The Hospital for Sick Children (SickKids) has been fortunate to have received funding from Citizenship and Immigration Canada to develop cultural competence programming to address health disparities experienced by newcomers to Canada. To ensure that the resources developed through this funding have a broad impact, SickKids would like to share them with other organizations interested in addressing health disparities, promoting cultural competence and health equity, and enhancing the quality of care and service delivered to newcomers.Purpose
The information presented in this Cultural Competence Train-the-Trainer Manual is intended for organizations interested in implementing cultural competence programming. Specifically, educators and others can use the manual as a resource to implement educational programming aimed at enhancing the knowledge and skill of healthcare providers and other health care staff
in providing culturally competent care and service. The manual is designed to orient the educator to specific considerations in the development, implementation and evaluation of a cultural competence education program. The resources in this manual were developed specifically for SickKids but can be adapted to meet the unique needs of any community or social service health care organization.
How can indigenous evaluators implement culturally competent models in First Nations communities while ensuring that government grant evaluation requirements are met? Through describing the challenges in one tribal community in the United States, this article will discuss how American Indian/Alaska Native substance abuse prevention programs are evaluating the implementation and outcomes of Strategic Prevention Framework grants from the federal government’s Center for Substance Abuse Prevention. Requirements for implementing evidence-based programs normed on other populations and for evaluating data based on quantitative methods add to the challenge. Throughout the process, much is being learned that it is hoped will strengthen indigenous grantees and increase the cultural competence of government evaluation requirements. (Contains 2 figures.)
This essay engages questions of evaluator role and indigenous peoples participation in evaluation within colonial and decolonization contexts. Specifically, I critique the Western emphasis on cultural competence and contrast the utility of ‘mainstream’ evaluation approaches alongside three indigenous inquiry models (Te Kotahitanga, Whakawhanaungatanga, and He Taniko) as utilized by/with indigenous Maori in Aotearoa/New Zealand. Using practical examples of evaluation projects conducted with and by Maori, the article highlights the very different ‘evaluation conversations’ happening amongst ‘mainstream’ practitioners—where the focus is on difference, competency, and issues of access—relative to those occurring amongst indigenous evaluators and communities—where evaluation praxis is framed within broader struggles for sovereignty and self-determination. By placing these paradigms in conversation with each other, I highlight the ways in which evaluation approaches that engage indigenous people and places are always representative of particular standpoints. This is because evaluation is unavoidably and simultaneous in dialog with the prevailing contexts of colonization and decolonization vis-a-vis the location and moment in which it occurs. The essay foregrounds the ways in which `mainstream’ evaluation’s preoccupation with issues of cultural competency fails to fully address the needs and aspirations of indigenous peoples. In contrast, the realization of Maori capacity to meet our evaluation needs as Maori, and as represented in the ongoing development and use of our own approaches and models, not only facilitates a more culturally meaningful evaluation process but also concurrently constitutes an expression of our sovereignty and agency.
This tool kit was prepared exclusively for the Ministry of Children and Youth Services by Ruby Lam and Bernice Cipparrone, Diversity Specialists. While the Ministry has attempted to verify the accuracy of the information contained in this tool kit, users should not rely solely on this information to make decisions regarding children and youth in residential care. The content of the tool kit is provided by the Ministry of Children and Youth Services for informational purposes only and should not be taken as advice or recommendations for any particular decision regarding a child or youth in residential care. Use of the tool kit is voluntary. There are web sites linked to and from this tool kit that are operated or created by or for organizations outside of the Government of Ontario. Those organizations are solely responsible for the operation and information (including the right to display such information) found on their respective web sites. These linked web sites may or may not be available in French. The linking to or from this site does not imply on the part of the Government of Ontario any endorsement or guarantee of any of the organizations or information (including the right to display such information) found on their respective web sites. The Government of Ontario does not assume and is not responsible for any liability whatsoever for the linking of any of these linked web sites, the operation or content (including the right to display such information) of any of the linked web sites, nor for any of the information, interpretation, comments or opinions expressed in any of the linked web sites. Any comments or inquiries regarding the linked web sites are to be directed to the particular organization for whom the particular web site is being operated.
What is a lens tool? A lens tool provides a way of applying a special filter to our work. In this case, the lens tool encourages us to apply diversity and inclusion concepts to all we do for patients and their families. The Diversity and Inclusion Lens Tool is a set of questions meant to help staff, physicians, learners and volunteers consider the concepts of diversity, inclusion and equity in the development, revision, implementation and evaluation of programs, policies and practices. Why have a lens tool? When the diversity of our staff, patients and families isn’t considered, our programs, policies and practices may not appropriately serve all of the people for which they are intended. This can lead to mistrust, delayed healing, misunderstanding and a reduced quality of service. In the end, this hurts our communities and all of us1 . What is a lens tool kit? To expand on the above definition… ? A lens tool refers to questions and reflection statements designed to help us take an inclusive and sometimes critical look at what we have been doing, what we want to do and how we want to work. ? A lens tool kit refers to the collection of resources we have compiled, including the following three sections: Lens Tools, Understanding Our Communities and Resources. ? It applies to our services, relationships, programs, policies, strategies and decisions.
Much of program evaluation is concerned with understanding and improving social programs so that they are ultimately more responsive and more reflective of program participant needs. At the same time, these programs exist and are embedded within specific social, cultural and historical contexts which impact program development, implementation, and eventual outcomes. Evaluations that attempt to address responsiveness to contextual and cultural specificity are often referred to as culturally competent, culturally responsive, inclusive, multicultural, or cross-cultural, among other terms. While there are no agreed upon terminologies, definitions, or even methodologies, what these approaches all share is the recognition that culture and context matter, and that there are no universally agreed upon rules or abstractions that can be applicable in all contexts (Guba & Lincoln, 2005). The recognition of culture and context thus becomes ìan explicit criterion rather than an unspoken expectationî (SenGupta, Hopson, & Thompson-Robinson, 2004, p. 15) in evaluations of this type
Cultural Competence aims to foster constructive interactions between members of different cultures. The following is a widely used definition: “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 professionals to work effectively in cross cultural situations” (Cross et al, 1989). The word “culture” implies an integrated pattern of human behavior and the word “competence” implies having the capacity to function effectively. Cultural competence should be viewed as an on-going process. Through this process, individuals develop awareness and knowledge about the value that diversity can bring to an organization and a community. Cultural competence goes beyond “culture as ethnicity” to discover the complexities of individual cultural identities (Cross et al, 1989). A culturally competent organization: Values diversity and incorporates at all levels the importance of culture.
Conducts an assessment of cross-cultural relations.
Is vigilant towards and manages the dynamics of cultural difference.
Expands its cultural knowledge.
Adapts its services to meet the culturally-unique needs of individuals served
(Cross et al, 1989).