Cultural Competence in Community Work Honor and pleasure to be here. Respect for faculty and institution. Sorry I have to leave at 3:30. I must teach tomorrow. I’m here as a non-nurse, a person who is not a nurse, but knows it and knows how important nurses are. Gail Worden at Henry Ford Health System. Noel Chrisman, PhD, MPH University of Washington School of Nursing

Cultural Competence Distinguish between activities that are culturally appropriate and cultural competence. Appropriate: there is a fit between the project (assessment, intervention, evaluation) and community culture. Cultural competence: individual & organizational ability and experience to work productively cross culturally. HSERV 576/NURS 557, Chrisman, Jan 15, 05

Cultural Competence Distinguish between CBPR and cultural competence. CBPR: a style of doing community work that requires working together, power sharing, and capacity building. Cultural competence: individual & organizational ability and experience to work productively cross culturally. HSERV 576/NURS 557, Chrisman, Jan 15, 05

Cultural Competence The researcher and organization should be culturally competent to carry out any kind of community work. Any community project is improved with culturally appropriate activities. A CBPR intervention has a higher likelihood of carrying out the project in culturally appropriate ways because of all the joint planning. It is easier to collaborate with community organizations and members when the researcher and the organization are culturally competent. HSERV 576/NURS 557, Chrisman, Jan 15, 05

Cultural Competence Professional Attitudes, Practice Skills, and System Savvy for Cross Cultural Situations. Chrisman & Zimmer, 2000

CULTURAL COMPETENCE Needed to gain access to and to sustain community relationships. And to develop culturally appropriate interventions, designs, and data gathering techniques. To deal with all this diversity, we need cultural competence. Ask about culture. What is it. It’s not the ballet, the stuff in a petri dish, it’s a way of life. It’s also not race or language. HSERV 576/NURS 557, Chrisman, Jan 15, 05

Respect is an attitude toward others that is grounded theoretically in an acceptance of shared participation in a common moral community, or, at least, of a common humanity. . . A respectful attitude values the core of humanity in the ‘other’ without necessarily admiring or even approving of the beliefs or other differences. I’ve provided the full text of this quote from the first AAN monograph on diversity because I think it’s the essence of what we are trying to accomplish. Lenburg et al., 1995

Culture vs. Cultures Culture: “the total lifeways of a human group. It consists of learned patterns of values, beliefs, customs, and behaviors that are shared by a group of interacting individuals...a set of rules or standards for behavior.” (Tripp-Reimer) Cultures: Groups of people who share a common culture. HSERV 576/NURS 557, Chrisman, Jan 15, 05

Culture vs. Cultures: Implications Behaviors might be cultural with norms and values supporting the behaviors at home. (Vs. psychological with less support.) To know customs or values from specific cultures allows you to work with and within the cultural patterns of the community. HSERV 576/NURS 557, Chrisman, Jan 15, 05

Central Elements of Culture: Custom Assess for customs. Ensure that customs such as interaction style are included in the plan. HSERV 576/NURS 557, Chrisman, Jan 15, 05

Central Elements of Culture: Custom Assess for customs. Ensure that customs such as diet, are included in the plan. HSERV 576/NURS 557, Chrisman, Jan 15, 05

Central Elements of Culture: Custom Assess for customs. Ensure that customs such as religious practices are included in the plan. HSERV 576/NURS 557, Chrisman, Jan 15, 05

Central Elements of Culture: Custom Assess for customs. Ensure that customs such as organizational patterns are included in the plan. HSERV 576/NURS 557, Chrisman, Jan 15, 05

Central Elements of Culture: Beliefs Assess for beliefs. Ensure that community activities are congruent with beliefs in the supernatural. HSERV 576/NURS 557, Chrisman, Jan 15, 05

Central Elements of Culture: Beliefs Assess for beliefs. Ensure that community activities are congruent with beliefs: about causes of illness, about healthy behaviors. HSERV 576/NURS 557, Chrisman, Jan 15, 05

Central Elements of Culture: Values Assess for values. Ensure that community activities reflect people’s values; e.g., interdependence, family solidarity, nature of men and women. HSERV 576/NURS 557, Chrisman, Jan 15, 05

Principles of Cultural Competence in Community Partnerships Listen for and integrate community concerns. HSERV 576/NURS 557, Chrisman, Jan 15, 05

Principles of Cultural Competence in Community Partnerships Understand and integrate community values HSERV 576/NURS 557, Chrisman, Jan 15, 05

Principles of Cultural Competence in Community Partnerships Learn and integrate cultural perspectives (beliefs) on health problems. HSERV 576/NURS 557, Chrisman, Jan 15, 05

Principles of Cultural Competence in Community Partnerships Recognize and integrate institutional and geographic expressions of concerns, values, and beliefs. HSERV 576/NURS 557, Chrisman, Jan 15, 05

Principles of Cultural Competence in Community Partnerships Identify and work closely with community leaders. HSERV 576/NURS 557, Chrisman, Jan 15, 05

Principles of Cultural Competence in Community Partnerships Identify and work closely with community leaders.

Common Organizational Schemes for Community Feedback Advisory Board/Steering Committee -offers advice -range of power and control HSERV 576/NURS 557, Chrisman, Jan 15, 05

Common Organizational Schemes for Community Feedback Broker, like Seattle Partners Grass roots committee Focus groups/surveys/other assessment HSERV 576/NURS 557, Chrisman, Jan 15, 05

Common Organizational Schemes for Community Feedback Town Meetings HSERV 576/NURS 557, Chrisman, Jan 15, 05

Examples of Strategies for Cross Cultural Community Practice Community or Organizational Board. Partner with Community Organizations and Agencies (e.g., churches, grocery stores, ethnic health agencies, newspapers). Recruit Researchers who are Linguistically, Culturally, and Ethnically Similar to the Study Population. Local Health Advisors. HSERV 576/NURS 557, Chrisman, Jan 15, 05

Examples of Strategies for Cross Cultural Community Practice Create Awareness Campaigns, Health Education Materials, and Media Approaches in the Local Language. Use or Create Local Literature (e.g., cookbooks, activity maps, resource lists) Incorporate Cultural Symbols in ALL Research Documents and Offices. You Must have a Culturally Competent Organization! HSERV 576/NURS 557, Chrisman, Jan 15, 05

ORGANIZATIONAL CULTURAL COMPETENCE Multicultural Mission/Goals Diversity in Hiring, Retention, Promotion Valuing and Managing Diversity Permeable Boundaries with the Community Chrisman & Schultz, 1997

Workshops for Organizational Cultural Competence Valuing Diversity Workshops for All Clinical Cultural Competence for Clinicians and Interventionists Managing Diversity for Administrators and Managers Visioning a Multicultural Organization Community and Interorganizational Partnerships Noel Chrisman 2002

MULTICULTURAL COMPETENCIES Understand and value diversity. Ability to manage workforce diversity. Clinical cultural competence. Community partnership skills (communities and organizations). We will now review a variety of ways to achieve these competencies. HSERV 576/NURS 557, Chrisman, Jan 15, 05

Colin Judson Chrisman Age 1 ½. We will now review a variety of ways to achieve these competencies. Colin Judson Chrisman Age 1 ½. HSERV 576/NURS 557, Chrisman, Jan 15, 05