CDE Appendix 1 Literature Review - Central East Local Health ...

The Culture, Diversity and Equity Project: Literature Review
Many variations of this framework appear in the literature (Campinha-Bacote, 1999; Rosenjack Burchum, 2002;
Kim-Godwin et al., 2001). For instance, the American College Health Association (ACHA) elaborates the following
individual competencies within the context of Sue et al.’s (1996) basic conceptual framework on their website.
With regard to beliefs/attitudes, the culturally competent individual is:
• Aware of and sensitive to her/his own cultural heritage and also respects and values different heritages;
• Aware of her/his own values and biases and how they may affect the perception of other cultures;
• Comfortable with differences that exist between her/his culture and other cultures' values and beliefs; and
• Sensitive to circumstances (personal biases, ethnic identity, political influence, etc.) That may require seeking
assistance from a member of a different culture when interacting with another member of that culture.
With regard to knowledge, the culturally competent individual must:
• Demonstrate good understanding of the power structure in society and how non-dominant groups are treated;
• Acquire specific knowledge and information about the particular group(s) s/he is working with; and
• Recognize institutional barriers that prevent members of disadvantaged groups from using organizational and
societal resources.
With regard to skills, the culturally competent individual must:
• Generate a wide variety of verbal and nonverbal responses (body language) when communicating with
individuals of different backgrounds or culture;
• Send and receive both verbal and nonverbal messages accurately and appropriately; and
• Intervene appropriately and advocate on behalf of individuals from different cultures (i.e., serve as an ally)
(american college health association, 2009).
The ACHA framework is distinguished by its attention to power relations in society and how this impacts upon
client-clinician/health practitioner relations and interactions.
Jirwe et al.’s (2006) Framework
In their (2006) article, Jirwe, Gerrish, & Emami (2006) systematically reviewed and analysed the core competency
components found in the nine most frequently cited theoretical frameworks of cultural competence in the nursing
literature.
The nine reviewed frameworks originated from three different continents: seven from the USA, one from the United
Kingdom and one from New Zealand (in many ways representing the global distribution of such cultural
competence frameworks).
Synthesizing the core cultural competencies elaborated in these nine theoretical frameworks, Jirwe et al. identify
four main recurring themes relating to cultural competence. These include:
1. An awareness of diversity among human beings: Under this theme, two underlying sub-themes are
identified: (A) Awareness of Oneself and; (B) Awareness of the Other.
2. An ability to care for individuals: In this theme, three underlying sub-themes are identified: (A) to be
skilled in performing cultural assessments, (B) to be knowledgeable about other cultures, and (C) to be able
to meet specific cultural needs.
3. Non-judgmental openness for all individuals: This competency revolves around the health practitioners’
“willingness to overcome prejudices and ethnocentrism and [demonstrate] a genuine interest in people from
other cultures” informed by a sense of equality, empathy and sensitivity.
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