The Cultural Broker Model

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The Cultural Broker Model

• From Paper to Practice

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The Cultural Broker Model

• Role Strain
• ?
• Bi-Cultural Competence
• ?
• Cultural Broker

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Bi-Cultural Competence

• Professional Culture
• Community/Family Culture

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Cultural Broker Key Role of Home Visitor

• Professional Culture
• ????
• Community/Family Culture

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Successful Site Characteristics

• HVs Professionalism
• HVs accept NFN model and parenting curricula
• HVs do curriculum
• HVs trust that supervisors share a deep concern
  for families
• HVs strive to achieve bi-cultural competence
• HVs express willingness to embrace cultural
  broker model

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Recommendations from Report

• Generalist v. Specialist role of HVs
• From role strain to cultural broker
• Organizational channels for HVs to participate in
  decision making
• Substance abuse, domestic violence and poor
  mental health
• Strengthen supervision
• Career Ladders

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Study Circles

• What is it?
• A democratic dialogue rooted in basic principles
  of action research designed to foster small group
  deliberation around common issues.
• Program staff asked to volunteer 94 participated

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Recommendations provided to

• Professionalize the home visitor role
• More clearly define and develop the supervisor
  role
• Expand parenting curricula
• Include home visitors in program decision-making
• Better accommodate mothers schedules, especially
  working moms

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Outcomes

• Resulted in staff network meetings and CQI
• Curricula Expanded
• Clinical Supervisor
• Home Visitor Training Increased
• Eliminated credentialing and left Healthy Families

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Revisiting the Cultural Broker Model

• Focus Group Study
• November and December, 2007

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Background

• New developmental stage period of growth
• New policies, training, curricula, supervision
• Hartford is first city to go to scale in 2005

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Focus Group Study Nov/Dec 2007

• Purpose Understand the decision-making process
  in identifying family needs and linking families
  to community resources
• 4 focus groups home visitors supervisors
• 8-10 participants/group, mix from different sites

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Focus Group Discussions

• Families with multiple problems
• The big three risk factors
• Creating change
• The cultural broker model

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Bridging Two Cultures

• like I came from where a lot of these girls came
  from. Life was hard for me growing upAnd I dont
  get personal with them but I let them know Ive
  been there. Another home visitor Exactly....
  And I need to come off my professional pedestal,
  so to speak, and come down a couple of notches on
  her level and be like Look. Get with the slang
  terms and everything for her to understand, where
  normally I dont talk like that. I used to, but I
  am here now and its like just to show her You
  can do it. Not to gloat to her. I dont gloat to
  her, but I am like Look. I been there. And she
  respects me...It works. It really does.

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Generalist v. Specialist

• Thats why so many families that come into the
  program new when we first start working with them
  there is no time to do any curriculum...Thats
  the last thing that they want to hear or see or
  read. They have so many other issues They need
  to know where their next meal is coming from,
  like you said where they are going to lay their
  head. All that type thing. How are they going to
  take the baby to the doctor with no medical
  insurance, and all this type thing.

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Curriculum ParentingOf Central Importance

• They are not ready for it. But then you get
  overwhelmed when they are going on and on about
  This is how I feel. This is whats going on.
  And you still have to try to find a way to bring
  it back to the child so that you are still being
  effective.
• So then I take the book out. Parents as Teachers.
  The best thingI like it a lotThats our Bible.
  laughter from everyoneAnd then I give them the
  handouts

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When and how is clinical supervision involved in
the process?

• What is the supervisors role??

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To Listen, Ask Questions

• Clinical supervisors have to know the
  family and they have to listen to what you say.
  Because we see them every week. So its a
  person thats really involved and really
  caring...Caring. Thats the key word. They have
  to be caring...And understanding, too. Clinical
  supervisors understand where the families are
  coming from. Not trying to put them where they
  think they should be,...

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And Provide Feedback

• With all the problems that NFN families have
  sometimes you dont know whether you are coming
  or going. So you need someone that has their head
  on their shoulders andsays, Why dont we try
  this?
• we always keep her informed and we are in her
  office a lot, too, to try to get ideas or ask
  questions
• Or by you telling supervisor whats been going
  on to develop that plan, how can we be creative?
  How can we address the curriculum in a different
  way? How can we get the baby out of the parents
  room?

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And Support

• Sometimes I feel really overwhelmed and drained
  and I sit with her and she can be very positive
  and help us a lot with our clients. others
  agreeAnd we do supervision every week.
  laughsOh, yeah. Because sometimes she has to
  tell us, Okay, dont take it personal about
  certain things... Lets think about how we can
  work around it, how we can make it better. Yeah,
  supervision is crucial

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Do you see change? Yes!

• Relationships
• Identifying problems with support and supervision
• Figuring out effective strategies
• Time and turning points

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Cultural Broker Model as the mechanism for
creating change

• Improve support by focusing on the frontlines
  where staff and families come together
• Professional Culture
• ????
• Community/Family Culture
• Experiences and knowledge that home visitors have
  of families and communities are a powerful
  resource for informing practice and policy

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Questions for Discussion
How can we improve the program model? What are
the most challenging issues right now and is the
program model effective in addressing them?