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

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The Culture, Diversity and Equity Project: Literature Review Summing up the importance and benefits of measuring and monitoring health inequities, the Canadian intergovernmental Health Disparities Task Group concludes: An essential element of any such strategy [to further prioritize commitments to disparities reduction and establish methods of accountability of all stakeholders for improvement] includes the measurement of disparities and regular reports on progress. Good data not only advances understanding of what works and what does not; good and clear reports also galvanize support for disparities reduction. With the right indicator sets, the health sector can achieve a better balance between accountability for providing high-quality health care services and accountability for addressing disparities. (Health Disparities Task Group, 2004, p.18). 98
The Culture, Diversity and Equity Project: Literature Review PART 3 CULTURAL COMPETENCE TRAINING AND EDUCATION While there is significant variation in the specific content of cultural competence training initiatives, these tend to fall into three main categories, in terms of their focus: (1) Attitudes, (2) Knowledge and (3) Skills (Curtis, 2007; California Endowment, 2003; Haarmans, 2004). Though not all training frameworks cover all three of these areas and differ in their emphases (see Limitations for instance), this threefold framework for training has been likened to a three-legged stool: “the structure would fail if one ‘leg were missing” (California Endowment, 2003). Further stabilizing these three training legs, researchers argue, is “a committed consciousness and receptive attitude” (ibid.), without which the knowledge and skills related to cultural competence in health care would be seriously compromised. This tripartite training framework - applicable at any and all stages of the developmental learning process - is discernible, in one form or another, in nearly all of the cultural competence training frameworks and modules discussed below. 5.1 CULTURAL COMPETENCE TRAINING FRAMEWORKS D.W. Sue et al. (1992) D. W. Sue, Arredondo & McDavis (1992) are widely credited with having developed this tripartite framework for cultural competency, which remains the most widely cited and recognized in the cultural competence training literature. The training framework they have conceptualized and developed (discussed also in Section 2.3B/I) to enhance the cultural competence of services and programs, particularly at the client-counsellor interface, revolves around the aforementioned three themes: • Cultural awareness and beliefs: Training in this ‘affective domain’ of competencies is designed to enhance providers’ sensitivity to their personal values and biases and how these may influence perceptions of the client, client’s problem, and the counselling relationship. • Cultural knowledge: Training in this ‘cognitive domain’ of competencies is designed to increase providers’ knowledge of the client’s culture, worldview, and expectations for the counselling relationship. • Cultural skills: Training in this ‘practice domain’ of competencies is designed to increase providers’ ability to intervene in a manner that is culturally sensitive and relevant in cross-cultural situations (Sue et al., 2006, 1992; see Haarmans, 2004 for more detailed elaboration of competencies within this tripartite framework). This framework informs the American Psychological Association’s Multicultural Guidelines (2003) and numerous other cultural competency training modules, frameworks, and standards (see for instance Miyake Geron, 2002; Campinha-Bacote, 1996; Rosenjack Burchum, 2002; Kim-Godwin et al., 2001). Haarmans (2004) In one of the most comprehensive reviews of the cultural competence training literature, Haarmans (2004) further develops and fleshes out Sue et al.’s (1992) tripartite framework and adds a critical fourth competency area that concerns ‘power/relationship’ issues (discussed below). 99
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Appendix 1: Health Equity Literatur
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HEALTH EQUITY LITERATURE REVIEW INT
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