AD-Perspective
Earlier in May, all NN/LM staff attended an educational session on cultural competence. The training was conducted by the National Center for Cultural Competence (http://gucchd.georgetown.edu/nccc/products.html). The following summary was written by Barbara Cosart, Special Populations Coordinator, NNLM-South Central Region, Houston Academy of Medicine- Texas Medical Center Library. The article first appeared in the July/August issue of SCR's Network News: http://nnlm.gov/scr/scnn/jul-aug04/)
Cultural Competence and Outreach to Diverse Communities
What is cultural competence?
Cultural competence can be defined in a number of different ways - in short, it is a set of values, behaviors, attitudes, and practices within a system, organization, program, or among individuals, which enables them to work effectively cross-culturally. Necessary to achieve this end is for organizations to develop adaptations to service delivery, policies, and structures reflecting an understanding of cultural diversity.
Several cultural factors influence diversity among individuals and groups. These include, among many others:
- Health beliefs and practices
- Language
- Religion and spiritual views
- Institutional biases
- Racism and discrimination
- Community economics
There are also a number of cultural influences on beliefs and practices related to the provision of healthcare services. These include, for example:
- Reliance on traditional remedies and healers
- Delaying access to healthcare
- Historical mistrust of healthcare, mental health, and social services professions
- Experiences of racism, discrimination, and bias, and cultural and linguistic barriers
- Perception of what is illness and disease, which varies across cultures
We must remain aware of these cultural influences as we continue our outreach to diverse populations. One of the main points I drew from the day was that for full community engagement in a project or program, community members must be full partners in decision-making from the very beginning, and benefit tangibly from the collaboration. Community engagement should result in the reciprocal transfer of knowledge and skills between all collaborators and partners. Too often, outreach projects fail as a result of assumptions being made about what is needed, and how the perceived 'gap' should be filled. For example, for health information outreach to be successful, it is necessary to understand which individuals in a community are seen as trusted sources of information about health practices. This is, for many cultures, not in a healthcare setting, or via a healthcare practitioner. Format and method of delivery of information is also an important consideration.
For information on cultural competence from the National Center for Cultural Competence, visit the NCCC's Products and Tools page which includes, among a number of helpful policy briefs and 'tools':
A Guide to Choosing and Adapting Culturally and Linguistically Competent Health Promotion Materials
http://gucchd.georgetown.edu/nccc/documents/Materials_Guide.pdf
A Guide to Planning and Implementing Cultural Competence Organizational Assessment
http://gucchd.georgetown.edu/nccc/documents/ncccorgselfassess.pdf
Javier Crespo, Associate Director
