Family Ties of NevadaMonthly Webinar Series

Thursday, April 12, 2012

Wendy Jones April 12, 2012

CULTURAL COMPETENCE: WHAT DOES IT MEAN FOR FAMILY RESOURCE CENTERS AND

THEIR PARTNERS?

National Center

for Cultural Competence

OBJECTIVES

Slide Source: © 2012 - National Center for Cultural Competence

Participants will:

1. define culture and cultural diversity.

2. describe the multiple dimensions of culture including cultural influences on individuals, groups, and organizations.

3. cite cultural influences on beliefs and practices related to health, mental health, well-being and systems and providers of health and human services.

4. examine and apply these cultural constructs to their respective roles and affiliations.

Culture is……

• Culture is a complex set of shared values, beliefs, understandings, behaviors, language, customs, activities, rites and rituals that guide specific groups of people.

• Culture includes a range of ideas about family, aspects of family life, wellness, disability, child rearing practices, interpersonal relationships and expectations for learning and child development.

• Culture changes over time, and is passed down from one generation to the next.

Slide Source:© 2012 - National Center for Cultural Competence

CultureCulture is an integrated pattern of human behavior which includes but is not limited to:

thought

languages

values

beliefs

customs

practices

courtesies

ritualscommunication

roles

relationships

expectedbehaviors

… of a racial, ethnic, religious, social, or political group; the ability to transmit the above to succeeding generations; dynamic in nature.

manners ofinteracting

Slide Source:© 2012 - National Center for Cultural Competence

Culture

Culture is akin to being the personobserved through a one-way mirror; everything we see is from our ownperspective.

It is only when we join the observed on the other side that it is possible to see ourselves and others clearly – but getting to the other side of the glass presents many challenges.

(Lynch & Hanson 1992 Developing Cross Cultural Competence)

Slide Source: 2012 - National Center for Cultural Competence

Culture … is applicable to all peoples

is active & dynamic

is multi-layered

is viewed as thick, thin, or compartmentalized

exists at conscious and unconscious levels

structures perceptions & shapes behaviors

is a total way of life – tells group members how to behave & provides their identity

Adapted from Vivian Jackson, NCCC, 2003Slide Source:© 2012 - National Center for Cultural Competence

An Iceberg Concept of Culture

dress agegender language race or ethnicity

eye behavior facial expressions

body language sense of self

concept of justice value individual vs. group

notions of modesty concept of cleanliness emotional response patterns rules for social interaction

child rearing practices decision-making processes

approaches to problem solving

perceptions of & beliefs about of mental health, health, illness, disability

patterns of superior and subordinate roles in relation to status by age, gender, class sexual orientation gender identity & expression

and much more…

Adapted by the NCCC

physical characteristics

Slide Source:© 2012 - National Center for Cultural Competence

Are we on the same page?

culturally aware

cultural sensitivity

culturally appropriate

culturally effective

culturally relevantculturally

competent

cultural humility

culturally & linguistically competent

linguistically competent

cultural proficiency

multicultural competence

T.D. GoodeSlide Source:© 2012 - National Center for Cultural Competence

culturally relevant cultural responsiveness

linguistically appropriate

policies

practices

behaviorsstructures

attitudes

…requires that organizations have a clearly defined, congruent set of values and principles, and demonstrate behaviors, attitudes, policies, structures, and practices that enable them to work effectively cross-culturally.

(adapted from Cross, Bazron, Dennis & Isaacs, 1989.

CULTURAL COMPETENCE

Slide Source:© 2012 - National Center for Cultural Competence

Five Elements of Cultural CompetenceINDIVIDUAL LEVEL

acknowledge cultural differences

understand your own culture

engage in self-assessment

acquire cultural knowledge & skills

view behavior within a cultural context

1

2

3

4

5

(Cross, Bazron, Dennis and Isaacs, 1989)Slide Source:© 2012 - National Center for Cultural Competence

1• value diversity

2• conduct self-assessment

3• manage the dynamics of difference

4• institutionalize cultural knowledge

5• adapt to diversity (values, polices, structures & services)

Five Elements of Cultural CompetenceORGANIZATIONAL LEVEL

(Cross, Bazron, Dennis and Isaacs, 1989)Slide Source:© 2012 - National Center for Cultural Competence

Organization culture is …a pattern of shared basic assumptions that the group learned as it solved its problems of external adaptation and internal integration, that has worked well enough to be considered valid and therefore, to be taught to new members as the correct way to perceive, think, and feel in relation to those problems. (Schein, E., 1985)

Slide Source: © 2012 - National Center for Cultural Competence

ESSENTIAL ELEMENTS IN ACULTURALLY COMPETENT SYSTEM

These five elements must be manifested at every level of an organization including:

policy makers administration practice & service delivery patient/family/consumer community

and reflected in its attitudes, structures, policies, practices, and services.

Adapted from Cross, Bazron, Dennis, & Isaacs, 1989

Slide Source:© 2012 - National Center for Cultural Competence

Cultural Destructiveness

CulturalIncapacity

Cultural Blindness

CulturalPre-Competence

CulturalCompetence

CulturalProficiency

Cultural Competence Continuum(Cross, Bazron, Dennis and Isaacs, 1989)

Slide Source:© 2012 - National Center for Cultural Competence

is the capacity of an organization and its personnel to communicate effectively, and convey information in a manner that is easily understood by diverse groups including persons of limited English proficiency, those who are not literate or have low literacy skills, individuals with disabilities, or those who are deaf or hard of hearing

requires organizational and provider capacity to respond effectively to the health literacy needs of populations served

ensures policy, structures, practices, procedures and dedicated resources to support this capacity

Linguistic Competence

Goode & Jones, Revised 2009, National Center for Cultural Competence

Slide Source:© 2012 - National Center for Cultural Competence

Slide Source: National Center for Cultural Competence,2007

Linguistic Competence

Goode & Jones, Revised 2009, National Center for Cultural Competence

bilingual/bicultural or multilingual/multicultural staffcross-cultural communication approachescultural brokersforeign language interpretation services (including distance technologies)sign language interpretation servicemultilingual telecommunication systems Videoconferencing & telehealth technologiesTTY, CART, VRT and other assistive technology devices

Slide Source: National Center for Cultural Competence,2007

Linguistic Competence

Goode & Jones, Revised 2009, National Center for Cultural Competence

materials in alternative formats (e.g. audiotape, Braille, enlarged print)

materials developed and tested for specific cultural groups, ethnic and linguistic groupsethnic media in languages other than English

(e.g. television, radio, Internet, newspapers, periodicals) print materials in easy to read and low literacy formats (e.g. picture and symbol formats)

LINGUISTICCOMPETENCE

POLICY

PRACTICES

STRUCTURES

PROCEDURES

DEDICATED PERSONNELRESOURCES

DEDICATED FISCAL

RESOURCES

LINGUISTIC COMPETENCE FRAMEWORK

Goode & Jones, Revised 2009, National Center for Cultural Competence

Slide Source:© 2011 - National Center for Cultural Competence

Key Values for Cultural Competence

Values and Guiding Principles for Cultural Competence

Cultural competence: embraces the principles of equal access and non- discriminatory practices in service

delivery.

is achieved by identifying and understanding the needs and help-seeking behaviors of individuals and families.

involves working in conjunction with natural, informal support and helping networks within culturally diverse communities.

Source: National Center for Cultural Competence, Foundations/Guiding Values and Principles http://nccc.georgetown.edu/foundations/frameworks.html

Slide Source: National Center for Cultural Competence, 2012

Key Values for Linguistic Competence

Values and Guiding Principles for Linguistic Competence

Services and supports are delivered in the preferred language and/or mode of delivery of the population served.

Written materials are translated, adapted, and/or provided in alternative formats based on the needs and preferences of the populations served.

Interpretation and translation services comply with all relevant Federal, state, and local mandates governing language access.

Consumers are engaged in evaluation of language access and other communication services to ensure for quality and satisfaction.

Source: National Center for Cultural Competence, Foundations/Guiding Values and Principles http://nccc.georgetown.edu/foundations/frameworks.html

Slide Source: National Center for Cultural Competence, 2012

Cultural Diversity and Differing World Views

Cultural Diversity

Goode & Jackson, 2009

The term cultural diversity is used to describe differences in ethnic or racial classification & self-identification, tribal or clan affiliation, nationality, language, age, gender, sexual orientation, gender identity or expression, socioeconomic status, education, religion, spirituality, physical and intellectual abilities, personal appearance, and other factors that distinguish one group or individual from another.

Slide Source: © 2012 - National Center for Cultural Competence

What are the demographic trends in

Slide Source:© 2012 - National Center for Cultural Competence

Religious Affiliations* Nevada

Religious Affiliation Number of Adherents

Evangelical Protestant 107,681

Mainline Protestant 44,187

Orthodox 3,048

Catholic 331,844

Other Includes Jewish Estimate. - 77,100

Includes Muslim Estimate. – 2,291

197,729

Unclaimed by the denominations in this

archive

1,313,768

Source: The Association of Religion Data Archives, 2000 http://www.thearda.com

*Archives188 denominations. Does not include historically African American denominations.

Top 10 Countries of Birth and State of Residence of Permanent Residents in Nevada

MexicoPhilippinesCuba ChinaEthiopia El SalvadorIndiaVietnamGuatemala Canada

2,5862,109 620 571 455 326 279 181 170 167

Data Source: Department of Homeland Security:Profiles of Legal Permanent Residents: Fiscal Year 2010

Total 56,920

Slide Source:© 2012 - National Center for Cultural Competence

Population by Race & Ethnicity in Nevada

Total Population 2,700,551

White

Hispanic or Latino

Black or African American

Asian

American Indian and Alaska Native

Native Hawaiian and Other Pacific Islander

Some other race

Two or more races

Data Source: U.S. Census Bureau, 2010 American FactFinder

Table QT-P4

1,786,688

716,501

218,626

195,436

32,062

16,871

324,793

126,075

Slide Source:© 2012 - National Center for Cultural Competence

Languages Spoken at Home in Nevada

English only 1,797,807

Total other languages 720,129

Speak Spanish or Spanish Creole 503,220

Speak Indo European languages 61,352[French (Patois, Cajun), French Creole, Italian, Portuguese, Portuguese Creole, German, Yiddish, Other West Germanic languages, Scandinavian languages, Greek, Russian, Polish, Serbo-Croatian, Other Slavic languages, Armenian, Persian, Gujarathi, Hindi, Urdu, Other Indic languages]

Speak Asian and Pacific Island languages 137,128[Chinese, Japanese, Korean, Mon-Kymer, Cambodian, Miao, Hmong, Thai, Laotian, Vietnamese, Tagalog, other Pacific Island language]

Other Languages 17,291[Navajo, Other Native American languages, Hungarian, Arabic, Hebrew, African languages, other unspecified languages]

Data Source: U.S. Census Bureau, 2010 American FactFinder

Total Population 5 years and over 2,517,937

Slide Source:© 2012 - National Center for Cultural Competence

What is Linguistic Isolation ?Linguistic Isolation refers to households in which no person over the age of 14 speaks English at least very well

Data Source: U.S. Census Bureau, 2010 American FactFinder Table S1

Linguistically Isolated Households in Nevada

All Households 6.4%

Households speaking --

Spanish 26.5%Other Indo-European languages 14.5%Asian and Pacific Island languages 18.9%Other Languages 27.6%

 

Slide Source:© 2012 - National Center for Cultural Competence

Cultural Factors That Influence Diversity Among Individuals and Groups

Adapted with permission from James Mason, Ph.D., NCCC Senior Consultant

Cultural/Racial/Ethnic IdentityTribal Affiliation/ClanNationalityAcculturation/AssimilationSocioeconomic Status/ClassEducationLanguageLiteracyFamily ConstellationSocial HistoryPerception of TimeHealth Beliefs & PracticesLiteracy

Internal FactorsHealth & Mental Health LiteracyBeliefs about Disability or Mental Health Lived Experience of Disability or Mental Illness Age & Life Cycle IssuesGender, Gender Identity & Expression Sexual OrientationReligion & Spiritual ViewsSpatial & Regional Patterns Political Orientation/Affiliation

Slide Source:© 2012 - National Center for Cultural Competence

Cultural Factors That Influence Diversity Among Individuals and Groups

Institutional BiasesRacism & DiscriminationCommunity EconomicsIntergroup RelationsGroup & Community Resiliency

External Factors

Natural Networks of SupportCommunity HistoryPolitical ClimateWorkforce DiversityCommunity Demographics

Slide Source:© 2012 - National Center for Cultural CompetenceAdapted with permission from James Mason, Ph.D., NCCC Senior Consultant

Superstition Fate or Destiny Karma Malevolent Forces Religiosity & Spirituality Cultural & Familial Folklore

Slide Source:© 2012 - National Center for Cultural Competence

Cultural Beliefs about Health, Mental Health, & Disability

Reliance on traditional remedies and healers

Culture bound syndromes

Delaying access to care Historical mistrust of health care, mental health, education, and social service professionals

Experiences of racism, discrimination, and bias

Cultural and linguistic barriers

Stigma

Cultural Influences on Beliefs and Practices Related to Systems and Providers of Human Services

T.D. Goode

Slide Source:© 2012 - National Center for Cultural Competence

Slide Source:© 2012 - National Center for Cultural Competence

What does cultural competence look like

philosophy

mission statement

policy, structures, procedures, practices

diverse, knowledgeable & skilled workforce

dedicated resources & incentives

community engagement & partnerships

conduct research for and with diverse communities

publish & disseminate

advocacy (disparities, health equity, social justice)

Characteristics of Culturally and Linguistically Competent Organizations and Systems

Slide Source:© 2012 - National Center for Cultural Competence

Cultural Competence:Staff Characteristics, Attributes, Knowledge, & Skills

demonstrate genuine interest

admit & identify areas of growth

willingness & skills to address the dynamics of difference

seek knowledge

Slide Source:© 2012 - National Center for Cultural Competence

T. D. Goode

Cultural Competence:Staff Characteristics, Attributes, Knowledge, & Skills

The capacity to incorporate cultural diversity and cultural competence into your work, such as:

Providing family-centered care

Connecting with families

Providing educational opportunities

Linking families for peer to peer support

Sharing information and making referrals

Supporting self-advocacy efforts

Advising and partnering

Slide Source:© 2012 - National Center for Cultural Competence

T. D. Goode

As a culturally competent _________ I am capable of interacting positively with

people who do NOT

look like,talk like,

think like,believe like,

act like,live like...

ME!!!Source Multnomah County Department of Health.

move like,

Modification from Mike Magy, Massachusetts Department of Mental Health, November 2005 . Slide Source:© 2012 - National Center for Cultural Competence

Cultural competence and linguistic competence

are a life’s journey … not a destination

Safe travels!

T.D. GoodeSlide Source: National Center for Cultural Competence, 2012

CONTACT US

National Center for Cultural Competencehttp://nccc.georgetown.educultural@georgetown.edu

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