Volume 15, No. 3, January 2004

This Transitions is also available in [PDF] format.

By Jennifer Augustine, MPH, CHES, Program Manager, HIV/STI Prevention Programs, Advocates for Youth

Cultural competence is an issue, not only for mainstream America, but also for all who want to reach people who don't look, think, or speak like them. Demographic changes in the United States and efforts to eliminate health disparities among people of diverse ethnic and cultural backgrounds demand culturally competent programs. Youth-serving organizations are most successful when their programs and services are respectful of the cultural beliefs and practices of the youth they serve.

A culturally competent program values diversity, conducts self-assessment, addresses issues that arise when different cultures interact, acquires and institutionalizes cultural knowledge, and adapts to the cultures of the individuals and communities served.¹ This may mean providing an environment in which youth from diverse cultural and ethnic backgrounds feel comfortable discussing culturally derived health beliefs and sharing their cultural practices.² Creating culturally competent programs is not difficult, but it requires conscientious attention. Here are important steps to take that will help.

• Assess your own values, attitudes, and beliefs about different racial/ethnic groups. Taking stock may help you to address internal biases, recognize personal limits, and identify areas for growth.
• Ask other staff members to take stock as well so that the organization can serve youth in an open, honest, respectful manner.
• Incorporate traditional elements of the culture(s) of youth served. Building upon the cultural beliefs and practices of client youth will reinforce the attitudes and skills the program seeks to strengthen. For example, an HIV prevention program for African American youth might build rites of passage into its efforts.³
• Recognize that youth are individuals, not representatives of their ethnic or racial group. Get to know each individual in the program.³
• Recognize the cultural roots of many behaviors. Youth from different cultures may behave differently, in accordance with what they have learned from their family. For example, some cultures encourage youth to challenge gender roles, whereas others do not. Some encourage an assertive communication style; others encourage a more passive communication style.
• Acknowledge that religious and other beliefs may influence how a young person responds to sexual and reproductive health issues. Some cultures discourage open communication about sexuality, making it difficult for youth to discuss, especially in large groups.
• Recognize that youth from culturally diverse backgrounds may experience varying degrees of acculturation into and comfort with the dominant culture.
• Recognize that some youth are bicultural or multicultural and strongly resist labels that emphasize only one or another of these cultural identities.
• Support young people's exploration of and pride in their individual racial/ethnic identity, including a bicultural or multicultural identity. Ask youth how they self-identify and respect that self-identification.³ This will support youth in building self-esteem and in actively and assertively debunking stereotypes and myths about people of different racial/ethnic backgrounds.
• Develop a "zero tolerance" policy regarding discriminatory words and behaviors based on racial/ethnic or cultural identity, including sexual orientation and gender identity. Post the policy in public areas and develop clear guidelines regarding disciplinary action.
• When training youth or staff to lead workshops, include opportunities for everyone (including volunteers), to practice responding appropriately to unacceptable language and/or behaviors.
• Involve youth as full partners in designing, implementing, and evaluating the programs aimed at youth. Ensure that youth leaders actually represent all the cultures served by the program.
• Encourage family involvement. Families offer a positive source of cultural strength as well as a primary source of information and support. Plan activities that encourage family participation.³
• Develop participatory, collaborative partnerships with the community. For example, an advisory committee of community representatives—including youth—can assess the needs of the community.²
• Make every effort to link with existing community service organizations to broaden the array of services available to the community's youth.⁴
• Hire diverse staff reflective of the youth served in the program. Program leaders, guest speakers, and/or volunteers should share the same cultural and ethnic backgrounds as youth.
• Provide language assistance and hire bilingual and bicultural staff.
• Schedule training workshops on cultural competence to provide ongoing education, moving staff from cultural awareness to cultural competence.
• Use diverse materials, including brochures and videos, that are reflective of the cultural and ethnic diversity of the youth and that are culturally, linguistically, and age appropriate. Planners will need to choose these materials wisely. For example, a video that features urban Latino/Hispanic teens may not be appropriate for rural Latino/Hispanic teens.
• Recognize that cultural competence is an ongoing process and make a commitment to building cultural competence in all available ways.

Creating culturally competent programs requires work and determination. The rewards, however, include more effectively 1) reaching young people, 2) achieving positive sexual health outcomes, and 3) supporting youth in attaining their individual goals.

References

1. Goode T, Jones W, Mason J. A Guide to Planning and Implementing Cultural Competence: Organizational Self-Assessment. Washington, DC: National Center for Cultural Competence, Georgetown University, Child Development Center, 2002.
2. Office of Minority Health, U.S. Dept. of Health and Human Services. Revised CLAS standards from the Office of Minority Health. Closing the Gap, February/March 2001.
3. Messina S. A Youth Leader's Guide to Building Cultural Competence. Washington, DC: Advocates for Youth, 1994.
4. Ross H. Linking minorities to health services: successful strategies for outreach workers. Closing the Gap, February/March 2001.