Displaying empathy and compassion by fostering mutual respect between the worker and the client is the foundation of any Human Services practice. As such, cultural competence is an integral component in this process. Cultural competence encourages the acknowledgement and acceptance of differences in appearance, behavior and culture.
In this field, you will encounter diverse clients from a wide range of backgrounds. Even students who come from diverse neighborhoods will likely come in contact with new cultures as they enter the Human Services field. Those who who have a career in Human Services should make an ongoing effort to increase their cultural competence. Many who enter the field may feel they have a good grasp on these concepts.
However, it is a skill that requires continuous development. Some believe that cultural competence is practiced by merely showing respect to everyone we encounter without considering our own bias. However, it is impossible to be an expert of knowledge in every culture.
Therefore, it is important to admit you are NOT an expert. Always be willing to ask questions with the understanding that you do not nor cannot fully understand the cultures of all the clients you will meet. Cultural competence is a set of congruent behaviors, attitudes, and policies that come together in a system, agency or among professionals and enable that system, agency or those professions to work effectively in cross-cultural situations.
The word culture is used because it implies the integrated pattern of human behavior that includes thoughts, communications, actions, customs, beliefs, values and institutions of a racial, ethnic, religious or social group.
The word competence is used because it implies having the capacity to function effectively. Five essential elements contribute to a system's institution's, or agency's ability to become more culturally competent which include:.
These five elements should be manifested at every level of an organization including policy making, administrative, and practice. Further these elements should be reflected in the attitudes, structures, policies and services of the organization. National Center for Cultural Competence, , modified from Cross et al. Cultural competence requires that organizations:. Cultural competence is a developmental process that evolves over an extended period.
Both individuals and organizations are at various levels of awareness, knowledge and skills along the cultural competence continuum. Betancourt et al. Cultural competence is the demonstrated awareness and integration of three population-specific issues: health-related beliefs and cultural values, disease incidence and prevalence, and treatment efficacy.
But perhaps the most significant aspect of this concept is the inclusion and integration of the three areas that are usually considered separately when they are considered at all. Roberts et al, Cultural competence refers to a program's ability to honor and respect those beliefs, interpersonal styles, attitudes and behaviors both of families who are clients and the multicultural staff who are providing services.
In doing so, it incorporates these values at the levels of policy, administration and practice. Denboba, MCHB, Cultural competence is defined as a set of values, behaviors, attitudes, and practices within a system, organization, program or among individuals and which enables them to work effectively cross culturally. Cultural competence is, ultimately, about valuing diversity for the richness and creativity it brings to society.
We introduce and explore the concepts from the standpoint of Aboriginal and Torres Strait Islander cultures as a first step. The program will be expanded to fully embrace the cultural diversity of the University, our region and the wider international community.
With almost half of all Australians having both parents or one of them born overseas, a growing Aboriginal and Torres Strait Islander population and a range of other factors affecting the cultural makeup of our society, we are living in an increasingly diverse global community. More often, we are being called on to work, learn and teach in situations where there is more than one culture at play. Acquiring the knowledge, skills and experience necessary to operate effectively and ethically in multicultural environments is crucial.
Home About us Our people What is cultural competence? Question 2 What is the effectiveness of interventions to improve culturally appropriate care for LGBTQI adolescents ages , young adult , and adults? Patient intermediate outcomes Improved access to health services Utilization of health services Patient experience and satisfaction, such as improved perceptions of care C. Final health or patient-centered health outcomes, including but not limited to: Improved mental health outcomes, such as depression, substance use Improved medical health outcomes, such as reduction in obesity, metabolic disorders, heart disease, breast cancer Patient health behaviors, such as tobacco use or health seeking behaviors Use of preventive services, and other access to care measures D.
Final health or patient-centered health outcomes, including but not limited to: Improved mental health outcomes, such as depression, substance use Improved medical health outcomes, such as reduction in obesity, kidney disease, heart disease, breast cancer, sickle cell disease D.
Adverse effects; unintended negative consequences of interventions Question 5 What is the effectiveness of organizational or structural interventions for promoting culturally appropriate care for each of the priority populations across providers? Analytic framework for improving cultural competence to reduce disparities in priority populations NOTE: Details of specific outcomes for a specific priority population can be found in Table 1.
Methods A. Table 2. Studies specifically addressing treatment harms may also include retrospective and case series designs. Systematic reviews must include risk of bias assessment with validated tools. Time of Publication Search all literature forward. Cultural competence as a concept and concerned gained traction in the published literature during the early s. Publication type Published in peer reviewed journals, grey literature sourced from governmental or research organizations Language of Publication English B.
Data Abstraction and Data Management Studies meeting inclusion criteria will be distributed among investigators for data extraction. Assessment of Methodological Risk of Bias of Individual Studies Risk of bias of eligible studies will be assessed using instruments specific to study design. Data Synthesis We will summarize the results into evidence tables and synthesize evidence for each unique population, comparison, and outcome combination. Table 3. Intermediate Provider Outcomes Intermediate Patient Outcomes Intermediate organizational outcomes- structural changes and availability of culturally competent healthcare across system Final Patient-Centered Outcomes- improved medical and mental health We will explore second order interactions if literature is identified allowing such examination.
Grading the Strength of Evidence SOE for Major Comparisons and Outcomes The overall strength of evidence for primary outcomes of KQ within each comparison will be evaluated based on four required domains: 1 study limitations risk of bias ; 2 directness single, direct link between intervention and outcome ; 3 consistency similarity of effect direction and size ; and 4 precision degree of certainty around an estimate.
Based on these factors, the overall strength of evidence for each outcome will be rated as: 12 High : Very confident that estimate of effect lies close to true effect.
Few or no deficiencies in body of evidence, findings believed to be stable. Moderate : Moderately confidence that estimate of effect lies close to true effect. Some deficiencies in body of evidence; findings likely to be stable, but some doubt.
Low : Limited confidence that estimate of effect lies close to true effect; major or numerous deficiencies in body of evidence.
Additional evidence necessary before concluding that findings are stable or that estimate of effect is close to true effect. Insufficient : No evidence, unable to estimate an effect, or no confidence in estimate of effect. No evidence is available or the body of evidence precludes judgment.
Assessing Applicability Cultural competence intervention research by definition generally draws on defined priority populations, and very possibly specific subgroups of those priority populations.
Last Accessed May 29, Gregg J, Saha S. Losing culture on the way to competence; the use and misuse of culture in medical education. Academic Medicine. MD, MPH. Prevalence of secondary conditions among people with disabilities. American Journal of Public Health.
Chapter 8: Assessing risk of bias in included studies. The Cochrane Collaboration; Viswanathan M, Berkman ND. Development of the RTI item bank on risk of bias and precision of observational studies. Journal of Clinical Epidemiology.
Using existing systematic reviews to replace de novo processes in conducting Comparative Effectiveness Reviews Agency for Healthcare Research and Quality. Rockville, MD: Review Manager RevMan [Computer program]. Version 5. PMID Methods Guide for Comparative Effectiveness Reviews.
Definition of Terms Not applicable. Summary of Protocol Amendments If we need to amend this protocol, we will give the date of each amendment, describe the change and give the rationale in this section. Key Informants Key informants are the end users of research, including patients and caregivers, practicing clinicians, relevant professional and consumer organizations, purchasers of health care, and others with experience in making health care decisions.
Technical Experts Technical experts constitute a multi-disciplinary group of clinical, content, and methodological experts who provide input in defining populations, interventions, comparisons, or outcomes and identify particular studies or databases to search.
Peer Reviewers Peer reviewers are invited to provide written comments on the draft report based on their clinical, content, or methodological expertise. Role of the Funder This project was funded under Contract No.
Appendixes Appendix A. Prospective Outcome has not occurred at the time the study is initiated and information is collected over time to assess relationships with the outcome. Mixed Studies in which one group is studied prospectively and the other retrospectively. Retrospective Analyzes data from past records. Yes Partially Some, but not all, criteria stated or some not clearly stated.
No 3 Are baseline characteristics measured using valid and reliable measures and equivalent in both groups? Yes No Uncertain Could not be ascertained. Yes Intervention described included adequate service details Partially Some of the above features. No None of the above features. Yes Considering patient characteristics 6 Did researchers isolate the impact from a concurrent intervention or an unintended exposure that might bias results? Yes Accounted for concurrent informal care Partially No 7 Any attempt to balance the allocation between the groups e.
Yes if yes, what was used? No Uncertain Could not be ascertained.
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