Delaware Cultural Competence Training

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Delaware Cultural Competence Training August 10,
2010 Wilmington, DE
Tracy Johnson, Central RET Coordinator Kara
Endsley, CRET SERET Associate
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Todays Agenda

• Introductions and Warm-Up
•  Our Objective
•  SPF Overview and Cultural Competence in the SPF
  SIG Program
• The Cultural Fabric of Delaware
• Definitions of Cultural and Linguistic Competence

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Todays Agenda (contd.)

• 6. Compelling Needs for Cultural and Linguistic
  Competence
• 7. Group Activity
• 8. Key Ingredients for Culturally Competent
  Provider
• 9. Next Steps
• 10.Evaluation and Wrap-Up

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Workshop Objectives

• Participants will be able to define cultural
  competency
• Participants will become familiar with cultural
  competency and describe its purpose in prevention
  planning and programming
• Participants will be able to identify the
  relationship between cultural competency and the
  SPF

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Questions to Consider

1. How do you define culture and cultural
   competence?
2. Why is cultural competence important within an
   organization?
3. How does an organization achieve cultural
   competence?

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Northeast Regional Expert Team
RI
DE
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SPF Overview
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SPF Examples

• Assessment What does the problem look like and
  what resources do we have and need to solve it?
• Capacity How can we build resources we need,
  use the resources we have and mobilize community
  people around the issue?
• Planning Put together a blueprint for
  addressing the problem

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SPF Examples (contd.)

• Implementation Putting the plan into action
• Evaluation Evaluating how we implemented the
  plan, what worked and what were the results

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The SPF and Sustainability

• Applies to more than funding
• Sustaining outcomes, not programs
• Think sustainability from the beginning
• Look to the system to sustain outcomes
• Sustain prevention by making it everyones job!

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In Your Own Words

• HOW DO YOU DEFINE CULTURAL COMPETENCE?
• Delaware SPF-SIG defines cultural competency as a
  comprehensive and sustainable approach to
  substance abuse prevention and awareness by
  integrating community values while utilizing
  multiple strategies.

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The SPF and Cultural Competence

• To eliminate service and participation
  disparities for people of diverse racial, ethnic,
  and linguistic populations
• To consider culture, gender, ability levels, and
  sexual orientation in all aspects of the SPF
• To improve the effectiveness and the quality of
  the programs, policies and practices chosen to
  achieve outcomes

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Cultural Competence and the SPF SIG Program

• Cultural competence is a critical component of
  the SPF SIG program.
• CSAP address the issue of cultural competence in
  its publications, programs, training and
  technical assistance and policy statements
• SAMHSA informs applicants in its documents and
  announcement regarding cultural competence.

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SPF SIG Cultural Competence Requirements

• Build a state- program-level database
  consisting of the following descriptive
  information
• Plans and strategies designed to implement
  culturally appropriate policies, programs
  practices
• Organizational capability experience of awardees

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SPF SIG Cultural Competence Requirements (contd.)

• Utilization, reliability validity of culturally
  appropriate psychometric methods and measures
• Types and utilization of culturally appropriate
  adaptations with evidence-based programs,
  policies, and practices.

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In Your Own Words

• HOW DO YOU DEFINE CULTURE?

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What is Culture?
Urban/City
?
SES
Culture
Traditions
Education
Acculturation
Nationality
Religion
Language
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Cultural Competence

• A set of behaviors, attitudes and policies
• that come together in a system, agency, or
• program or among individuals, enabling
• them to function effectively in diverse
• cultural interactions and similarities within,
• among, and between groups.
• Sources U.S. Department of Health and Human
  Services

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Cultural Competence

• Cultural Competence is a point on a continuum
  that represents the POLICIES and PRACTICES of an
  organization, or the VALUES and BEHAVIOR of an
  individual which enable that organization or
  person to interact effectively in a culturally
  diverse environment.

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What is Linguistic Competency?

• The capacity of an organization and its
  personnel to convey information that is easily
  understood by diverse audiences, including
  persons of limited English proficiency, those
  with low literacy skills, and individuals with
  disabilities.

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Cultural and Linguistic Competency

• At all levels, a culturally and
  linguistically competent system of care
  acknowledges and incorporates
• the importance of culture and language
• the cultural strengths associated with people and
  communities
• the assessment of cross-cultural relations

Source Cross, T. L., et al. (1989). Toward a
culturally competent system of care A monograph
on effective services for minority children who
are severely emotionally disabled. Washington,
DC CASSP Technical Assistance Center at
Georgetown University Child Development Center.
T-13.18
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Cultural and Linguistic Competency (contd.)

• vigilance of cultural and linguistic differences
• the expansion of cultural and linguistic
  knowledge
• the adaptation of services to meet unique
  cultural and linguistic needs.

Source Cross, T. L., et al. (1989). Toward a
culturally competent system of care A monograph
on effective services for minority children who
are severely emotionally disabled. Washington,
DC CASSP Technical Assistance Center at
Georgetown University Child Development Center.
T-13.18
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Compelling Needs for Cultural Competence

• To respond to current and projected demographic
  changes in the U.S.
• To eliminate disparities in services to people of
  diverse racial, ethnic, and cultural backgrounds
• To improve the quality of services to all

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Compelling Needs for Cultural Competence (contd.)

• To gain a competitive edge in the marketplace
• To increase staff satisfaction
• To decrease the likelihood of liability/malpractic
  e claims

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Compelling Needs for Cultural Competence (contd.)

• To meet legislative, regulatory, and
  accreditation mandates
• To add to the body of knowledge, awareness and
  skill in the design, implementation, and delivery
  of prevention programs, policies, and practices.
• To promulgate the philosophy that an effective
  program is a culturally competent program across
  the board, i.e., agency, policies, staff, and
  programs/practices.

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Fabric of Delaware Compared to U.S.

• Delaware 885,122 vs. US 307,006,550
• White Non-Hispanic 68.3 vs. 65.6
• African American 20.9 vs. 12.8
• Hispanic/Latino Origin 6.8 vs. 15.4
• American Indian 0.4 vs. 1.0
• Native Hawaiian/Pacific Islander 0.1 vs. 0.2
• Asian American 2.9 vs. 4.5
• Two races 1.4 vs. 1.7
• Living below poverty level 10.3 vs. 13.2
• Speak other language at home 9.5 vs. 17.9

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Enhancing Cultural Competence

• Valuing Diversity
• Awareness of the Dynamic of Difference
• Attitude
• Ability to Institutionalize

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Enhancing Cultural Competence (contd.)

• Cultural Knowledge Practice
• Adaptation to Diversity
• Cultural Self-Assessment

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Four Stages of Individual Cultural Competence

• Awareness
• Knowledge
• Skills
• Desire

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Four Stages

• AWARENESS
• The process of conducting a self examination
  of ones own biases toward other cultures and in-
  depth exploration of ones own culture.
• KNOWLEDGE
• The process in which the professional seeks
  and obtains a worldview of different cultural and
  ethnic groups.
• Recognizing different values
• What is important in your culture? Whats it like
  in your native country?

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Four Stages

• SKILLS
• The ability to effectively apply awareness
  and knowledge to interactions and relationships
  with people from different cultures.
• Aware of your culture and values but recognizing
  that other values are different
• Interaction will change
• DESIRE
• The motivation to engage in the process to
  become culturally aware, knowledgeable, skillful,
  and seek cultural encounters.
• Make the cross-cultural connections/out of your
  comfort zone
• Fun part!

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Why is it Important to be Culturally Competent?

• Russian ice dance tribute to Aborigines offensive
  to
• Aborigines

• "They have got the whole thing wrong," .. there
  were no traditional movements in the routine, the
  music sounded more like it came from India or
  Africa and the body paint looked like a
  three-year-old child had drawn it on it said
  Stephen Page, artistic director of the respected
  indigenous group, the Bangarra Dance Company.

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GROUP ACTIVITY
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The Cultural Competency Cycle
Acknowledgment Cultures Profound Effect on
Health and Health Outcomes
Awareness of Cultural Differences Among People
Mentoring
Culturally Competent Health Care Providers
Respectful Interaction and Communication
Knowledge and Understanding of Culture
Revision and Refinement of Preventive
Interventions
Engagement and Integration of Cultural Knowledge
and Sensitivity into Preventive Interventions
Source Center for Cross-Cultural Health,
Continuing Education Committee. (modified)
T-13.37
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Knowing the Landscape

• An important first step in doing any
  environmental strategy is to know the landscape
  of the community
• Conduct an inventory of the community
• Commonly spoken languages
• Socio-economic issues
• Neighborhood alliances
• Allegiances non-allegiances
• Municipal profiles
• Key leaders

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Ensuring Effective Participation in Planning Step

• Provide all coalition members with training on
  prevention planning and risk and protective
  factors
• Provide opportunities for coalition members to
• Give a cultural perspective on risk factors and
  how they may be viewed in different cultures
• Assist with collecting data on risk factors
• Provide feedback on the criteria for risk factor
  prioritization (importance and changeability)
  from cultural perspective

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Looking at Cultural Relevancy

• Is the strategy culturally relevant and
  applicable across sub-populations?
• Will the strategy work with the sub-populations
  you have identified, as well as with the
  population as a whole?
• What cultural elements such as language,
  attitudes, values, norms and customs do you need
  to consider in planning for implementation of the
  strategy?
• How might you involve the sub-populations in
  looking at the appropriateness of a strategy?

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Cultural Considerations

• Technology access and availability
• Interpretation issues
• Working with people who speak different languages
• Working with individuals who are deaf or hard of
  hearing
• Religious/cultural issues
• Age issues
• Reaching/including small/under-represented
  populations

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Delaware RFP

• INFORMATION DISCUSSION

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Activity Questions

• If you could only choose one step to ensure
  cultural competency, which step do you feel you
  would spend the most time on and why?
• Which step would you find the most challenging to
  ensure cultural competency and why?

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Next Steps
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Wrap-Up
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Thank You

• GRACIAS
• MERCI