Definition
Organizational Environment
Staff and Team Development
Service Delivery
Community Partnerships

Definition
Cultural competence refers to a set of interpersonal and intrapersonal skills that allow individuals and organizations to increase their understanding and appreciation of cultural differences within, among, and between groups. More formally defined, it is "a set of congruent practice skills, attitudes, policies, and structures that come together in a system or agency or among professionals and enable that system or agency or those professionals to work effectively in cross-cultural situations." (Cross 1989)

This requires a willingness to draw on community-based values, traditions, and customs and to work with knowledgeable persons of and from the community in developing targeted interventions, communications, and other supports.

A culturally competent program is one that demonstrates sensitivity to and understanding of cultural differences in program design, implementation, and evaluation. At WIPHL, we strive for cultural competence in several target areas:

Organizational Environment
Does the organization or clinic create an environment that is proactive and responsive to the diverse cultural needs of internal and external stakeholders? The physical environment, accessibility, organizational structure, diversity, and cultural competency skills of staff, as well as a sense of safety and respect, are all components of an organizational environment.

Staff and Team Development
Does the staff/team reflect the community that it serves? Building a team or staff that has experience working cross-culturally is very important. The way that a project or clinic recruits staff, develops staff skills and leadership, and respects and values staff can either strengthen or hinder the cultural competency of a project. With the help of the Associate Director for Cultural Competence, the Coordinating Center and other sub-recipients will recruit and hire staff and health educators who reflect the cultures of the patient population they serve. WIPHL will provide cultural competence training for all project leaders, including two days of training on clinical aspects of cultural competence, plus an additional day on building cultural competence into our organization. Each group of health educators will receive the same two-day cultural competence training before they begin providing SBIRT services.

Service Delivery
Is the service culturally sensitive? Are services available to all eligible patients? Has the implementation team identified barriers to services? Has the implementation team identified strategies to overcome barriers to service? Are quality assurance measures in place to evaluate outcome objectives to ensure accessibility cross-culturally? The protocol for service delivery was designed to be sensitive to cultural differences. The use of motivational interviewing is culturally sensitive in that health educators largely avoid giving unwanted advice and ask patients to weigh the pros and cons of behavior change in light of their own goals and values, which are influenced greatly by their own culture. In year one, WIPHL is working with clinics to identify barriers and strategies to support culturally competent service delivery. In particular, WIPHL is planning for and developing multilingual resources.

Community Partnerships
Are project staff and WIPHL clinic teams striving to build buy-in and strengthen community relationships? In order to maximize the success of WIPHL and the sustainability of our efforts, we recognize the importance of community relationships. WIPHL and cultural competence is a standing agenda item on the Governor's Policy Advisory Committee. The expertise of the committee will help inform the strategies that are used to address disparities. Also, the Associate Director of Cultural Competence serves on the Statewide Committee on Alcohol and Other Drug Abuse, Diversity Subcommittee. SCAODA will advise WIPHL on meeting needs of racial and ethnic minority populations in Wisconsin.