Implementing Evidence-Based Practices for Culturally Diverse Communities

1. Implementing Evidence-Based Practices for Culturally Diverse Communities 2011 Annual Conference August 25, 2011 Orlando, FL

2. Michael D. Dozier, President & CEO Mississippi CommunityPartnership (601) 953-6930 dozier_michael@yahoo.com

3. Section 1. CORE CONCEPTS

4. Culture The shared values, traditions, norms, customs, arts, history, folklore, and institutions of a group of people that are unified by race, ethnicity, language, nationality, or religion Source: “Perspectives of Difference,” Division of General Internal Medicine, University of California, San Francisco

5. Culture of Origin “One’s culture of origin provides him/her with a basic understanding of the world. It provides the means to perceive and explain our experiences. It teaches about customs, philosophy, and behavior.”

6. Culture - an individual can identify with multiple groups • National origin • Ethnicity • Race • Gender • Sexual orientation • Religion • Rural, urban, suburban • Socio-economic status

7. Competence Acquisition of knowledge, skills, and experience necessary for the development and implementation of services to different groups served

8. U.S. Dept. of Health and Human Services “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.”

9. 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.

10. Cultural Competence Continuum Destructiveness Incapacity Blindness Pre-Competence Competence Proficiency

11. Four levels to the concept 1. Cultural knowledge – Individuals know about some cultural characteristics, history, values, beliefs, and behaviors 2. Cultural Awareness – next stage, individual is open to the idea of changing cultural attitudes

12. Four levels to the concepts 3. Cultural Sensitivity – knowing differences exist between cultures, but not assigning values to the difference. At this point clashes, and internal conflicts most often occur.

13. Four levels of the concept • Cultural Competence, brings together the previous stages, and adds operational effectiveness. A culturally competent organization brings together different behaviors, attitudes, and policies and works effectively in cross-cultural settings to produce better results Source: Community Tool Box, Univ. of Kansas

14. Cultural Competence is not the same as cultural diversity. Cultural Diversity – DIFFERENCES in race, ethnicity, language, nationality, or religion among various groups within a community. A community is said to be culturally diverse its its residents include members of different groups.

15. Guiding Principles of Cultural Competency Each group has unique cultural needs Action: Make room in your organization for several paths that lead to the same goal

16. Guiding Principles of Cultural Competency Diversity within cultures is important Action: Recognize that cultural groups are complex and diverse, do not view them as monolithic

17. Guiding Principles of Cultural Competency People have group identities and personal identities Action: Although it is important to treat all people as individuals, also acknowledge their group identity

18. Guiding Principles of Cultural Competency People are served in varying degrees by the dominant culture Action: Recognize that what works well for the dominant cultural group, may work against members of other cultural groups

19. Guiding Principles of Cultural Competency Culture is ever-present Action: Acknowledge culture as a predominant force in shaping behaviors, values, and institutions.

20. Section 2 Value and importance of cultural competence

21. Cultural Competence Why is cultural competence important for you, your organization, and your community?

22. Why is being culturally competence important to you?

23. Benefits of Organizational Cultural Competence • Increase respect and mutual understanding among those involved • Increases civility in problem-solving through new perspectives, ideas, strategies • Decreases unwanted surprises that might slow progress

24. Benefits of Organizational Cultural Competence • Increases participation and involvement of other cultural groups • Increases trust and cooperation • Helps overcome fear of misteaks, competition or conflict • Promotes inclusion and equity Source: Community Tool Box, Univ. of Kansas

25. Thus, How could your organization benefit from being culturally competent (if it isn’t already!)?

26. “Organizations have a ‘culture’ of policies, procedures, programs, and processes, and incorporate certain values, beliefs, assumptions and customs… An organizational culture may not lend itself to culture competence, so that’s where skill building comes in.”Source: Univ. of Kansas, Community Took Box

27. Critical Domains for Measuring Cultural Competencies“Literature suggests that cultural competence must be evidenced or manifested in a broad range of spheres or areas.”Source: HRSA - OMH

28. Cultural Competency Domains Policy Physical Environment Effective Prevention Values Training Community Participation Communication Style

29. Organizational DiversityPrimary • Ethnicity • Gender • Sexual Orientation • Social Class • Spiritual beliefs and practice • Physical and mental ability

30. Organizational DiversityOther types – less salient • Age • Language • Education • Customs • Customs • Skills and Talents • National/regional origins

31. Challenges for Professional • Value Diversity • Understand their cultural biases • Internalize Cultural Knowledge • Develop Adaptations to Diversity • Source: HRSA – Office of Minority Health

32. Indicators of culturally competent organizations • Outreach – outreach to diverse groups is encouraged and is part of organizational plan • Cultural concepts – inclusive language is used: cross-cultural concepts are understood

33. Indicators of culturally competent organizations • Leadership – leadership is supportive and committed to cultural competence • Vision/Mission – diversity is integral to the program vision/mission • Staff composition – staff reflects the diversity of the community

34. Indicators of culturally competent organizations • Training/staff development – Organization provides/facilitates training on cultural diversity issues. • Collaboration – staff and diverse community members work together and share responsibility for addressing substance abuse problems

35. Section 3 Building a Culturally Competent Organization

36. Action Steps for Achieving Cultural Competence • Develop support for change throughout the organization (who wants change and who doesn’t?) Is this a top-down mandate? How deep is the “buy in?” Do you need a representative committee?

37. Action Steps for Achieving Cultural Competence • Identify the cultural groups to be involved. Who needs to be involved in the planning, implementation, and reinforcement of the change?

38. Action Steps for Achieving Cultural Competence • Identify barriers to cultural competence at work in your organization What is currently not working, what will slow you down or stop you?

39. Organizations barriers • Lack of understanding • Lack of resources • Lack of leadership commitment • Lack of training opportunities • Staff resistance

40. Cross-Cultural Stumbling Blocks • Language – different languages, dialects, certain concepts hard to translate • Class-related values • Culture-related values – different meanings and values attached to behavior, events, situations • Non-verbal communication – gestures, facial expressions, eye contact may have different meanings

41. Cross-cultural Stumbling Blocks • Stereotyping – assignment of characteristics or beliefs about another culture based on prejudice, or limited exposure • Racism • Ethnocentricity – belief that ones ethnicity provides the true or correct view of the world

42. Action steps for Achieving Cultural Competence 4. Assess your current level of cultural competence • What knowledge, skills, and resources can you build on? Where are the gaps?

43. Some guideposts for assessing organizational cultural competence • Experience or track record of involvement with the target population • Staffing • Training availability and scope • Community representation • Language

44. Further guideposts for assessing organizational cultural competence • Environment • Materials • Evaluation • On-going self-assessment

45. Action Steps for Building Cultural Competence • Identify the resources needed How much funding is required to bring about the changes? Where can you find the resources?

46. Action Steps for Building Cultural Competence 6 Develop goals and implementation steps and deadlines for achieving them.

47. Action Steps for Achieving Cultural Competence 7. Commit to an ongoing evaluation of progress (measuring outcomes) and be willing to respond to change • What will success look like? How do you know you are on the right track?

48. Interventions for increasing organizational cultural competence • Increase the number of diverse persons in the organization • Develop educational plan for employees, coalition members, volunteers, to improve competencies required for effective cross-cultural work

49. Interventions for increasing organizational cultural competence • Identify and re-write policies, practices, and structures that limit the full participation of diverse communities • Hold educational events exploring diverse group’s history, cultural, issues, and strengths

50. Interventions for increasing cultural competence • Assure that the right voices are “at the table” • Establish, communicate, and model how the mission, vision, goals and values of the coalition align with and are served by a diverse membership and inclusive practices.