Multicultural Differences

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Definitions of Cultural Competence
There is no one definition of cultural competence. Definitions of cultural competence have evolved from diverse perspectives, interests and needs and are incorporated in state legislation, Federal statutes and programs, private sector organizations and academic settings. The seminal work of Cross et al in 1989 offered a definition of cultural competence that established a solid foundation for the field. The definition has been widely adapted and modified during the past 15 years. However, the core concepts and principles espoused in this framework remain constant as they are viewed as universally applicable across multiple systems.

A number of definitions and descriptions of cultural competence were reviewed to compile the selected list. The following definitions of are highlighted because they represent or are based on original and exemplary work and because of their potential impact to the field of health and human services.

Cross et al, 1989

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 professions to work effectively in cross-cultural situations.

The word culture is used because it implies the integrated pattern of human behavior that includes thoughts, communications, actions, customs, beliefs, values and institutions of a racial, ethnic, religious or social group. The word competence is used because it implies having the capacity to function effectively.

Five essential elements contribute to a system's institution's, or agency's ability to become more culturally competent which include:

Valuing diversity
Having the capacity for cultural self-assessment
Being conscious of the dynamics inherent when cultures interact Having institutionalized culture knowledge
Having developed adaptations to service delivery reflecting an understanding of cultural diversity These five elements should be manifested at every level of an organization including policy making, administrative, and practice. Further these elements should be reflected in the attitudes, structures, policies and services of the organization.

National Center for Cultural Competence, 1998, modified from Cross et al

Cultural competence requires that organizations:

Have a defined set of values and principles, and demonstrate behaviors, attitudes, policies, and structures that enable them to work effectively cross-culturally. Have the capacity to (1) value diversity, (2) conduct self-assessment, (3) manage the dynamics of difference, (4) acquire and institutionalize cultural knowledge, and (5) adapt to diversity and the cultural contexts of communities they serve. Incorporate the above in all aspects of policy-making, administration, practice and service delivery, systematically involve consumers, families and communities. Cultural competence is a developmental process that evolves over an extended period. Both individuals and organizations are at various levels of awareness, knowledge and skills along the cultural competence continuum.

Betancourt et al., 2002

Cultural competence in health care describes the ability of systems to provide care to patients with diverse values, beliefs and behaviors, including tailoring delivery to meet patients’ social, cultural, and linguistic needs.

Lavizzo-Mourey & Mackenzie, 1996

Cultural competence is the demonstrated awareness and integration of three population-specific issues: health-related beliefs and cultural values, disease incidence and prevalence, and treatment efficacy. But perhaps the most significant aspect of this concept is the inclusion and integration of the three areas that are usually considered separately when they are considered at all.

Roberts et al, 1990

Cultural competence refers to a program's ability to honor and respect those beliefs, interpersonal styles, attitudes and behaviors...
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