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.”

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

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 10-15-20 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

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

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

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

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

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

Components of Systems Assessment April

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

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

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

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

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

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

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

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

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

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

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

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

Application— Stages of Readiness Model Reflection and Dyads April

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

Center for Health Training www.centerforhealthtraining.com Thank You! Alfonso Carlon Project Director/Senior Staff Trainer acarlon@jba-cht.com