Moving Towards Cultural Competence in Schools of Public Health

1
Moving Towards Cultural Competence in Schools of
Public Health

• Myrtis Sullivan, MD, MPH, FAAP
• University of Illinois at Chicago
• School of Public Health
• May 4, 2004

2
Overview

• Defining cultural competence
• Strategies for achieving cultural competence
• Faculty and staff self assessment and awareness
• Training recruiting and educating graduate
  students
• Monitoring and continuous quality improvement
  (CQI) and assessment

3
Defining Cultural Competence

• 11 Definitions (handout)
• Conceptual Framework
• Issues to consider
• Narrow vs. broad definition and mission
• Lack of national standards complicates efforts to
  make cc training a requirement for health
  professionals and health organization staff
• Need for a standardized curriculum and evaluative
  measures to discern quality of training programs

4
Definitions

• Broad vs. Narrow
• The way culture is defined varies and may include
  differences based upon economic status, sexual
  orientation, gender, and lifestyle.
• Narrow focusing more on ethnic, racial and
  linguistic differences.
• Definition and measurement of CC are evolving.

5
Definitions

• Cultural competence is
• a set of congruent behaviors, attitudes, and
  policies that come together in a system, agency,
  or among professionals and enables that system,
  agency or those professionals to work effectively
  in cross cultural situations (Cross et al., 1989)

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Definitions

• Cultural competence in health care describes the
  ability of systems to provide care to patients
  with diverse values, beliefs and behaviors,
  including tailoring delivery to meet patients
  social, cultural, and linguistic needs
  (Betancourt et al., 2002).

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Definitions

• Cultural competence
• comprises behaviors, attitudes, and policies that
  come together on a continuum that will ensure
  that a system, agency, program, or individual can
  function effectively and appropriately in diverse
  cultural interaction and settings. It ensures an
  understanding, appreciation, and respect of
  cultural differences and similarities within,
  among and between groups. Cultural competency is
  a goal that a system, agency, program or
  individual continually aspires to achieve
  (DHHS,HRSA).

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Cultural Competence in SPHs Challenges and
Opportunities

• Achieving Cultural Competence
• Faculty and staff self assessment and awareness
• Training recruiting and educating graduate
  students
• Admissions and promotions
• Curricular challenges
• Monitoring and Continuous Quality Improvement and
  Assessment

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Faculty and Staff Self Assessment and Awareness

• NCCC views self-assessment as an on-going
  process
• Helps to gauge the degree to which organizations
  and individuals are effectively addressing the
  needs of culturally and linguistically diverse
  groups.
• Can lead to the development of a plan with
  clearly defined short- and long-term goals,
  measurable objectives and identified resources.
  National Center for Cultural Competence

10
Training

• Broadly defined (Hughes, 1997 Pierce, 1997) all
  activities related to recruiting, preparing,
  qualifying, supporting and retaining the public
  health workforce.
• Admissions and promotions
• Curricular changes
• Involves strategies and models for promoting CC
  at the individual, program and systems levels.

11
Research

• CC methodologies to effectively address the
  history of mistrust of research.
• To mitigate long-standing exclusionary research
  methodologies and ensure reciprocity within
  diverse communities
• Urgent need for racial/ethnic health data and
  differential responses to treatment.
• Need for research to validate the efficacy of
  culturally and linguistically competent
  approaches to health care delivery.

12
Monitoring and Continuous Quality Improvement and
Assessment

• NCCC tools
• USDHHS National Standards for Cultural and
  Linguistically Appropriate Services (CLAS)-14
  standards.

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Where Do We Go From Here?

• Work group/Task force
• Consensus Building and Guidelines Formation
• Recommendations for Implementation