Achieving cultural competence is a process, not an end point.
There are no pat answers or a cookbook models that guarantee success.
Instead, individuals and organizations achieve specific goals and outcomes for cultural competence by engaging in such activities as:
- Developing a process for self-assessment at the organizational and individual levels.
- Developing and implementing policy and guidelines.
- Conducting and participating in training and professional development activities.
- Providing a forum for safe and honest dialogue with and among agency personnel and the diverse communities they serve.
These activities must be an ongoing process and integral to the individual’s, organization's, or program's core functions. There's room for creativity — and for accomplishment — on the road to cultural competence.
Major Values and Principles of a Culturally Competent System
- The family as defined by each culture is the primary system of support and preferred intervention.
- The system must recognize that racial and ethnic populations have to be at least bicultural and that this status may create a unique set of issues to which the system must be equipped to respond.
- Individuals and families make different choices based on cultural forces. these choices must be considered if education/service delivery are to be helpful and appropriate.
- Practice is driven in the service delivery system by culturally preferred choices, not by culturally blind or culturally free interventions.
- Inherent in cross-cultural interactions are dynamics that must be acknowledged, adjusted to and accepted.
- The system must sanction and in some cased mandate the incorporation of cultural knowledge into policy making, education and practice.
- Cultural competence involves determining an individual or family's cultural identity and levels of acculturation and assimilation in order to more effectively apply the helping principle of "starting where the individual or family is."
- Cultural competence involves working in conjunction with natural, informal support and helping networks within culturally diverse communities (or example neighborhood, civic and advocacy associations, ethnic, social and religions organizations, and where appropriate, spiritual healers).
- Cultural competence extends the concept of self-determination.
- Cultural competence seeks to identify and understand the needs and help-seeking behaviors of individuals and families. Cultural competence seeks to design and implement services that are tailored or matched to the unique needs of individuals, children and families.
- An agency or education program staffing pattern that reflects the make-up of the population within the geographic locale helps ensure the delivery of effective services.
- Cultural competence embraces the principles of equal access and non-discriminatory practices in service delivery and education.
Cultural Competence and the APTA Vision
The Vision Statement of the Physical Therapy Profession, "Transforming society by optimizing movement to improve the human experience," is far reaching and inclusive.
Cultural competence is essential to that vision. Achievement of the vision and devotion to cultural competence go hand in hand.
Several of the Guiding Principles to Achieve the Vision are directly related to cultural competence. These include:
- Consumer-centricity. "Patient/client/consumer values and goals will be central to all efforts in which the physical therapy profession will engage. The physical therapy profession embraces cultural competence as a necessary skill to ensure best practice in providing physical therapist services by responding to individual and cultural considerations, needs, and values."
- Access/Equity. "The physical therapy profession will recognize health inequities and disparities and work to ameliorate them through innovative models of service delivery, advocacy, attention to the influence of the social determinants of health on the consumer, collaboration with community entities to expand the benefit provided by physical therapy, serving as a point of entry to the health care system, and direct outreach to consumers to educate and increase awareness."
- Advocacy. "The physical therapy profession will advocate for patients/clients/consumers both as individuals and as a population, in practice, education, and research settings to manage and promote change, adopt best practice standards and approaches, and ensure that systems are built to be consumer-centered."
Other Cultural Competence Resources
- Agency for Health Care Research and Quality Innovations Exchange: Cultural Competence. Not so much a single resource as a collection of articles and online tools, this branch of the AHRQ exchange offers everything from case profiles to data on health care disparities.
- National Center for Cultural Competence. This Georgetown University-based organization's website offers distance learning opportunities and a self-assessment tool.
- National Institute on Minority Health and Minority Disparities. This branch of NIH includes a regular blog, recent news, and a portal to more resources—plus funding opportunities and calls to participate in resource initiatives.
Office of Minority Health. Offered by HHS, the OMH website includes an online library search, a downloadable "health disparities data widget," population profiles, and a frequently-updated selection of news and spotlight articles.