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Technical Assistance Bulletin

Following Specific Guidelines Will Help You Assess Cultural Competence in Program Design, Application, and Management

September 1994

In order for prevention programs to be effective, they must acknowledge and incorporate the culture of the service recipients that they are trying to reach. Programs that are applying for funding, or existing projects that are being evaluated, must be measured by how appropriately they address culture in their design and implementation. However, it is difficult to evaluate the cultural elements of a program because, unlike other areas of evaluation, there have been few guidelines offered to assess these elements.

The knowledge base on managing and evaluating programs and preparing grant applications continues to expand. Evaluators generally consider factors such as cost effectiveness, replicability, possibility of linkages with other programs, potential impact, and content quality when assessing a program's efficacy. While these considerations have become standard, the important aspects of culture are often omitted from the assessment process.

To address this need, this bulletin presents seven indicators or guidelines to assist you in developing or assessing the cultural competence of prevention programs. These guidelines will be useful for evaluators who are assessing existing programs or grant application as well as for individuals who are developing prevention programs. Although these guidelines were developed specifically to assess alcohol, tobacco, and other drug (ATOD) problem prevention programs, they can also be used to help assess the cultural competence of other kinds of programs.


Why Consider Culture?

Culture provides people with a design for living and for interpreting their environment.

Culture has been defined as "the shared values, traditions, norms, customs, arts, history, folklore, and institutions of a group of people." Culture shapes how people see their world and structure their community and family life. A person's cultural affiliation often determines the person's values and attitudes about health issues, responses to messages, and even the use of alcohol, tobacco, and other drugs.

A cultural group consciously or unconsciously shares identifiable values, norms, symbols, and ways of living that are repeated and transmitted from one generation to another.

Race and ethnicity are often thought to be dominant elements of culture. But the definition of culture is actually broader than this. People often belong to one or more subgroups that affect the way they think and how they behave. Factors such as geographic location, lifestyle, and age are also important in shaping what people value and hold dear.

Organizations that provide information services to diverse groups must understand the culture of the group that they are serving, and must design and manage culturally competent programs to address those groups.


Culturally Competent Programs

Cultural competence refers to a set of academic and interpersonal skills that allow individuals to increase their understanding and appreciation of cultural differences and similarities within, among, and between groups. This requires a willingness and ability to draw on community-based values, traditions, and customs and to work with knowledgeable persons of and from the community in developing targeted interventions, communications, and other supports.

A culturally competent program is one that demonstrates sensitivity to and understanding of cultural differences in program design, implementation, and evaluation. Culturally competent programs:

  • Acknowledge culture as a predominant force in shaping behaviors, values, and institutions

  • Acknowledge and accept that cultural differences exist and have an impact on service delivery

  • Believe that diversity within cultures is as important as diversity between cultures

  • Respect the unique, culturally defined needs of various client populations

  • Recognize that concepts such as "family" and "community" are different for various cultures and even for subgroups within cultures

  • Understand that people from different racial and ethnic groups and other cultural subgroups are usually best served by persons who are a part of or in tune with their culture

  • Recognize that taking the best of both worlds enhances the capacity of all.

Guidelines for Assessing a Program's Cultural Competence

A careful consideration of the following guidelines or indicators can help you in developing, implementing, and evaluating the cultural aspects of a prevention program.

These guidelines or indicators have been designed to raise awareness and to stimulate thinking about the important role that culture plays in successful prevention programs and activities. They should be expanded and tailored to your prevention program or organization.

Organizations that are engaged in prevention activities must often balance money, staff, and time. Following guidelines such as these may seem too expensive and time consuming. These problems may not be easy to solve and may require dedicated and creative solutions. But it is well worth the effort because a culturally competent program and organization will help to create strong and sound prevention efforts.

Experience or Track Record of Involvement With the Target Audience

The sponsoring organization should have a documented history of positive programmatic involvement with the population or community to be served. The organization's staff, its board, and volunteers should have a history of involvement with the target population or community to be addressed that is verifiable by the general cultural group and by the specific community to be served.

Training and Staffing

The staff of the organization should have training in cultural sensitivity and in specific cultural patterns of the community proposed for services. Staff should be identified who are prepared to train and translate the community cultural patterns to other staff members.

There should be clear cultural objectives for staff and for staff development. These objectives can be demonstrated by a staff training plan that:

  • Increases and/or maintains the cultural competency of staff members

  • Clearly articulates standards for cultural competency, including credibility in hiring practices, and calls for periodic evaluations and demonstration of the cultural and community-specific experience of staff members.

Emphasis should be placed on staffing the initiative with people who are familiar with, or who are themselves members of, the community to be served.

Community Representation

The community targeted to receive services should be a planned participant in all phases of program design. There should be an established mechanism to provide members of the target group with opportunities to influence and help shape the program's proposed activities and interventions. A community advisory council or board of directors of the organization (with legitimate and working agreements) with decision-making authority should be established to affect the course and direction of the proposed program. Members of the targeted cultural group should be represented on the advisory council and organizational board of directors. The procedures for making contributions or changes to the policies and procedures of the project should be described and made known to all parties.

Language

If an organization is providing services to a multilinguistic population, there should be multilinguistic resources, including use of skilled bilingual and bicultural translators whenever a significant percentage of the target community is more comfortable with a language other than English. There should be printed and audiovisual materials sufficient for the proposed program. If translations from standard English to another language are to be used, the translation should be done by individuals who know the nuances of the language as well as the formal structure. All translations should be carefully pretested with the target audience.

Materials

It should be demonstrated that audiovisual materials, PSA's, training guides, print materials, and other materials to be used in the program are culturally appropriate or will be made culturally consistent with the community to be served. Pretesting with the target audience and gatekeepers should provide feedback from community representatives about the cultural appropriateness of the materials under development.

Evaluation

Program evaluation methods and instruments should be consistent with the cultural norms of the group or groups being served. There should be a rationale for the use of the evaluation instruments that are chosen, including a discussion of the validity of the instruments in terms of the culture of the specific group or groups targeted for interventions. If the instruments have been imported from another project using a different cultural group, there should be adequate evaluation and/or revision of the instruments so that they are now demonstrably culturally specific to the target group(s). The evaluators should be sensitized to the culture and familiar with the culture whenever possible and practical.

Implementation

There should be objective evidence/indicators that the organization understands the cultural aspects of the community that will contribute to the program's success and knows how to recognize and avoid pitfalls.

Glossary of Key Terms

Culture: The shared values, traditions, norms, customs, arts, history, folklore, and institutions of a group of people that are unified by race, ethnicity, language, nationality, or religion.

Cultural Competence: A set of academic and interpersonal skills that allows individuals to increase their understanding and appreciation of cultural differences and similarities within, among, and between groups. This requires a willingness and ability to draw on community-based values, traditions, and customs and to work with knowledgeable persons of and from the community in developing targeted interventions, communications, and other supports.

Cultural Group: A group of people who consciously or unconsciously share identifiable values, norms, symbols, and some ways of living that are repeated and transmitted from one generation to another.

Cultural Diversity: Differences in race, ethnicity, language, nationality, or religion among various groups within a community, organization, or nation. A Community is said to be culturally diverse if its residents include members of different groups.

Cultural Sensitivity: An awareness of the nuances of one's own and other cultures.

Culturally Appropriate: Demonstrating both sensitivity to cultural differences and similarities and effectiveness in using cultural symbols to communicate a message.

Ethnic: Belonging to a common group -- often linked by race, nationality, and language -- with a common cultural heritage and/or derivation.

Language: the form or pattern of speech -- spoken or written -- used by residents or descendants of a particular nation or geographic area or by any large body of people. Language can be formal or informal and includes dialect, idiomatic speech, and slang.

Multicultural: Designed for or pertaining to two or more distinctive cultures.

Race: A socially defined population that is derived from distinguishable physical characteristics that are genetically transmitted.


Please feel free to be a "copy cat" and make all the copies you want. You have our permission!

Developed and Produced by the CSAP Communications Team.
Patricia A. Wright, Ed.D., Managing Editor.
Distributed by the National Clearinghouse for Alcohol and Drug Information, P.O. Box 2345, Rockville, MD 20852.

This bulletin is one in a series developed to assist programs that are working to prevent alcohol, tobacco, and other drug problems. We welcome your suggestions regarding information that may be included in future bulletins. For help in learning about your audience, developing messages and materials, and evaluating communications programs, contact the CSAP Communications Team, 7200 Wisconsin Avenue, Suite 500, Bethesda, MD 20814-4820, (301) 941-8500.
 
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