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Building Providers’ Capacity to Provide Culturally Appropriate Care Web Series

Tai Edward Few, M.Div., Consultant

Aniz, Incorporated

Current issues in cultural competency frameworks: perspectives and examples from practice (Counterpoints)

Carlos A. O. Pavao, MPA, DrPH(c)

Research and EvaluationAniz, Incorporated

Mission § Aniz, Inc. promotes emotional and

physical wellness by providing mental health and substance abuse counseling, support services, and sexual heath education.

§ We do this work with the overarching objective of reducing risk behaviors in individuals and families affected by sexual health disparities including HIV/AIDS.

Programs

§ LGBT T.R.U.S.T§ We Want to Know § Holistic Harm Reduction § Grandparents Hands§ Community-Based Research§ AFLASH

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Webcast Objectives

1. Describe different cultural competency frameworks and the impact of those frameworks

2. List strategies to improve knowledge of cultural competency and the ability to develop and implement culturally competent prevention programs

3. Identify resources for agencies looking to develop innovative and evidence-informed cultural competency practices

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CulturalCompetencyisajourney,notadestination

The Cultural Competency Journey

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(Freire & Macedo,1995)

Cultural Competency

Cultural Diversity

Cultural Awareness

Cultural Sensitivity

Diversity

Cultural Inclusion

What comes to mind when we think of Cultural Competency?

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Elements of Culture

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Messages from Dominant US Values

1. Individualism 6. Freedom2. Activity and Work 7. Group Superiority3. Material Comfort 8. Equal Opportunity4. Science 9. Progress5. Achievement and 10. Practicality and

Success Efficiency

(Macionis 1991, 2005)

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The Pillars of Cultural Competency

AdaptedfromtheNationalCenterforCulturalCompetence(Ahmann, 2002).

Cultural Competency

Transformation Respect Knowledge

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Culturally Competent Infrastructure

Culturally Competent Services

Compatibility between the infrastructure & Direct Service Functions

Cultural Competence in Organizations

(Harper et. al. 2006)

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The National CLAS Standards are intended to advance health equity, improve quality, and help eliminate health care disparities by establishing a blueprint for individuals as well as health and health care organizations to implement culturally and linguistically appropriate services.

National CLAS Standards:Purpose

Comparison–2000 and 2012 National CLAS Standards

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2000 Standards 2012 Standards

Goal: to decrease health care disparities and make practices more culturally and linguistically appropriate

Goal: to advance health equity, improve quality and help eliminate health and health care disparities.

“Culture”: racial, ethnic and linguistic groups “Culture”: racial, ethnic and linguistic groups, as well as geographical, religious and spiritual, biological and sociological characteristics

Audience: health care organizations Audience: health and health care organizations

Implicit definition of health Explicit definition of health to include physical, mental, social and spiritual well-being

Recipients: patients and consumers Recipients: individuals and groups

Cultural Continuum

Destructiveness Incapacity Blindness Pre-Competence Competence

AdoptedfromtheNationalCenterforCulturalCompetence

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Sociocultural Model

My greater context and history (cultural historical/phylogensis)

My local context (ontogensis)

Me and my nature (microgenesis)

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(Cox, 1994) (Knight, & Sayegh, 2009)

Diversity – Culture Kaleidoscope: the art of smuggling

(Fuchs,1990)

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What is Culture?

Culture

?

Traditions

SES

Acculturation

Language

Urban/Rural

Religion

Nationality

Education

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(Spencer-Oatey, 2012)

Cultural Competency

The applied ability to effectively communicate and work with other people, groups, and/or organizations of different cultures or backgrounds.

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Four Stages of Individual Cultural Competence

§Awareness

§Knowledge

§Skills

§Desire

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Knowledge§ What does knowledge do?

Shifts perspectiveGuidesEnlightensChangesEmpowers

§ How do we gain knowledge?ExperienceReflectingReadingLISTENING

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Skills and Practice

What skills do we need in cultural competence?Social skills

Emotional skillsCognitive skills

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Cultural Competency

Cultural Diversity

Cultural Awareness

Cultural Sensitivity

Diversity

Cultural Inclusion

Revisiting what comes to mind when we think of Cultural Competency?

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Knowledge and Understanding

of Culture

The Cultural Competency Cycle

Respectful Interaction and Communication

Acknowledgment Culture’s Profound Effect

on Health and Health Outcomes

Mentoring

Culturally Competent Health Care Providers

Revision and Refinement of

Preventive Interventions

Source: Center for Cross-Cultural Health, Continuing Education Committee. (modified)

Engagement and Integration of Cultural

Knowledge and Sensitivity into

Preventive Interventions

Awareness of Cultural

Differences AmongPeople

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Ask the Professional?Contact Information:

Carlos A. O. Pavao, MPA, DrPH(c)Research and Evaluation

Aniz, Incorporatedresearch@aniz.org

www.aniz.org

The Dots Are Connecting......

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ReferencesAhmann, E. (2002). Developing cultural competence in health care settings: National Center for Cultural Competence.(Family Matters). Pediatric Nursing, 28(2), 133-138.

Cox, T. (1994). Cultural diversity in organizations: Theory, research and practice. Berrett-Koehler Publishers.

Freire, P., & Macedo, D. (1995). A dialogue: Culture, language, and race. Harvard Educational Review, 65(3), 377-403.

Fuchs, L. H. (1990). The American kaleidoscope: Race, ethnicity, and the civic culture. Wesleyan University Press.

Harper, M., Hernandez, M., Nesman, T., Mowery, D., Worthington, J., Isaacs, M., & de la Parte, L. (2006). Organizational cultural competence: a review of assessment protocols. FMHI pub, (240-2).

Knight, B. G., & Sayegh, P. (2009). Cultural values and caregiving: The updated sociocultural stress and coping model. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, gbp096.

Macionis, J. J.: Sociology. 3rd edition, Englewood Cliffs, New Jersey (1991).

Macionis, John, J (2005) ‘What is Culture’, in John J. Macionis Sociology: 59-61. New Jersey: Pearson-Prentice Hall.

Spencer-Oatey, H. (2012). What is culture. A compilation of quotations. GlobalPAD Core Concepts.

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