Transcript Document

Reaching a Culturally Diverse Community
Barri Burrus, Ph.D., Phillip Graham, DrPH, Maria Girlando; BA
Linda Bailey Stone, MS; Mary Council, BA - RTI International
Presented at the
North Carolina’s
Health & Wellness Trust Fund’s
Annual Meeting
October 23, 2009
Greensboro, NC
www.rti.org
RTI International is a trade name of Research Triangle Institute
Overview
•
•
•
•
•
Introduction to RTI team
Session approach
Defining the terms
Highlights on cultural tailoring
Working within the community setting
www.rti.org
What Do We Mean By “Culture”
Examples from Merriam Webster:
• the customary beliefs, social forms, and material
traits of a racial, religious, or social group; the set of
shared attitudes, values, goals, and practices that
characterizes an institution or organization
• the integrated pattern of human knowledge, belief,
and behavior that depends upon the capacity for
learning and transmitting knowledge to succeeding
generations
• the set of values, conventions, or social practices
associated with a particular field, activity, or societal
characteristic
www.rti.org
Breaking Down the Definition
• The customary beliefs, social forms, and material
traits of a racial, religious, or social group; the set of
shared attitudes, values, goals, and practices that
characterizes an institution or organization
– Culture is not just determined by race and ethnicity…also
has religious culture, regional culture, youth culture, etc.
– Although culture is viewed from a group perspective, the
blending of all of the different components in an individual
contributes to that person’s individuality
www.rti.org
Breaking Down the Definition (cont.)
• The integrated pattern of human knowledge, belief,
and behavior that depends on the capacity for
learning and transmitting knowledge to succeeding
generations
– Culture is a learned phenomenon rather than a biological or
fixed characteristic
– Cultures evolve over time
• Examples: ethnic groups, youth cultures
www.rti.org
Breaking Down the Definition (cont.)
• The set of values, conventions, or social practices
associated with a particular field, activity, or societal
characteristic
– Cultural lenses include many different aspects that influence
a person’s “world” view
– Cultural lenses can’t be determined by looking at the person
www.rti.org
Examples of Possible Cultural Components
at the Individual Level
Age Group
Geographic
Region
Peer Group
Religious Belief
System
SES Status
Ethnic
Affiliation
www.rti.org
Diversity
• Diversity―composed of distinct or unlike elements or
qualities (Merriam Webster)
• Example: Diverse cultures
www.rti.org
Cultural Diversity
www.rti.org
Cultural Relativism
• Ethnicity refers to selected cultural and sometimes physical
characteristics used to classify people into groups or categories
considered to be significantly different from others. Commonly
recognized American ethnic groups include American Indians,
Latinos, Chinese, African Americans, European Americans,
etc.
• Cultural relativism: judging and interpreting the behavior and
beliefs of others in terms of their own cultural traditions and
experiences. This suspension of one’s own ethnocentric views
is necessary in order to begin to truly understand another
culture or ethnic group.
Source: http://anthro.palomar.edu/ethnicity/ethnic_1.htm
www.rti.org
Implications for Interventions: Some Do’s
and Don’ts
• Don’t generalize by “race,” “culture,” or “ethnic”
characteristics
• Do seek to understand the cultural context in your
communities
• Do focus on commonalities for your community
• Do continue to focus on priority population groups
• DO focus on the “culture” of youth at risk
• DO focus on the “culture” of youth at risk within
priority groups
www.rti.org
Culturally Tailored Interventions
 The extent to which ethnic/cultural characteristics,
experiences, norms, values, behavioral patterns, and
beliefs of a target population as well as relevant
historical, environmental, and social forces are
incorporated in the design, delivery, and evaluation of
targeted health promotion materials and programs.

Resnicow, K., Baranowski, T., Ahluwahlia, J. S. and Braithwaite, R. L. (1999) Cultural sensitivity
in public health: defined and demystified. Ethnicity and Disease, 9, 10–21
12
www.rti.org
Keys for Reaching Cultural Diverse Groups
Cultural
competence of
team members
• We are committed to ensuring culturally competent
approaches by developing culturally diverse teams
that are reflective of the priority populations with
whom we are working.
Inclusivity
• Members of the priority population group to be
served should be included in the planning and
implementation process to help guide what is to be
done and how it is to be accomplished.
Cultural
appropriateness
of the
intervention
www.rti.org
• The intervention is occurring within a community
setting and in a unique cultural context. The
intervention activities should be respectful of, and
sensitive to that context.
Culturally tailored programs
 The extent to which ethnic/cultural characteristics,
experiences, norms, values, behavioral patterns, and
beliefs of a target population as well as relevant
historical, environmental, and social forces are
incorporated in the design, delivery, and evaluation of
targeted health promotion materials and programs.

Resnicow, K., Baranowski, T., Ahluwahlia, J. S. and Braithwaite, R. L. (1999) Cultural sensitivity
in public health: defined and demystified. Ethnicity and Disease, 9, 10–21
14
www.rti.org
August 2009
Cultural tailoring
Hire knowledgeable
and culturally
competent staff
Document effective
recruitment and
retention strategies
Conduct formative
research
Identify the
community’s
priorities
Field test materials
Design services
/materials
specifically for
targeted population
www.rti.org
Engage
stakeholders in
project planning
August 2009
15
What Does It Mean to Have Culturally
Competent Staff?
 Considerations
–
–
–
–
www.rti.org
Geography
Urbanicity
Race/Ethnicity
Gender
Operationalization at Different Levels




State-level Considerations
Regional-level Considerations
Community-level Considerations
Programmatic-level Considerations
www.rti.org
Overarching Examples & Principles
 CSAP’s State Incentive Grant program
–
–
–
–
–
–
–
www.rti.org
Vermont
Louisiana
Maine
Nebraska
North Carolina
Georgia
District of Columbia
Application to Teen TUPC Grantees
 Identify needed skill set
 Understand the community context
 Understand the specific needs of program
participants (i.e., what are the underlying contributing
factors to tobacco use among the groups you are
working with)
 Where attributes are needed to have credibility
among program participants?
www.rti.org
Key Take Home Message
 Having culturally competent staff is only second to
selecting and implementing culturally competent evidencebased strategies.
 Being culturally competent means more than just looking
like program participants
 Understanding the community context that allows target
risk behaviors to operate must be fully assessed to
appropriately engage program participants
 Staff must demonstrate a working knowledge or
understanding challenges and barriers encountered by
program participants
 Bicultural competence
www.rti.org