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Planning, Implementing and Evaluating Culturally Competent Service Delivery Systems in Primary Health Care Settings

Implications for Policy Makers and Administrators


Tawara D. Goode - National Center for Cultural Competence
3307 M Street, NW, Suite 401, Washington, D.C. 20007-3935
202-687-5387 * 800-788-2066 (voice) * 202-687-8899 (fax) * cultural@georgetown.edu

This checklist was developed by the National Center for Cultural Competence (NCCC). It is designed to assist programs and organizations which are concerned with the delivery of primary and community-based health care, to begin strategic development of policies, structures, procedures and practices that support cultural and linguistic competence. It is also designed to support the campaign launched by the Bureau of Primary Health Care, "Zero Disparities and One Hundred Percent Access".

Nationally, health care programs and organizations are struggling with the challenges and opportunities to respond effectively to the needs of individuals and families from racially, ethnically, culturally and linguistically diverse groups. There is no one method for getting started on the journey towards cultural competence. Individuals and programs/organizations may embark on this journey at different points of departure with different estimated times of arrival for achieving specific goals and outcomes. Health and human service organizations and their personnel are at various levels of awareness and stages along the cultural competence continuum. Few have evolved to a degree of proficiency in which they systematically incorporate culturally competent principles and practices into the policy making, administrative, practice/service delivery and consumer levels. This checklist provides guidance for getting started.

  • Convene a cultural competence committee, work group or task force within your program or organization. This group should have representation from policy making, administration, practice/service delivery and consumer levels and reflect the diversity within the program or organization and the community at large. The group can serve as the primary body for planning, implementing and evaluating organizational cultural competence initiatives.

  • Ensure that the program's or organization's mission statement commits to cultural competence as an integral component of all of its activities. The mission statement should articulate principles, rationale and values for culturally and linguistically competent health care service delivery. The cultural competence work group should be involved in or facilitate the development of this statement.

  • Determine the racially, ethnically, culturally and linguistically diverse groups within your geographic locale served by your program or organization. Assess the degree to which these groups are accessing services and the level of satisfaction with the services received.

  • Determine what percentage of the population that resides in the geographic locale served by your program or organization is affected by the following six health disparities: cancer, cardiovascular disease, infant mortality, diabetes, HIV/AIDS, and child and adult immunizations. Collaborate with consumers, community-based organizations and informal networks of support to develop approaches for delivering preventive health messages in a culturally and linguistically competent manner. This collaborative process can help to inform your program or organization of adaptations to service delivery that respond to the needs and interests of diverse populations.

  • Conduct a comprehensive program or organizational cultural competence self-assessment. Determine which instrument(s) and or consultant(s) best match the needs and interests of your program or organization. Use the self-assessment results to develop a long-term plan, with measurable goals and objectives, strategies and fiscal resources. This plan should allow for the incorporation of cultural and linguistic competence into all aspects of your program or organization. This may include, but is not limited to, changes in the following: mission statement, policies, procedures, program administration, staffing patterns, position descriptions, personnel performance measures, professional development, pre-service and inservice training activities, service delivery practices, strategies for outreach, telecommunications and information dissemination systems.

  • Conduct an assessment of staff to determine their perceived staff development needs that will enable them to provide services to racially, ethnically, culturally and linguistically diverse groups.

  • Convene focus groups or use other approaches to solicit consumer input on professional or staff development needs related to the provision of culturally and linguistically competent health care.

  • Network and dialogue with other programs or organizations, concerned with primary and community-based health care, that have begun the journey towards developing, implementing and evaluating culturally competent service delivery systems. Adapt their processes, policies and procedures and other information to meet your program's or organization's needs and interests. Encourage partnerships and establish mechanisms to share training resources at the local, state or regional levels.

  • Seek resources from federally and privately funded technical assistance centers that catalog information on cultural and linguistic competence, primary health care, and health care issues specific to racially, ethnically, culturally and linguistically diverse groups (e.g., treatment, interventions, how to work with natural healers, outreach approaches, consumer education programs etc).

  • Convene informal brown bag lunches or other forums to engage program or organization personnel in discussions and activities that offer an opportunity to explore attitudes, beliefs and values related to cultural diversity and cultural and linguistic competence.

  • Identify and include budgetary expenditures each fiscal year for resource development and professional development through participation in conferences, workshops, colloquia and seminars on cultural and linguistic competence and other issues related to primary and community-based health care.

  • Gather and categorize resource materials related to primary health care and culturally diverse groups for use as references by program or organization personnel.

  • Build and utilize a network of natural helpers, community informants and other "experts" who have knowledge of the racially, ethnically, culturally and linguistically diverse groups served by your program or organization.

  • Network with advocacy organizations concerned with specific health care, social and economic issues impacting racially, ethnically, culturally and linguistically diverse communities. Solicit their involvement and input in the design, implementation and evaluation of primary and community-based health care service delivery initiatives at the local, state, regional and national levels.

RESOURCES

Monographs

  • Building Cultural Competence: A Blueprint for Action (1995). Washington State Department of Health, Division of Community & Family Health.

  • Diversity Journal, (1997). Harvard Pilgrim Health Care, Inc., Brookline, MA

Web Sites

About the National Center for Cultural Competence

The National Center for Cultural Competence (NCCC) is a funded project of the Health Resources and Services Administration (HRSA). The project is a collaboration between: the Maternal and Child Health Bureau's (MCHB) Division of Services for Children and Youth with Special Health Needs and its Infant and Child Health Branch; and the Bureau of Primary Health Care (BPHC). The mission of the NCCC is to increase the capacity of health care programs to design, implement and evaluate culturally competent service delivery systems. The NCCC is focusing on HRSA funded programs including: 1) Maternal and Child Health Title V programs concerned with Children and Youth with Special Health Needs and their families; 2) primary health care programs such as Community Health Centers, Migrant Health Centers, Health Care for the Homeless Grantees, Healthy Schools, Healthy Communities Grantees, Primary Care Associations and Primary Care Offices; and 3) programs supporting families affected by Sudden Infant Death Syndrome and Other Infant Death.

The NCCC is a component of the Georgetown University Center for Child and Human Development (also known as Georgetown University Child Development Center), Center for Child Health and Mental Heath Policy, and is housed within the Department of Pediatrics of the Georgetown University Medical Center. For additional information contact the NCCC as listed below.
Permission is granted to reproduce this document for distribution. The only requirement is that proper credit be given to the National Center for Cultural Competence and the author.

Tawara D. Goode - National Center for Cultural Competence
3307 M Street, NW, Suite 401, Washington, D.C. 20007-3935
202-687-5387 * 800-788-2066 (voice) * 202-687-8899 (fax) * cultural@georgetown.edu

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