Ensuring cultural competence

Individuals and groups can differ in ethnicity, gender, age, sexual orientation, and language. Their experiences may cause cultural variations that support these differences. It is important to look at the meaning of cultural variations when setting up and delivering your programs and services. Having an intervention delivered by a member of the target population does not mean it will be appropriate or successful. Reaching a population means understanding the culture of the population. Cultural competency is important for your intervention to be successful.

To make your intervention successful, you need to know the health needs of the persons you are trying to reach, as well as their cultural experience. This is a first step to a culturally competent program.

In 2001, the Office of Minority Health (OMH) in the Department of Health and Human Services published national standards for delivering services that reflect a group's culture and language. This is referred to as culturally and linguistically appropriate services (CLAS).

• To be culturally competent, a person must
• value the differences between persons and groups
• understand any negative feelings against a group
• be aware of what happens when different cultures come together
• make the knowledge of a culture a part of oneself
• make changes as necessary guided by what is needed to reach diverse groups.

The Office of Minority Health began by defining cultural competence as follows:

A set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective work in cross-cultural situations.

Culture refers to integrated patterns of human behavior that include the language, thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups. Competence implies having the capacity to function effectively as an individual and an organization within the context of the cultural beliefs, behaviors, and needs presented by consumers and their communities.

Office of Minority Health Standards for Measuring Cultural and Linguistic Competency

• Ensure that clients/consumers receive from all staff members effective, understandable, and respectful care that is provided in a manner compatible with their cultural beliefs and practices and preferred language.
• Implement strategies to recruit, retain, and promote at all levels of the organization a diverse staff and leadership that are representative of the demographic characteristics of the service area.
• Ensure that staff at all levels and across all disciplines receive ongoing education and training in culturally and linguistically appropriate service delivery.
• Offer and provide language assistance services, including bilingual staff and interpreters, at no cost to each client/consumer with limited English proficiency at all points of contact in a timely manner during all hours of operation.
• Provide to clients/consumers in their preferred language both verbal offers and written notices informing them of their right to receive language assistance services.
• Ensure the competence of language assistance provided to limited English proficient clients/consumers by interpreters and bilingual staff. Family and friends should not be used to provide interpretation services (except on request by the client/consumer).
• Make available easily understood, client-related materials, and post signage in the languages of the commonly encountered groups and/or groups represented within the service area.
• Develop, implement, and promote a written strategic plan that outlines clear goals, policies, operational plans, and management accountability/oversight mechanisms to provide culturally and linguistically appropriate services.
• Conduct initial and ongoing organizational self-assessments of CLAS-related activities. [Organizations] are encouraged to integrate cultural and linguistic competence-related measures into their internal audits, performance improvement programs, patient satisfaction assessments, and outcomes-based evaluations.
• Ensure that data on the individual client's/consumer's race, ethnicity, and spoken and written language are collected in health records, integrated into the organization's management information systems, and periodically updated.
• Maintain a current demographic cultural and epidemiologic profile of the community as well as a needs assessment to accurately plan for and implement services that respond to the cultural and linguistic characteristics of the service area (the HIV prevention community plan and other sources of relevant information).
• Develop participatory, collaborative partnerships with communities, and utilize a variety of formal and informal mechanisms to facilitate community and client/consumer involvement in designing and implementing CLAS-related activities.
• Ensure that conflict and grievance resolution processes are culturally and linguistically sensitive and capable of identifying, preventing, and resolving cross-cultural conflicts or complaints by clients/consumers.
• Regularly make available to the public information about their progress and successful innovations in implementing the CLAS standards, and provide public notice in (the organization's) communities about the availability of this information.

Making The Interventions Work For Your CBO (Adapting)