1. Reaching New Heights Achieving Cultural Proficiency:
Working with the Changing Populations of Family Planning Clinics
2007 Family Planning Project Director’s Meeting
Austin, Texas
November 13, 2007
Alfonso Carlon
Center for Health Training
April—Introduce CHT and share “The Four Friends.”

2. Center for Health Training June 19, 2007
Learning Objectives
Define culture, cultural proficiency, community proficiency, diversity and parity
Describe the power of a systems approach to cultural proficiency
Explore steps to building organizational cultural capacity
Wendy—By the end of this session, you should be able to…
Center for Health Training June 19, 2007

3. Center for Health Training June 19, 2007
Exercise – Diversity Profile (Pam Wilson, Wilson Consulting Group, 2007)
Silently complete (2 minutes)
Find one person you do not know
Share one item that is very different for you today than years ago
One partner shares for 4 min, while the other listens, then switch when time is called
Center for Health Training June 19, 2007

4. Center for Health Training June 19, 2007
What part of ourselves do we leave at home? What do organizations loose when they do not see, hear or understand this diversity?
Center for Health Training June 19, 2007

5. Center for Health Training June 19, 2007
Definitions
Culture
One’s worldview, values, beliefs, customs and behaviors influenced by one’s race, ethnicity, national origin, primary language, religious beliefs/spirituality, class/socioeconomic status, gender, sexual orientation, age, history, gender identity, geography, etc.
Wendy—During this session, we will be using a number of terms that move beyond the traditional definition of “culture” as race/ethnicity. These terms include “culture,” “cultural proficiency,” “community proficiency,” “diversity” and “parity.” With that in mind, I’d like to ask a few of you to help us review definitions of these terms. These definitions are adapted from those used by APPEAL…Asian Pacific Partners for Empowerment and Leadership.
[Call on participants to read each definition.]
Center for Health Training June 19, 2007

6. Center for Health Training June 19, 2007
Definitions
Cultural Proficiency
Possessing sufficient knowledge, skills, and experience to communicate effectively with and work together with someone from a different culture
Community Proficiency
Evolves from the concept of cultural proficiency and is tied to the history of a community (connected to the current actions you want to take)
Wendy—Before we review definitions of the next two terms, I want to note that we choose to use the term “cultural proficiency,” rather than “cultural competency,” because we feel that word “proficiency” connotes a sense of growth and development in a way that “competency” does not.
Center for Health Training June 19, 2007

7. Center for Health Training June 19, 2007
Definitions
Diversity
Having individuals or organizations of different backgrounds as a part of a group (static make-up of a group, rather than processes).
Parity
Being equal in process and outcomes and having the ability to equally participate in the planning and implementation of key activities, programs and policies
Wendy—Thank you. Now, I’ll turn it over to April to talk about the power of a systems approach.
Center for Health Training June 19, 2007

8. Power of a Systems Approach
Moves beyond cultural proficiency training for board, staff and volunteers
Focuses on organizational components that impact cultural proficiency
Promotes ongoing assessment and staging of recommendations for action
April
Center for Health Training June 19, 2007

9. Components of Systems Assessment
April

10. Terry Cross— Model of Cultural Competency
Offers an organizational and individual framework
Describes cultural competency as movement along a continuum
Can be at different stages of development simultaneously on the continuum
--Terry L. Cross, Towards a Culturally Competent System of Care (Vol. 1), June 1989
April
Center for Health Training June 19, 2007

11. Cultural Competency Continuum
Advanced Competence (Responsibility)
Basic Competence (Integration)
Pre-Competence (Awareness)
Blindness (Denial)
Incapacity
Destructiveness (Intolerance)
Cultural Competency Continuum
April

12. Steps in the Assessment Process
Meet with the organization’s leaders
Collect data and documents
Conduct a management assessment
Conduct staff and volunteer surveys
Conduct client surveys and community assessment
Review results and implement action planning process
Center for Health Training June 19, 2007

13. Case Study: Board Findings
Board has a goal statement that explicitly incorporates a commitment to cultural proficiency.
Staff not aware of Board’s commitment.
Center for Health Training June 19, 2007

14. Center for Health Training June 19, 2007
Case Study: Staff Findings
There were efforts to recruit more diverse staff.
Lack of bilingual staff and no formal interpreter services.
Center for Health Training June 19, 2007

15. Case Study: Client-Level Findings
LaWonderful agency has a client satisfaction survey in English and Spanish.
Center for Health Training June 19, 2007

16. Case Study: Community Findings
Staff identified specific populations they were reaching, but could not identify current organizational community partnerships.
Center for Health Training June 19, 2007

17. Center for Health Training June 19, 2007
Where to go next? Action!
Use a stages of readiness model to develop, launch, and sustain cultural and community proficiency efforts.
Model informed by Prochaska and DiClemente’s “stages of change”
Pre-contemplation
Contemplation
Preparation
Action
Maintenance
April
Center for Health Training June 19, 2007

18. Center for Health Training June 19, 2007
Action!
The key is evaluation of organizational progress from one stage to the next on any of the areas listed in the work plan.
Tracking changes can inform a plan to address cultural proficiency within your organization.
April
Center for Health Training June 19, 2007

19. Stages of Readiness Model
Examples
Pre-Contemplation
Contemplation
Preparation
Action
April—Make flipchart. Insert example.
Center for Health Training June 19, 2007

20. Center for Health Training June 19, 2007
Instructions
Select an issue
Identify the stage of readiness for your organization
Brainstorm strategies
Identify one strategy that will help move your organization to the next stage
April
Center for Health Training June 19, 2007

21. Application— Stages of Readiness Model
Strategy
Pre-Contemplation
Contemplation
Preparation
Action
Maintenance
April—Handout. Use issue from SWOT and plot your issue. Discuss in dyads.
Center for Health Training June 19, 2007

22. Application— Stages of Readiness Model
Reflection and Dyads
April

23. Culture can be vibrant and loud or sometimes quiet and subtle, but it is always there, shaping the ways in which we view the world.
~ Mona Lake Jones ~
April

24. Center for Health Training
Thank You!
Alfonso Carlon
Project Director/Senior Staff Trainer