
“It stays with me always how things could have been. Every day I still count my blessings.”
TTTS affects between 10 and 15 per cent of identical twins who share a placenta, representing around 300 to 400 pregnancies in the UK each year.
The uneven blood flow causes excess fluid to build up around the larger recipient baby, while leaving dangerously little fluid around the smaller donor baby.
Treatment usually involves inserting a needle into the womb to drain some of the fluid or using a laser to seal the connecting blood vessels.
Garrett’s procedure took about 20 minutes. She lay flat while a specially designed machine directed high-powered ultrasound waves at small blood vessels in her placenta.
She said: “It was very quick and pretty painless.”
Christoph Lees, head of fetal medicine at Imperial College Healthcare NHS Trust and professor of obstetrics at Imperial College London, described the research as “very promising”.
He said: “If this could work in a fully-fledged study, it could give hope to a lot of women who otherwise might have to have quite invasive treatment.”
Ultrasound is commonly used during medical scans to produce images of the body, but this procedure uses much more focused waves.
Heat generated by the waves can seal blood vessels about 2mm in diameter and located around 5cm to 6cm beneath the skin.
The procedure blocked blood flow in 90 per cent of the vessels treated during the study, with no unwanted side-effects reported.
Twins Trust, which supported the study, said the approach could make a significant difference for families affected by TTTS.
Helen Peck, head of healthcare engagement and research, said: “Any procedure that is non-invasive and can potentially identify TTTS earlier and improve outcomes for our families with this life-threatening condition could be a turning point.”
Scans carried out weeks after Garrett’s procedure showed that blood flow between the babies had been rebalanced, although other problems developed during the pregnancy.
Garrett said Margo, who had too little fluid around her, “was in a much better position” and that “the strain on Nancy’s heart had eased”.
Nancy and Margo were born at nearly 34 weeks, weighing 3lb 7oz and 3lb 3oz respectively.
Garrett said: “They were both healthy, and Margo wasn’t as small as we worried she was going to be.”
The twins are due to start primary school in September.
Garrett said: “They’re funny, smart, energetic little girls that just fit right in with their age group.”
Insight
Breast cancer rising rapidly in Asian American women, study finds

Breast cancer rates have risen rapidly among Asian American women over the past two decades, with some of the steepest increases among women under 50, new research has revealed.
Rates rose by more than three per cent a year in nearly every Asian American ethnic group studied, much faster than in any other US ethnic group.
The increase was particularly marked among women under 50 and in cases involving advanced-stage disease or certain aggressive subtypes of the cancer.
The study found even larger increases among Chinese and Vietnamese women.
Breast cancer rates among Native Hawaiian women were already among the highest recorded among US women, but rose by about one per cent a year, less than the increases seen in Asian American groups.
The researchers said increased screening was unlikely to explain the trend because screening would be expected to identify more cancers at an earlier stage.
Instead, cancers that had already spread increased at the fastest rate.
Triple-negative breast cancer, considered the most aggressive subtype, rose by more than six per cent a year among Chinese American women between 2017 and 2022.
Scarlett Lin Gomez, senior author and professor of epidemiology and biostatistics at the University of California, San Francisco, said: “These patterns are highly concerning from a disparities standpoint.
“They underscore why it is so important to move beyond treating Asian Americans, Native Hawaiians, and Pacific Islanders as a single population.”
Researchers analysed about 150,000 cases of invasive breast cancer diagnosed between 2000 and 2022 using data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results Programme.
The analysis covered nine Asian American, Native Hawaiian and Pacific Islander populations across 14 states. Together, these states account for about two-thirds of the US population within these groups.
Except for Native Hawaiian women, Asian American women have historically had lower breast cancer rates than non-Hispanic white women.
However, the gap has narrowed rapidly. By 2022, incidence among Asian American women under 50 was comparable with that recorded among white women.
The reasons for the increase among women under 50 remain unclear.
Changes in reproductive patterns, diet and other lifestyle factors may play a part, but researchers said they did not fully explain the findings.
They said previously unidentified risk factors may also be contributing to the rises in some Asian American communities.
Researchers hope two UCSF-based studies, the CRANE breast cancer study and the ASPIRE cohort study, will provide insights into these factors.
Gomez said: “Understanding why breast cancer is increasing so rapidly in these communities is critical.
“At the same time, we need to ensure that women across all Asian American, Native Hawaiian, and Pacific Islander communities have access to culturally appropriate education, screening, and timely follow-up care.”
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