Cultural Competency Training

1. Cultural Competency Training Family Medicine Research Department Department of Family Medicine University at Buffalo Frances Saad, B.A., Psychology, MSW student, School of Social Work © 2005 CDHS College Relations Group Buffalo State College/SUNY at Buffalo Research Foundation

2. What is Culture? • Culture includes the shared values, traditions, norms, customs, religion, arts, history, folklore, language and/or institutions of a specific group of people. • In other words, culture is what we live everyday and what we display in our daily interactions with others. “That is true culture which helps us to work for the social betterment of all” -Henry Ward Beecher © 2005 CDHS College Relations Group Buffalo State College/SUNY at Buffalo Research Foundation

3. Cultural Awareness & Sensitivity • Cultural Awareness • General term used to indicate that a person is conscious of the similarities and differences within, between, and among cultures • Cultural Sensitivity • Indicates that a person not only has been an awareness of the nuances of one’s own culture as well as those of other cultures, but also that he or she does not assign a negative or positive value to the differences within, between, and among cultures-accepts cultural differences non- judgementally. © 2005 CDHS College Relations Group Buffalo State College/SUNY at Buffalo Research Foundation

4. What is Cultural Competency • Includes skills that enable individuals to increase their understanding and appreciation of cultural differences and similarities. • Allows providers to understand, appreciate, and work with individuals of cultures other than their own. • Involves the willingness and ability of a system to value the importance of culture in the delivery of services to all segments of the population. © 2005 CDHS College Relations Group Buffalo State College/SUNY at Buffalo Research Foundation

5. Organizational vs. Individual • Cultural Competence • Individual • Organization © 2005 CDHS College Relations Group Buffalo State College/SUNY at Buffalo Research Foundation

6. A Definition Specific to Systems of Care • The integration of knowledge, information, and data about individuals and groups of people into: • Clinical standards • Skills • Service approaches and supports • Policies • Measures • Benchmarks • This occurs on the individual, program and system level • This promotes effective work in cross-cultural situations (Cross et al., 1989; Davis 1997) © 2005 CDHS College Relations Group Buffalo State College/SUNY at Buffalo Research Foundation

7. Rationale for cultural competency • Numerous reasons justify the need for cultural competence within the health care system: ■ diverse belief systems exist related to health, mental health, healing and well-being ■ culture influences help-seeking behaviors and attitudes toward health care providers ■ individual preferences affect traditional and other approaches to health care ■ patients must overcome personal experiences of biases within health care systems ■ health care providers from culturally and linguistically diverse groups are under-represented in current service delivery systems. Cohen, E., & Goode, T. D. (1999) © 2005 CDHS College Relations Group Buffalo State College/SUNY at Buffalo Research Foundation

8. Model for Cultural Competency • The National Center for Cultural Competence embraces a conceptual framework and model for achieving cultural competence based on the Cross et al. definition (1989). • Cultural competence requires that organizations: • have a defined set of values and principles, and demonstrate behaviors, attitudes, policies and • structures that enable them to work effectively cross-culturally. • have the capacity to • value diversity • conduct self-assessment • manage the dynamics of difference • acquire and institutionalize cultural knowledge • adapt to diversity and the cultural contexts of the communities they serve. • incorporate the above in all aspects of policy making, administration, practice/service delivery and involve systematically consumers/families. © 2005 CDHS College Relations Group Buffalo State College/SUNY at Buffalo Research Foundation

9. Barriers to Achieving Cultural Competency • Language • Non-verbal communication • Gestures, facial expressions, eye contact may have different meanings in certain cultures • Stereotyping • Assignment of characteristics or beliefs about another culture based on prejudice or limited exposure • Racism • Ethnocentrism • Belief that one’s ethnicity provides the true or correct view of the world © 2005 CDHS College Relations Group Buffalo State College/SUNY at Buffalo Research Foundation

10. Successful Practices in Delivering Culturally Competent Care • Define Culture Broadly • Value Clients’ Cultural Beliefs • Recognize Complexity in Language Interpretation • Translation • Interpretation • Facilitate Learning Between Providers and Communities Health Resources and Services Administration U.S. Department of Health & Human Services © 2005 CDHS College Relations Group Buffalo State College/SUNY at Buffalo Research Foundation

11. Delivery of Culturally Competent Care • Tips for Delivering Culturally Competent Care: • Know where your client was born and what the implications of birthplace have on health care. • Know what language your client speaks at home. • Know whether your client has specific dietary patterns based on his/her culture. • Know your client's religion and what treatments may be prohibited because of its teachings. • Know the level of independence the client had before the visit. Know whether independence is a problem for the client or a welcome asset to the quality of the client's life. © 2005 CDHS College Relations Group Buffalo State College/SUNY at Buffalo Research Foundation

12. Con’t Delivery of Culturally Competent Care • Know the support systems in the clients life. • Have the client describe how health issues are handled at home to be aware of the role of family in the patient's culture. • Understand the importance of individualizing each situation based on the multitude of cultural issues that can arise. • Assess the emotional state of the client and try to determine the cultural dimensions that support it. • Allow the client to assist you in learning words that describe his/her illness or situation. Malone, Beverly L., Ph.D., R.N., FMN, Minority Health Today Magazine, Vol. 1, Number 2, Jan/Feb 2000. © 2005 CDHS College Relations Group Buffalo State College/SUNY at Buffalo Research Foundation

13. Enhancement of Cultural Competence • Cultural Competence activities should include: • Development of skills through training, use of self-assessment for providers and systems, • Implementation of objectives to ensure that governance, administrative policies and practices, • Clinical skills and practices are responsive to the culture and diversity within the populations served. • It is a process of continuous quality improvement. © 2005 CDHS College Relations Group Buffalo State College/SUNY at Buffalo Research Foundation

14. Cultural Competency Resources • U.S. Dept. of Health and Human Services, Health Resources and Services Administration, Office of Minority Health, “Conceptualizing Cultural Competence and Identifying Critical Domains”  http://www.hrsa.gov/OMH/cultural/sectionii.htm  • U.S. Dept. of Health and Human Services, Office of Minority Health, National Standards for Culturally and Linguistically Appropriate Services in Health Care.  Washington, D.C. 2001  • U.S. Dept. of Health and Human Services, Office of the Surgeon General, Mental Health:  Culture, Race and Ethnicity.  Rockville, 2001 © 2005 CDHS College Relations Group Buffalo State College/SUNY at Buffalo Research Foundation

15. Cultural Competence is a journey, not a destination… © 2005 CDHS College Relations Group Buffalo State College/SUNY at Buffalo Research Foundation