Cultural Competency for Health Science Librarians

1. Cultural Competency for Health Science Librarians Nancy Ottman Press May 24, 2006

2. Cultural Competency A competency based on the premise of respect for individuals and cultural differences, and an implementation of a trust-promoting method of inquiry.(Durham, M., 2002.)

5. I Don’t Know • I don’t know as much about anybody as that person knows about him or herself • I never will • I don’t know as much about a group of people different from my own as that group knows • I never will • I have to believe people when they tell me about themselves

7. Without knowing and without judging… can you make a personal connection?

9. A Collaboration That Worked • African Americans Reach and Teach Health Ministry (AARTH) • Mars Hill Graduate School Library (MHGS) • RML that encourages collaborations between libraries and community-based organizations

10. AARTH Ministry A faith-based nonprofit established to help build the capacity of faith houses and institutions that serve people of African descent through: • Health education and training • Compassionate service • Access to health resources • Self-advocacy for better health care systems

11. Mars Hill Graduate School Library • Evangelical graduate school that combines faith and health, specializing in counseling and ministry • 90% of students and 100% faculty are Caucasian • School hopes to increase its diversity and have greater connection to the Seattle community • Librarian trying to encourage breadth of thought in graduate students

12. AARTH Ministry – MHGS Library Collaboration • Received two NN/LM awards – the first faith-based outreach awards • AARTH was the primary agency, NOT the library • Goal: to increase the capacity of African American faith communities to share and provide health information

13. What Do I Do? • Ask lots of questions about what information is needed • Look for culturally relevant health information on the web on topics of interest (AIDS, diabetes, etc.) • Made up web pages for health topics • Continue to maintain AARTH web site • Help write grant applications

14. What Do I Do? • Teach classes with health ministry representatives from churches • Find answers to specific reference questions • Sold tickets at a Zimbabwean concert • Attended African American Legislative Day in the Washington State Capitol

15. What Did I Do? • Prayed during the African American Church Week of Prayer for the Healing of AIDS • Serve on the AARTH Board as secretary • Do NOT provide direct service to communities

16. Challenges for Librarian • I don’t know much about African Americans • There’s a history of Black-White relations • Trust took a long time to build • I wasn’t in control; I was follower, not leader • My institution was supportive of me, but uninvolved • I’m not good at picking up verbal and unspoken clues

17. Opportunities for Librarian • Work with groups I never imagined I’d be able to • Have the opportunity to ask questions—to learn • Was more widely welcome since the CBOs goals were up front • Library’s work was spread by others • My institution gained experience and connections

18. Shared Concerns and Beliefs • Concern over health disparities • Belief that information leads to better choices and can improve health • Concern over the lack of culturally appropriate health information • Belief that faith communities have a responsibility for health • Concern that faith communities don’t yet have enough capacity to provide and share health information • Belief that prayer isn’t enough; action is necessary

19. Personal ConnectionI and Thou • Ask questions—ask for advice • Find something you can offer that will be personally useful to the other person • Explain what you want; be transparent in your motives • Discover shared concerns, beliefs, values • Enter the world of the other person • Share experiences • Allow time for trust to develop

21. Reviewing the Literature Cultural competency literature comes mainly from the fields of healthcare, social work, psychology and education, not librarianship.(Press, N. & Diggs-Hobson, M., 2005)

22. Developmental Model of Intercultural Sensitivity • Denial • Defense • Minimization • Acceptance • Adaptation • Integration (Trader-Leigh, K., 2002)

23. Denial • An individual’s own culture is experienced as the only real culture • Other cultures are avoided • There is no interest in cultural difference

24. U.S. Population 1990-2000 • 58% increase - Latino/Hispanic • 50% increase - Asian American/Pacific Islanders • 16% increase – African Americans • 15.5% increase – American Indian/Alaska Native • 7.3% increase – Caucasian People of color now over 30% of population

25. Defense • An individual’s own culture is the only good one • World is viewed as “us” and “them”—we are superior • Critical of other cultures • Defensive, even threatened, by cultural differences

26. “Then it’s good that we’re in the old U.S. of A.” --quote from a Caucasian strategic planning consultant

27. Minimization • An individual’s own cultural world is universal • Deep cultural differences are obscured, trivialized or romanticized

28. “I don’t think race is all that important. I simply see each person as an individual, not as a member of a racial group.” --quote from a member of a diversity task force

29. Acceptance • An individual’s own culture is experienced as one of many equally complex worldviews • Acceptance, however, does not mean agreement • There is a curiosity about and a respect for differences

30. “I don’t remember seeing discrimination against Koreans in Seattle, but Abbie told me that she has experienced discrimination. I guess I haven’t been aware. I find it so interesting to talk with Abbie about it.” • --Quote from a library staff member

31. Adaptation • Experiencing another culture results in perceptions and behavior appropriate to that culture • Worldview expands to include other worldviews • Possible to look at the world through the eyes of others • Adapts behavior to communicate more effectively

32. I look to my church for health information • It’s important for my whole body to be buried so I can’t donate organs, even after death • When the pastor is praying, I voice the agreement I feel • No reporters came to our press conference on health disparities; they just want flashy stories like Black-on-Black violence • I feel that recent African immigrants to the U.S. look down on me. • If I participate in a clinical trial, how can I be sure I won’t be treated as a guinea pig?

33. Integration • Able to move in and out of different cultural worldviews • Adapts easily to situations that demand intercultural competence

34. Librarians are Ready • We already accept our patron’s needs as important • We already know how to question to find out more about what someone else needs • We know we don’t know everything • We have curiosity • We aren’t as threatening as other professions

35. The Culturally Competent Librarian Attitude • Is becoming culturally aware and sensitive to his or her own heritage, along with the cultural heritage of others. • Can conduct self-assessment and is aware of how his or her own values, biases, attitudes, and beliefs may affect different or minority patrons. • Is comfortable with differences that exist between the librarian and patrons.

36. The Culturally Competent Librarian • The culturally competent librarian values: Individual identity: what makes individual unique. Group identity: reference base that may incorporate family, race, ethnicity, gender, religion, age, etc. Universal identity: common aspects that all share as human beings.

37. The Culturally Competent Librarian II. Knowledge • Seeks to possess specific knowledge and information about the particular group with which he or she is working. • Seeks to understand the sociopolitical system with respect to its treatment of minorities.

38. The Culturally Competent Librarian • Has knowledge and understanding of characteristics of information-seeking and information use. • Is aware of institutional barriers that prevent minorities from gaining information.

39. The Culturally Competent Librarian III. Skills • Generates, sends, and receives a wide variety of verbal and non-verbal responses. • Develops and implements institutional strategies in partnership with communities, including: setting goals, assessing need, developing a diverse work force, and evaluating services. • Can incorporate his or her values and knowledge in policy making, practice, administration, and service delivery.

40. The Culturally Competent Librarian • Is able to play partner roles: consultant- serving as resource person outreach- moving out of libraries and into patrons’ communities ombudsman- accompanying partners and patrons through bureaucratic mazes and procedures facilitator of indigenous support systems- structuring activities to supplement, not supplant, existing information-seeking systems.

41. Practically Speaking… • Distinguish between behaviors that are crazy/wrong/rude and those that result from oppression and survival. • Don’t personalize suspicions of your motives. • Monitor your own reactions and question your own beliefs.

42. Practically Speaking… • Your credentials might not be enough to. Your trustworthiness may be tested. Factors like authenticity, sincerity and openness might be more important than credentials. • You might not be the best person to serve the patron. Consider options. (Sue, D.W. & Sue, D., 2002)

43. AARTH Board Members

45. Nancy Ottman Press pressno@speakeasy.net

47. Cultural Competency Continuum Model • Cultural Destructiveness • Cultural Incapacity • Cultural Blindness • Cultural Pre-Competence • Basic Cultural Competence • Advanced Cultural Competence (Taylor, C. ,1994)

48. Advanced Cultural Competence • Seek knowledge • Develop skills to interact in diverse environments (real engagement) • Actively educate less-informed individuals about cultural differences • Act as change agents • Are comfortable interacting in multicultural settings • Champion diversity

49. Cultural Destructiveness • View culture as a problem • Believe people should be more like the “mainstream.”

50. Cultural Incapacity • Lack cultural awareness and skills • Believe in racial superiority of dominant group, paternalistic to others • Brought up in a homogenous society and therefore behave in ways that don’t recognize systematic inequities • Have never questioned inequities