Reaching New Heights

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

2. 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 Center for Health Training June 19, 2007

3. 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

4. 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. 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. Center for Health Training June 19, 2007

6. 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) Center for Health Training June 19, 2007

7. 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 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 Center for Health Training June 19, 2007

9. Components of Systems Assessment

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 Center for Health Training June 19, 2007

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

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

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

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

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

17. 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 Center for Health Training June 19, 2007

18. 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. Center for Health Training June 19, 2007

19. Stages of Readiness Model Center for Health Training June 19, 2007

20. 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 Center for Health Training June 19, 2007

21. Application—Stages of Readiness Model Center for Health Training June 19, 2007

22. Application—Stages of Readiness Model Reflection and Dyads

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 ~

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