Rose Khalifa has spent the past decade creating ways to introduce modern medical care to a large and culturally diverse Arab-American population in southeast Michigan. As a transcultural nurse, she's developed the nation's first Arabic language prenatal program that offers a "comfort zone" for Arab women who traditionally avoid medical care until late in their pregnancy.

Khalifa speaks their language and understands their fears and stresses, having just given birth to a baby girl. She also has a 6-year-old son and finds her mothering experience a big plus in getting reluctant women to accept her nursing skills and advice.

The program, in which she was instructor, was set up to cover what women should know from early pregnancy to postpartum. Translator packages were provided for those who couldn't attend the class. Although designed to pack everything into one session, women still were reluctant to attend, so Khalifa modified the plan.

"I ended up going from a structured class to more of a one-on-one environment because the women aren't comfortable with others in the room watching a birthing video, or with asking questions because they don't want their private information known."

Khalifa said she decided to conduct two-hour personal appointments and goes over the educational packets and specific information with each woman. "It is very customized and private, the only one they're with is me."

Her outreach work has involved hundreds of personal hours providing special prenatal support to women in their homes and even in schools. In one case, a local school nurse requested information for a student in late pregnancy. Khalifa supplied materials, but also met with the teen to instruct her on labor and delivery, breast-feeding and other pertinent subjects.

"I do love it-making a difference in someone's life," Khalifa said.

"It's especially rewarding when someone names their child after you because, otherwise, they would have had difficulty going through the pregnancy. That's been one of the highest compliments."

Khalifa said her transcultural nurse duties also involve educating entire communities on the need to accept and help people with cultural differences not only with direct health care needs, but with getting along in work settings and in neighborhood activities. She's also involved in a domestic-violence awareness campaign.

"Having sensitivity and awareness of different cultures is important on all social levels," Khalifa said, who patients sometimes refer to as "Dr. Khalifa" because of their trust of her clinical expertise.

In May 2002, Khalifa developed and founded the American Arab Nurses Association, for which she serves as president. The association has 25 board members and is dedicated to promoting and supporting Arab-American nurses throughout the country.

The association has secured scholarship funding for students of Arab heritage and is working to provide annual scholarships. Another project is developing international relationships that could result in three- to four-year employment contracts for nurses from abroad.

"Right now we're putting together the logistics for an international conference in 2005," Khalifa said. "We'll be inviting all ethnic groups to attend workshops on nursing and combine efforts to help address the current nursing shortage."

Khalifa has been both innovative and creative in providing health care for the culturally diverse population, and for three years co-hosted a bilingual talk show, "Ask Oakwood," during which Arabic-speaking viewers could ask questions about health care topics.

Khalifa said the show, broadcast to 25,000 homes monthly, offered those who called in an appealing anonymity that addressed a cultural "fear factor" and allowed her to address health care questions and concerns.

At Oakwood, Khalifa has developed and implemented cultural competency tools for the organization's staff and physicians as well as working with librarians to establish a library of health education materials translated to several languages.

Before joining Oakwood, Khalifa launched her own home care agency in 1993 when she noticed that other such companies lacked a bilingual staff to serve non-English-speaking populations. Her business quickly grew to include 76 employees, largely due to referrals from health plans that could save money by not having caregivers go to patients' homes several times because of their lack of language skills.

"It was the first agency in the country to focus on Arab Americans and offer multicultural home health care," said Khalifa, who sold her business to a larger home care agency after it got too big, resulting in a 30 percent increase in patient volume for the agency.

After earning her nursing degree from Henry Ford Community College, Khalifa said the doors "just opened for me," as she saw the cultural needs of the ethnic communities and began to work in that area. She started her home nursing business and then joined Oakwood in 1998 to help in providing services to Arab-American patients that resulted in her being named the system's transcultural nurse.

She's received numerous honors for her work with the Arab-Muslim community, and in 2002, won the Nightingale Award for Nursing and the Michigan Department of Community Health Healthy Mothers/Healthy Babies Award for Exemplary Service.

Khalifa said she wanted to be a nurse since age 11 when she had a tonsillectomy and the attending nurse was unpleasant. "I told my mom I was going to grow up and be a nurse with a positive attitude and I never changed my mind."