This document discusses cultural competence and diversity. It provides definitions of culture, cultural determinism, ethnocentrism, and cultural relativity. It describes how culture manifests itself through symbols, heroes, rituals, and values. The document also discusses developing culturally competent health promotion programs by understanding an individual's worldview, assessing one's own organization, and utilizing the National CLAS Standards. The overall purpose is to facilitate understanding of cultural diversity.

1. T R U E COLORS Appreciating Our Multicultural World Mary Langley, PhD, MPH, RN, ICPS Alice Jackson, BS, LPN, CPE, ICPS Facilitators

2. INTRODUCTION STORY OF THE GRAY PEOPLE

3. PURPOSE To facilitate a process of understanding ourselves in order that we might better communicate and embrace the uniqueness of others.

4. Learning Objectives By the end of this workshop participants will, Know their T R U E COLORS Personality and gain a better understanding of self and others. Understand the concepts of cultural diversity, cultural competence, cultural worldview. Understand Cultural Competence Continuum as it relates to Systems, Organizations, Institutions and Agencies Be able to develop culturally competent health promotion/prevention programs and strategies.

5. EXPECTATIONS NORMS

6. TRUE COLORS What are your

7. Man’s project has been to make all those near him just like him. Fortunately, this project is impossible. To sculpt the other into his own likeness fails before it begins. Remove the fangs of the lion and behold, a toothless lion, not a domestic cat. Attempts to change the spouse. Offspring, or student can create a change, but the result is a scar, not a transformation .

8. Valuing Differences and Creating Unity Copyright, 1996-98 © True Colors, Inc. - (888) 558.2577

9. TRUE COLORS PERSONALITY ASSESSMENT ACTIVITY

10. Remember If there is no harmony in your life Try playing another tune

11. Expectations What does “culture” mean? What are your expectations when it comes to talking about culture? What words, topics, and information do you expect to hear and discuss?

12. A Definition of Culture The collectively agreed upon knowledge, experience, values, ideas, attitudes, skills, tastes and techniques that are passed on from more experienced members of a community to new members

13. Culture A culture is a way of life of a group of people---the behaviors, beliefs, values, and symbols that they accept, generally without thinking about them, and that are passed long by communication and imitation from one generation to the next.

14. Theory of Cultural Determinism The position that the ideas, meanings, beliefs and values people learn as members of society determines human nature. People are what they learn. Optimistic version of cultural determinism place no limits on the abilities of human beings to do or to be whatever they want. Some anthropologists suggest that there is no universal "right way" of being human. "Right way" is almost always "our way"; that "our way" in one society almost never corresponds to "our way" in any other society. Proper attitude of an informed human being could only be that of tolerance.

15. CULTURAL RELATIVISM Different cultural groups think, feel, and act differently. There is no scientific standards for considering one group as intrinsically superior or inferior to another. Studying differences in culture among groups and societies presupposes a position of cultural relativism. It does not imply normalcy for oneself, nor for one's society. It, however, calls for judgment when dealing with groups or societies different from one's own.

16. CULTURAL ETHNOCENTRISM Ethnocentrism is the belief that one's own culture is superior to that of other cultures. It is a form of reductionism that reduces the "other way" of life to a distorted version of one's own.

17. Cultural differences manifest themselves in different ways and differing levels of depth. Symbols represent the most superficial and values the deepest manifestations of culture, with heroes and rituals in between. Symbols are words, gestures, pictures, or objects that carry a particular meaning which is only recognized by those who share a particular culture. New symbols easily develop, old ones disappear. Symbols from one particular group are regularly copied by others. This is why symbols represent the outermost layer of a culture. Manifestation of Culture

18. Heroes are persons, past or present, real or fictitious, who possess characteristics that are highly prized in a culture. They also serve as models for behavior. Rituals are collective activities, sometimes superfluous in reaching desired objectives, but are considered as socially essential. They are therefore carried out most of the times for their own sake (ways of greetings, paying respect to others, religious and social ceremonies, etc.).

19. The core of a culture is formed by values. They are broad tendencies for preferences of certain state of affairs to others (good-evil, right-wrong, natural-unnatural). Many values remain unconscious to those who hold them. Therefore they often cannot be discussed, nor they can be directly observed by others. Values can only be inferred from the way people act under different circumstances. Symbols, heroes, and rituals are the tangible or visual aspects of the practices of a culture. The true cultural meaning of the practices is intangible; this is revealed only when the practices are interpreted by the insiders.

21. LAYERS OF CULTURE People even within the same culture carry several layers of mental programming within themselves. Different layers of culture exist at the following levels: The national level: Associated with the nation as a whole. The regional level: Associated with ethnic, linguistic, or religious differences that exist within a nation. The gender level: Associated with gender differences (female vs. male) The generation level: Associated with the differences between grandparents and parents, parents and children. The social class level: Associated with educational opportunities and differences in occupation. The corporate level: Associated with the particular culture of an organization. Applicable to those who are employed.

22. Cultural Competence Cultural competence is the process of communicating with audiences from diverse geographic, ethnic, racial cultural, economic, social, and linguistic backgrounds. Becoming culturally competent is a dynamic process that requires cultural knowledge and skill development at all service levels, including policymaking, administration and practice.

23. Culture produces worldview, which in turn modifies culture, which in turn produces modified worldview, and so on.

24. A culturally competent individual is able to: share social experiences; project a feeling of respect for others listen and communicate with understanding; empathize; avoid making value judgments; identify with others’ socioeconomic status; and be sensitive to different perspectives.

25. Dr. Ed Nichol’s Model: The Philosophical Aspects of Cultural Differences Worldview Values (Axiology) Knowledge (Epistemology) Reason (Logic) Process European Euro-American Member-Object The highest value lies in the object or in the acquisition of the object Cognitive One knows through counting and measuring Dichotomous Either/Or Technology All processes are repeatable and reproducible African Afro-American Native American, Hispanics Arabic Member-Member The highest value lies in the interpersonal relationship between persons Affective One knows through symbolic imagery and rhythm Diunital The union of opposites Ntuology All processes are interrelated through human and spiritual networks Asian Asian-American Polynesian Member-Group The highest value lies in the cohesiveness of the group Conative One knows through striving toward the transcendence Nyaya The objective world is conceived independent of thought and mind Cosmology All processes are independently interrelated in the harmony of the universe

26. Your Worldview In your True Colors Groups discuss how your True Color Personality might impact your Culture Worldview using the Nichol’s Chart. Select a reporter and be prepared to report out to the general audience.

27. Values of Dominant U.S. Culture Individualism Activity and work Material comfort Science Achievement and success Freedom Group superiority Equal opportunity Progress Practicality and efficiency (Macionis, 1991)

31. Dimensions of Diversity What does Diversity mean? In pairs review the definitions on your Key Definitions in Diversity Information Sheet and discuss: Which definition or definitions are most relevant to your current work in prevention? Which definition or definitions do you want to learn more about in order to be more successful as a preventionist?

32. In conclusion, we can say that: Diversity is defined as differences in qualities, attributes, or conditions that are socially defined as significant. For example, skin color may be seen as significant in our society, but whether or not you have detached earlobes is not. Even though we may use the terms interchangeably, diversity is different from culture in that culture is collectively agreed upon, learned, and inherently meaningful to its members. On the other hand, categories of diversity may be imposed from outside of the group itself and may not necessarily have a collectively agreed-upon inherent meaning for group members. At the same time, these categories of diversity may have real social and political consequences for their members.

33. Utilize resources to appropriately address the diverse needs, histories, cultures and strengths within a community Culturally Effective Health Promotion/Prevention Services

34. Assess Your Own Organization Organizational diversity Community interfacing Capacity for investment Appropriateness of materials and process Where is your organization successful? (Office of Minority Health, Public Health Service, and U. S. Department of Health and Human Services publication available at http://www.omhrc.gov.CLAS )

36. Culturally & Linguistically Appropriate Services The U.S. Department of Health and Human Services (HHS) Office of Minority Health (OMH) has developed recommendations for national standards for culturally and linguistically appropriate services (CLAS) in health care. Based on an analytical review of key laws, regulations, contracts, and standards currently in use by federal and state agencies and other national organizations, these standards were developed with input from a national advisory committee of policymakers, health care providers, and researchers. The following has been adapted to be relevant to all service providers (i.e., prevention, treatment, social agencies, etc.)

37. CLAS Standards Service organizations should ensure that consumers receive from all staff members effective, understandable, and respectful care that is provided in a manner compatible with their cultural health/social beliefs and practices and preferred language. Servic e organizations should implement strategies to recruit, retain, and promote at all levels of the organization a diverse staff and leadership that are representative of the demographic characteristics of the service area. Service organizations should ensure that staff at all levels and across all disciplines receive ongoing education and training in culturally and linguistically appropriate service delivery. Service organizations must offer and provide language assistance services, including bilingual staff and interpreter services, at no cost to each consumer with limited English proficiency at all points of contact, in a timely manner during all hours of operation. Service organizations must provide to consumers in their preferred language both verbal offers and written notices informing them of their right to receive language assistance services.

38. Service organizations must assure the competence of language assistance provided to limited English proficient consumers by interpreters and bilingual staff. Family and friends should not be used to provide interpretation services (except on request by the patient/consumer). Service organizations must make available easily understood consumer-related materials and post signage in the languages of the commonly encountered groups and/or groups represented in the service area. Service organizations should develop, implement, and promote a written strategic plan that outlines clear goals, policies, operational plans, and management accountability/oversight mechanisms to provide culturally and linguistically appropriate services. Service organizations should conduct initial and ongoing organizational self-assessments of CLAS-related activities and are encouraged to integrate cultural and linguistic competence-related measures into their internal audits, performance improvement programs, consumer satisfaction assessments, and outcomes-based evaluations. Service organizations should ensure that data on the individual consumer’s race, ethnicity, and spoken and written language are collected in health records, integrated into the organization’s management information systems, and periodically updated.

39. Service organizations should maintain a current demographic, cultural, and epidemiological profile of the community as well as a needs assessment to accurately plan for and implement services that respond to the cultural and linguistic characteristics of the service area. Service organizations should develop participatory, collaborative partnerships with communities and utilize a variety of formal and informal mechanisms to facilitate community and patient/consumer involvement in designing and implementing CLAS-related activities. Service organizations should ensure that conflict and grievance resolution processes are culturally and linguistically sensitive and capable of identifying, preventing, and resolving cross-cultural conflicts or complaints by consumers. Service organizations are encouraged to regularly make available to the public information about their progress and successful innovations in implementing the CLAS standards and to provide public notice in their communities about the availability of this information.

40. Group Activity Discuss what a culturally competent and inclusive health/human services organization would look like based on CLAS Use the worksheet to report the outcome of your group discussion

41. An Organization That Makes A Difference: Five Key Ingredients Visionary Leadership – High Expectations Clear Mission Statement – Culturally Competent Organizational Environment Member Commitment – The Right Fit Member Development – Knowledge Power Member Recognition – Motivational Tool