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CLCPA: Resources

 

Demographic Data

https://perfdata.hrsa.gov/mchb/mchreports/Search/program/prgsch01.asp
Maternal and Child Health Bureau—State Priority Health Areas (by state and region)

http://www.childhealthdata.org/content/Default.aspx
Data Resource Center for Child & Adolescent Health (home of searchable databases on the National Survey of Children’s Health and on the National Survey of Children with Special Health Care Needs)

http://factfinder.census.gov/home/saff/main.html?_lang=en&_ts=
U.S. Census Bureau—American FactFinder (a wealth of Census-related information by county, state, and nation)

http://www.mla.org/census_compare&source=county
Modern Language Association (searchable data center with Census data on languages spoken and on the numbers of speakers; these data are available by age categories)

http://www.statehealthfacts.org/cgi-bin/healthfacts.cgi
Kaiser Family Foundation Health Facts (state and national health facts including infant mortality, HIV/AIDS, child and adult immunizations, cardiac disease, and cancer)

http://www.nicwa.org/resources/factsheets/index.asp
National Indian Child Welfare Association (fact sheets provide tribal information by state and regional contacts)

http://www.uscis.gov/graphics/shared/statistics/data/DSLPR04s.htm
U.S. Department of Homeland Security, Office of Immigration Statistics (information on legal permanent residents)

http://www.uscis.gov/graphics/shared/statistics/yearbook/index.htm
U.S. Department of Homeland Security, Office of Immigration Statistics—Yearbook of Immigration Statistics (compendium of tables that provide data on foreign nationals who, during a fiscal year, were granted lawful permanent residence [i.e.: admitted as immigrants or became legal permanent residents], were admitted into the United States on a temporary basis [e.g.: tourists, students, or workers], applied for asylum or refugee status, or were naturalized)

http://www.ers.usda.gov/statefacts
U.S. Department of Agriculture—State Fact Sheets (provides statistics on urban and rural populations by state)

http://www.urban.org/publications/1000587.html
Urban Institute—Publications (provides materials that report on the numbers and status of undocumented citizens in the United States)

Plan Development

Disparities and quality improvement: Federal policy levers. (2005, March-April), by Nicole Lurie, Minna Jung, and Risa Lavizzo-Mourey, Health Affairs, The Policy Journal of the Health Sphere (Millwood), Volume 24, No. 2, 354-364. Available from http://content.healthaffairs.org/cgi/content/full/24/2/354

Improving Care for Children with Special Health Care Needs from Diverse Cultural Backgrounds: An Action Plan. (1999), by Theora Evans, Ann Garwick, and Peggy Mann Rinehart. For more information, call National Maternal and Child Health Clearinghouse at (888) 434-4624. This monograph presents recommendations and strategies on how to improve care for children with special health care needs from diverse cultural backgrounds.

Building Cultural Competence: Guidelines for Action. (2001), by the Washington Department of Health; Multicultural Work Group. For more information, contact Ruth Abad, Health Educator, at www.HEREinWA.org This resource was developed by the Multicultural Work Group of the Washington Department of Health. The group has worked since 1991 to integrate cultural competency at program and system levels. This resource documents their efforts and provides examples of strategies to operationalize concepts of cultural competence in a meaningful way for the health care staff and to aid programs with long-range planning in protecting and improving the health of Washington state residents.

Building Systems of Care: A Primer. (2002, Spring), by Sheila Pires. This primer is intended for use with training in systems of care. It integrates concepts of cultural competence throughout the exploration and planning of structures of systems of care. Available from: National Technical Assistance Center for Children’s Mental Health Georgetown University Center for Child and Human Development 3300 Whitehaven Street, N.W., Suite 3300 Box 571485 Washington, DC 20057-1485 Tel.: (202) 687-5000 Fax: (202) 687-8899 http://gucchd.georgetown.edu/research
Sponsoring Organization: Child, Adolescent and Family Branch, Center for Mental Health Services, Substance Abuse and Mental Health Services Administration (DHHS).

Crafting Logic Models for Systems of Care: Ideas into Action. (2003), by Mario Hernandez and Sharon Hodges. This monograph presents an introduction to theories of change. It is designed to assist mental health Systems of Care stakeholders in developing a logic model that will aid at all levels of planning and implementation. It can be adapted to use with diverse community stakeholders for a more culturally competent organization and to encourage the development of culturally relevant outcome measures. Developing a logic model with a broad range of stakeholders can be part of an organizational cultural self-assessment process. Available from http://cfs.fmhi.usf.edu/cfsnews/cfsnewscategory.cfm?category=1

Cultural Competency Strategic Planning Process: Narrative and Appendices (HIV Client Services). (2001), by the Washington State Department of Health. This report describes a year-long process to develop a plan to improve the cultural competence of HIV Client Services, a small program of the Washington State Department of Health. Appendices outline the strategic plan and provide background documents (including NCCC Policy Brief 1). This report is available with or without appendices. For copies of either version, contact: HIV Client Services, PO Box 47841, Olympia, WA 98504-7841, (360) 236-3426.

Human Resources

In the Nation’s Compelling Interest: Ensuring Diversity in the Health Care Workforce. (2004), by the Institute of Medicine. Washington, DC: National Academy Press. See www.nap.edu

Disparities in Patient Experiences, Health Care Processes, and Outcomes: The Role of Patient-Provider Racial, Ethnic, and Language Concordance. (2004), by Lisa Cooper and Neil Powe. This July 2004 report, supported by the Commonwealth Fund, reviewed the literature in racediscordant relationships between physicians and patients to determine whether this factor had an effect on outcomes for the patient. “Race-discordant” means when patients from ethnic groups are treated by professionals from a different ethnic background. From the abstract: “The research reviewed here documents ongoing racial and ethnic disparities in health care and links patient/physician race and ethnic concordance with higher patient satisfaction and better health care processes. Based on this research, the authors issue the following recommendations: 1) health policy should be revised to encourage workforce diversity by funding programs that support the recruitment of minority students and medical faculty; 2) health systems should optimize their providers’ ability to establish rapport with minority patients to improve clinical practice and health care delivery; 3) cultural competency training should be incorporated into the education of health professionals; and 4) future research should provide additional insight into the mechanisms by which concordance of patient and physician race, ethnicity, and language influences processes and outcomes of care.” See publications of the Commonwealth Fund available from http://www.cmwf.org

Fostering Diversity: Some Major Hurtles Remain, by Mary P. Rowe. This brief contains strategies to promote and maintain diversity, particularly in academic settings. See http://aad.english.ucsb.edu/docs/Change6.html

Promoting Cultural Competence in Children’s Mental Health Services. (1998), by Mario Hernandez and Mareasa R. Isaacs, from the Systems of Care for Children’s Mental Health Series, edited by Beth Stroul and Robert Friedman. This book focuses on the implications of critical areas for growth of cultural competence for systems of care in children’s mental health, including, but not limited to (1) the need to develop organizational infrastructures to support and enhance cultural competence; and (2) recruitment, retention, and training of staff. See bookstores such as www.amazon.com

Recruiting and Retaining Diverse Parent Representation on Interagency Councils. (2004), by the National Early Childhood TA Center (NECTAC). This brief presents the recommendations of the NECTAC-sponsored meeting in Chapel Hill to discuss cultural and linguistic diversity in early childhood education. Although it specifically concerns parent members, this paper can be useful for general recruitment to achieve diverse representation” (Introductory letter by Pascal Trohanis, Director of NECTAC). http://www.nectac.org/pubs/titlelist.asp

What are Some Strategies for Recruiting and Retaining a Diverse Workforce? (2003), by the Society for Human Resource Management. This Web site offers advice for recruiting and retaining diverse employees, compiling suggestions from other sources. It also has links to other diversity and business issues. http://www.shrm.org/diversity/recruitretain.asp

Clinical Practice

Cultural competence of nurse practitioner students: A consortium’s experience. (2005, May), by Benkert R, Tanner C, Guthrie B, Oakley D, Pohl JM, Journal of Nursing Education, Volume 44, No. 5, 225-233.

Improving care and interactions with racially and ethnically diverse populations in healthcare organizations. (2004, July-August), Reynolds D., Journal of Healthcare Management, Volume 49, No. 4, 237-249.

Social work and the house of Islam: Orienting practitioners to the beliefs and values of Muslims in the United States. (2005, April), by Hodge DR, Social Work, Volume 50, No. 2, 162-173. (Review) http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_ui ds=15853193&query_hl=8

Cultural issues in palliative care. (2005, February), by Kemp C, Seminars in Oncology Nursing, Volume 21, No. 1, 44-52. (Review). http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_ui ds=15807056&query_hl=8 A course on the transition to adult care of patients with childhood-onset chronic illnesses. (2005, April), by Hagood JS, Lenker CV, Thrasher S, Academic Medicine, Volume 80, No. 4, 352-355. (Review). http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_ui ds=15793019&query_hl=8

Enhancing cultural competencies of advanced practice nurses: Health care challenges in the twentyfirst century. (2004, Fall), by Ndiwane A, Miller KH, Bonner A, Imperio K, Matzo M, McNeal G, Amertil N, Feldman Z, Journal of Cultural Diversity, Volume 11, No. 3, 118-121. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_ui ds=15689146&query_hl=8

Cultural caring in nursing practice: A meta-synthesis of qualitative research. (2004, Fall), by Coffman MJ, Journal of Cultural Diversity, Volume 11, No. 3, 100-109. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_ui ds=15689144&query_hl=8

Cultural competence now mainstream medicine. Responding to increasing diversity and changing demographics. (2004, December), by Cole PM, Postgraduate Medicine, Volume 116, No. 6, 51-53. (Review). http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_ui ds=15620127&query_hl=8

Agenda dissonance: Immigrant Hispanic women’s and providers’ assumptions and expectations for menopause healthcare. (2005, February), by Esposito N, Clinical Nursing Research, Volume 14, No. 1, 32-56. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_ui ds=15604227&query_hl=8

Budget Allocation

A Guide to Developing and Using Performance Measures in Results-Based Budgeting. (1997), by Mark Friedman; The Finance Project. This paper is part of a series of papers published by The Finance Project on the subject of results accountability. A previous paper, A Strategy Map for Results-Based Budgeting, embedded the challenge of this paper of holding programs accountable for the best possible performance, while ensuring that their performance is aligned with, and supports, overall efforts to improve results, in other words, how to create performance accountability within a results framework.

Assessment of the Total Benefits and Costs of Implementing Executive Order 13166: Improving Access to Services for Persons with Limited English Proficiency. (2002, March 14), by the Office of Management and Budget (OMB), Report to Congress. This report by OMB reflects that Office’s cost-benefit analysis of implementing the contested Executive Order (E.O.) 13166. Highlights: (1) calls for clear and uniform standards for implementation, (2) cites substantial benefits to “improve health and quality of life of many LEP individuals and families. Moreover, language-assistance services may increase the efficiency of distribution of government services to LEP individuals and may measurably increase the effectiveness of public health and safety programs,” (3) encourages a focus on Spanish language as the most frequent language spoken in the United States other than English, (4) predicts that provision of language services will be most costly for the healthcare sector, and (5) estimates a cost between $1 billion and $2 billion to implement E.O. 13166. See http://www.omb.gov/inforeg/regpol.html

Shortchanging America’s Health: A State-by-State Look at How Federal Public Health Dollars are Spent. (2005), by the Trust for America’s Health. The Robert Wood Johnson Foundation sponsored a report just released (February 7, 2005) that gives information, by state, on (1) the difference between dollars spent on medical care/treatment versus health promotion; (2) defines the Federal agencies that have a role in public health (hint: the total is surprising); (3) charts per state give percentage of *adults* with asthma, diabetes, obesity, cancer, heart disease, West Nile disease, AIDS; *children* with asthma, overweight, fully immunized, infant mortality, rate of Low Birth Weight CDC funds per line item of cancer prevention; chronic disease prevention/health promotion; diabetes control; environmental health; HIV prevention; immunization; infectious disease, with totals and per capita as well as state rank; (4) bio-terrorism preparedness spending from the CDC and HRSA and the totals; (5) HRSA spending from Ryan White, Maternal and Child Health Block grant; and Health Professionals Grant; and (6) the number of primary care health professions shortage areas. See http://healthyamericans.org/reports/budget05/

Role of the Planning Process

The Role of Self-Assessment in Achieving Cultural Competence. (2001), by Tawara Goode. Available for direct download from the NCCC Web site at http://gucchd.georgetown.edu/nccc/documents/ selfassessment.pdf

The Cultural Competence Self Assessment Protocol for Health Care Organizations and Systems, developed by Dennis Andrulis, Thomas Delbanco, Laura Avakian, and Yoku Shaw-Taylor. Available from http://erc.msh.org/mainpage.cfm?file=9.1g.htm&module=provider&language=English

A Manager’s Guide to Cultural Competence Education for Health Care Professionals. (2003), edited by M. Jean Gilbert and prepared for the California Endowment. See http://www.calendow.org/reference/ publications/pdf/cultural/TCE0217-2003_A_Managers_Gui.pdf

Example of a cultural competence plan from the California Department of Mental Health (includes administration goals and structures). See http://www.uacc4families.org/documents/ CultCompPlan-for-LTCS.pdf

Health sector reform and public sector health worker motivation: A conceptual framework. (2002, April), by L. M. Franco, S. Bennett, and R. Kanfer, Social Science Medicine, Volume 54, No. 8, 1255-1266.

Creating an Internal Management Structure for the Process

The NCCC Policy Brief series discusses organizational structures as a key part of cultural and linguistic competence. These policy briefs are available at http://gucchd.georgetown.edu/nccc/ products.html

There is some general information on establishing a diversity committee at http://www.casanet.org/program-management/diversity/cultural-competence.htm

The Director’s Query, a report on the results of interviews of State Title V Directors, will be available from the NCCC Web site in 2005/2006. This report will contain information on the different internal structures some State Title V Directors are using to infuse cultural and linguistic competence at all levels of their organizations.

The Contra Costa Health Services for Contra Costa County in California (see www.cchealth.org) developed an organizational plan to address health disparities by infusing cultural and linguistic competence. See Reducing Health Disparities: Diversity & Cultural and Linguistic Competence. Available online at http://www.cchealth.org/topics/publications/pdf/ reducing_health_disparities_article_nov03.pdf

Office of Multicultural Services, South Carolina Department of Mental Health, developed a cultural competence plan, which is available online at http://www.state.sc.us/dmh/cultural_competence/ cultural_plan.htm

Identifying Fiscal and Personnel Resources

Assessment of the Total Benefits and Costs of Implementing Executive Order 13166: Improving Access to Services for Persons with Limited English Proficiency, by OMB. Report to Congress. See http://www.omb.gov/inforeg/regpol.html

Pay now or pay later: Providing interpreter services in health care. (2005, March-April), by L. Ku, G. Flores; Center on Budget and Policy Priorities, Health Affairs: The Policy Journal of the Sphere (Millwood), Volume 24, No. 2, 435-444. Federal civil rights policy obligates health care providers to supply language services, but wide gaps persist because insurers typically do not pay for interpreters, among other reasons. Health care financing policies should reinforce existing medical research and legal policies: Payers, including Medicaid, Medicare, and private insurers, should develop mechanisms to pay for interpretation services for patients who speak limited English” Excerpt from abstract. Available from http://content.healthaffairs.org

Reducing disparities through culturally competent health care: An analysis of the business case. (2002, Summer), by C. Brach and I. Fraser, Quality Management in Health Care, Volume 10, No. 4, 15-28.

The Role of Self-Assessment in Achieving Cultural Competence. (2001), by Tawara Goode. This is an excerpt from the Cultural Competence Exchange newsletter of 2001 that identifies fiscal and resource benefits of self-assessment by identifying and utilizing current staff knowledge and skills more effectively, for example, those with multiple language skills, experience, and credibility with communities. Available directly from the NCCC Web site at http://gucchd.georgetown.edu/nccc/ documents/selfassessment.pdf

Identifying Collaborating Partners and Engaging Community Members in the Process

Policy Brief 4: Engaging Communities to Realize the Vision of One Hundred Percent Access and Zero Health Disparities: A Culturally Competent Approach. (2001), by Tawara Goode. Available for download directly from the NCCC Web site at http://gucchd.georgetown.edu/nccc/documents/ncccpolicy4.pdf

Bridging the Cultural Divide in Health Care Settings: The Essential Role of Cultural Broker Programs. (2003), by Tawara Goode, Suganya Sockalingam, and Lisa Lopez-Snyder. Available for download directly from the NCCC Web site at http://gucchd.georgetown.edu/nccc/documents/ Cultural_Broker_Guide_English.pdf

The Contra Costa Health Department developed a guide for community building, Healthy Neighborhoods Project: A Guide for Community Building and Mobilizing Around Health (1.3MB PDF, 102pp.). This guidebook presents a strategy that health departments and other agencies can use to improve community health. It presents the asset-based, community-building model of the Healthy Neighborhoods Project and how it has been implemented in Contra Costa County.

Keys to Access: Encouraging the Use of Mediation by Families From Diverse Backgrounds. (1999), by Anita Engiles, Cathy Fromme, Diane LeResche, and Philip Moses; Consortium for Appropriate Dispute Resolution in Special Education. This resource, designed for professionals in special education, provides guidance on understanding “ why some families may not participate in mediation, and strategies for increasing the participation from diverse backgrounds...practical recommendations. to develop the knowledge, positive attitudes, skills and strengths necessary for genuine collaboration” (p. 3). http://www.directionservice.org/ cadre/audio55.cfm

Community-based research partnerships: challenges and opportunities. (2005, June), by M. Minkler, Journal of Urban Health, Volume 82, No. 2, Suppl. 2, ii3-ii12. Epub 2005, May 11. Abstract: “The complexity of many urban health problems often makes them ill suited to traditional research approaches and interventions. The resultant frustration, together with community calls for genuine partnership in the research process, has highlighted the importance of an alternative paradigm. Community-based participatory research (CBPR) is presented as a promising collaborative approach that combines systematic inquiry, participation, and action to address urban health problems. Following a brief review of its basic tenets and historical roots, key ways in which CBPR adds value to urban health research are introduced and illustrated. Case study examples from diverse international settings are used to illustrate some of the difficult ethical challenges that may arise in the course of CBPR partnership approaches. The concepts of partnership synergy and cultural humility, together with protocols such as Green et al._s guidelines for appraising CBPR projects, are highlighted as useful tools for urban health researchers seeking to apply this collaborative approach and to deal effectively with the difficult ethical challenges it can present.” See http://www.ncbi.nlm.nih.gov/ entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15888635&dopt=Abstract

Building on leadership and social capital to create change in 2 urban communities. (2005, April), by S. A. Farquhar, Y. L. Michael, and N. Wiggins, American Journal of Public Health, Volume 95, No. 4, 596-601. This project addressed health disparities in the African American and Latino communities by enhancing community-level social capital. The article contains “specific examples of how this intervention uses community health workers and popular education to reduce language and cultural barriers and enhance community social capital. Although the communities share fundamental challenges related to health disparities, the ways in which the Latino and African American communities identify health concerns, create solutions, and think about social capital vary” (Abstract).

Using community-based participatory research methods to reach women with health messages: Results from the North Carolina BEAUTY and Health Pilot Project. (2005, April), by L. A. Linnan, Y. O. Ferguson, Y. Wasilewski, A. M. Lee, J. Yang, F. Solomon, and M. Katz, Health Promotion Practice, Volume 6, No. 2, 164-173. This study used a community-based participatory research approach to recruit and train five licensed cosmetologists from two beauty salons to deliver health promotion messages to their customers.“ At 12 months, 55% of customers reported making changes in their health because of the conversations they had with their cosmetologist. Customers who spoke more often with their cosmetologists about health also reported a higher percentage of self-reported behavior changes. It appears that trained licensed cosmetologists are effective in promoting health messages to their customers” (Abstract). See http://hpp.sagepub.com/cgi/content/abstract/6/2/164

Community Engagement in Public Health. (2006, March), by Mary Anne Morgan and Jennifer Lifshay. This paper introduces a conceptual framework for community engagement in public health. It highlights the examples of the Contra Costa (California) Health Services’ community engagement program. See http://www.cchealth.org/topics/publications/pdf/community_engagement_in_ph.pdf

Planning and Conducting Consumer Focus Groups

A New Use for Focus Groups—Building and Empowering a Culturally Diverse Team. (1996, November- December), by Sandra Hellman and Lynn Baker, Best Practices and Benchmarking in Healthcare, Volume 1, No. 6, 297-300.

Community-Based Participatory Research. (2004, July), by the Agency for Healthcare Research and Quality (AHRQ); Evidence-Based Practice Program. [Full citation: Viswanathan M, Ammerman A, Eng E, Gartlehner G, Lohr KN, Griffith D, Rhodes S, Samuel-Hodge C, Maty S, Lux, L, Webb L, Sutton SF, Swinson T, Jackman A, Whitener L. Community- Based Participatory Research: Assessing the Evidence. Evidence Report/Technology Assessment No. 99 (Prepared by RTI-University of North Carolina Evidence-based Practice Center under Contract No. 290-02-0016). AHRQ Publication 04-E022-2. Rockville, MD: Agency for Healthcare Research and Quality. July 2004.]

Families as Full Research Partners: What’s in it for Us? (1999, August), by Ann Vander Stoep, Marilynn Williams, Robert Jones, Linda Green, and Eric Trupin, Journal of Behavioral Health Services & Research, Volume 26, No. 3, 329-344.

Hearing their Voices: Lessons from the Breast and Cervical Cancer Prevention and Treatment Act (BCCPTA), Focus Group Findings from California. (2004, Fall), by the Kaiser Family Foundation. See http://www.kff.org/womenshealth/7146.cfm

Mexican-Origin Children’s Health in Cultural Context. (2005), by Lauren Clark; University of Colorado Health Sciences Center. This article is an example of a “focused ethnography” intended to describe the cultural context of “ child health production activities” for the benefit of nurses assisting Mexican-origin families. Study structures include home visits, unstructured interviews, photographs, and focus groups with different stakeholders, including a grandmother group, a friends/sisters of mothers group, and a health care professionals group. See http://156.40.88.3/cpr/dbs/res_mexican.htm

Responsible Research with Communities: Participatory Research in Primary Care: A Policy Statement. (1998), by N. Gibson (Editor). This is a policy statement on participatory research at the North American Primary Care Research Group (NAPCRG) Annual Membership Meeting. http://napcrg.org/exec.html

Developing Guidelines for Data Analysis and Report Development

W.K. Kellogg Foundation Evaluation Handbook. (1998), by W.K. Kellogg Foundation, Call (800) 819-9997 for a free copy. This handbook was designed by the Kellogg Foundation staff in order to make evaluation techniques more useful to organizational and program development. According to the introduction, this handbook “provides a framework for thinking about evaluation and outlines a blueprint for designing and conducting evaluations, either independently or with the support of an external evaluator/consultant.” The process explicitly calls for addressing “real issues” in the community and creating a participatory process. When infused with principles of cultural and linguistic competence, this tool can be used to evaluate health and mental health systems for the diversity that exists in the United States.

Step into my zapatos, doc: Understanding and reducing communication disparities in the multicultural informed consent setting. (2005, Winter), by C. M. Simon and E. D. Kodish, Perspectives in Biology and Medicine, Volume 48, 1 Suppl., S123-138. Abstract: “Current informed consent standards are aimed at promoting an equitable and ethical environment for conducting research across diverse patient populations. This paper explores the possible effects of ethnicity and culture on the consent process for pediatric cancer clinical trials. Informed consent discussions were observed, recorded, transcribed, and coded. Question asking by parents and clinician/parent word ratios were used to create an interactivity measure, or “I-score.” Visual analog scales were used to rate the clarity of specific explanations. Cases were sorted into two groups on the basis of parents’ self-reported ethnicity: Caucasian (n=79, 56%) and minority (predominantly Latino) parents (n=61, 44%). Chi-square and t-tests were used to compare the groups. A series of logistic regression analyses (controlling for ethnicity and SES) were run for variables that showed statistically significant differences (p < 0.05). Our findings suggest that the content and quality of the informed consent process is linked to parental ethnicity, or clinician attitudes toward parental ethnicity. These findings are discussed in terms of current perspectives on culture and “cultural competence” in health care. Further research is needed to understand how cultural factors affect outcomes such as parental understanding, decision making, mutual trust, and satisfaction within the informed consent process.”

Developing a cultural competence assessment tool for people in recovery from racial, ethnic and cultural backgrounds: The journey, challenges and lessons learned. (2005, Winter), by T. E. Arthur, I. Reeves, O. Morgan, L. J. Cornelius, N. C. Booker, J. Brathwaite, T. Tufano, K. Allen, and I. Donato, Psychiatric Rehabilitation Journal, Volume 28, No. 3, 243-250. Abstract: “In 1997, Maryland implemented a new managed care mental health system. Consumer satisfaction, evaluation and cultural competency were considered high priorities for the new system. While standardized tools for measuring consumer satisfaction were readily available, no validated, reliable and standardized tool existed to measure the perception of people from minority groups receiving mental health services. The MHA*/MHP* Cultural Competency Advisory Group (CCAG) accepted the challenge of developing a consumer assessment tool for cultural competency. The CCAG, composed of people in recovery, clinicians and administrators used their collective knowledge and experiences to develop a 52-item tool that met standards for validity and reliability. Consultation from a researcher helped to further develop the tool into one possessing tremendous potential for statewide implementation within Maryland’s Public Mental Health System. Recognizing the limitations of the study and the need for further research, this instrument is a work in progress. Strategies to improve the instrument are currently underway with the Mental Hygiene Administration’s Systems Evaluation Center of the University of Maryland and several national researchers.”

Developing Suggested Best Practices for Disseminating the Results of the Self-Assessment

Promising Practices Contra Costa County (in progress).

Infusing Cultural & Linguistic Competence into Health Promotion Training (DVD). See http://gucchd.georgetown.edu/nccc/sidsdvd.html

Changing Channels and Crisscrossing Cultures: A Survey of Latinos on the News Media (2004), by Roberto Suro; Pew Hispanic Center. From the Introduction: “This report shows that the news media powerfully influence the twin processes of cultural change at work in the Hispanic population: the assimilation of American attitudes and the formation of a distinct ethnic identity. Even as the English-language media purveys values and cultural expressions drawn primarily from the experience of the native born, the Spanishlanguage media reflects the immigrant experience and reinforces ties to the home country. Nearly half of the adult Hispanic population crisscrosses between the two, getting some of its news in both languages.” http://pewhispanic.org/reports/report.php?ReportID=27

The value of engaging stakeholders in planning and implementing evaluations. (2002, June), by A. Gilliam, D. Davis, T. Barrington, R. Lacson, G. Uhl, and U. Phoenix, AIDS Education and Prevention, Volume 14, No. 3, Suppl. A, 5-17. Abstract: “Stakeholder participation in evaluation has surfaced as a major factor contributing to the effectiveness of HIV prevention programs. In recognition of the multiple benefits, the Centers for Disease Control and Prevention (CDC), has used a framework to involve stakeholders in the evaluation of its programs. This article describes the framework used by the CDC and provides examples of four studies that involved various stakeholders from health departments, communitybased organizations, and community planning groups to national and regional organizations in designing and implementing evaluations that yielded results useful for program improvement. The participatory process involved stakeholders in each of the four phases of the framework: evaluation planning, implementation, development of action plans, and dissemination. Lessons learned include the importance of having a facilitator to coordinate activities and ongoing communication with those involved in the evaluation. Stakeholders shared that using the evaluation results for action planning was beneficial for improving their programs. Despite many challenges faced in the stakeholder evaluation process, most stakeholders agreed that many benefits grew out of the multiple perspectives presented and understanding of the service agencies.”

Policy Brief 3. Cultural Competence in Primary Health Care: Partnerships for a Research Agenda. (2000), by Tawara Goode and Sharonlyn Harrison. This brief includes strategies for dissemination. See http://gucchd.georgetown.edu/nccc/documents/ Policy%20Brief%203.pdf Cardiovascular health among Asian Indians (CHAI): A community research project. (2004, November), by S. L. Ivey, S. Patel, P. Kalra, K. Greenlund, S. Srinivasan, and D. Grewal, Journal of Interprofessional Care, Volume 18, No. 4, 391-402. Abstract: “The object of this research was to assess cardiovascular (CV) risks in Asian Indians in California. We conducted eight focus groups and a pilot survey using community-based participatory research (CBPR) methods. Focus groups were held in six communities. Surveys were conducted by telephone or in person in areas selected for high population densities of Asian Indians. We selected focus group subjects by snowball sampling (n = 57). We held six English and two Punjabi groups. We used a surname-based phone list from three area codes for telephone interviews (n = 254). We added 50 in-person interviews for comparison (total n = 304) and did 50 interviews in Punjabi. We held community meetings for dissemination. Focus groups discussed CV risks; themes developed aided survey development. In-person and telephone surveys were feasible. Telephone surveys were more gender-balanced and people more often answered alcohol, tobacco, and income questions. Selfreported prevalences for hypertension, hypercholesterolemia, and diabetes were 20.4, 35.3 and 10.6%, respectively. Only 11.9% of persons reported ever smoking cigarettes. It was concluded that CBPR methods were effective in this exploratory study assessing CV risks in Asian Indians. Hypertension, high cholesterol, and diabetes were more prevalent in participants than the population average; other risk factors were less common (tobacco).”

‘ Imi Hale—the Native Hawaiian cancer awareness, research, and training network: Second-year status report. (2003, Winter-Spring), by K. L. Braun, J. Tsark, L. A. Santos, and L. Abrigo; Native Hawaiian Cancer Awareness Research and Training Network, Asian American and Pacific Islander Journal of Health, Volume 10, No. 1, 4-16. Abstract: “PURPOSE: The purpose of this paper is to describe ‘Imi Hale, a program developed and managed by Native Hawaiians to increase cancer awareness and research capacity among Native Hawaiians. This US subgroup of indigenous people of the Hawaiian islands has disproportionately high rates of cancer mortality and low rates of participation in health and research careers. METHODS: As a community-based research project, ‘Imi Hale spent its first year gathering data from Native Hawaiians about their cancer awareness and research priorities. These findings guide ‘Imi Hale’s community and scientific advisors, a community-based Institutional Review Board, Na Liko Noelo (budding researchers), and staff in developing and carrying out projects that address these priority areas. Emphasis is placed on transferring skills and resources to Native Hawaiians through training, technical assistance, and mentorship. A biennial survey assesses the extent to which community-based participatory research principles are being followed. PRINCIPAL FINDINGS: By the end of the school year, statewide and island-specific awareness plans were produced, and 9 funded awareness projects are supporting the development and dissemination of Hawaiian health education materials. Research accomplishments include the enrollment of 42 Native Hawaiian Na Liko Noelo (budding researchers), 22 of which are involved in 14 funded research projects. The biennial evaluation survey found that 92% of our advisors felt that ‘Imi Hale was promoting scientifically rigorous research that was culturally appropriate and respectful of Native Hawaiian beliefs, and 96% felt that ‘ Imi Hale was following its own principles of community-based participatory research. CONCLUSION: ‘Imi Hale’s community-based approach to promoting cancer awareness will result in a sustainable infrastructure for reducing the cancer burden on Native Hawaiians.”

The East Side Village Health Worker Partnership: Integrating research with action to reduce health disparities. (2001, November-December), by A. J. Schulz, B. A. Israel, E. A. Parker, M. Lockett, Y. Hill, and R. Wills, Public Health Reports, Volume 116, No. 6, 548-557. Abstract: “This article describes the work of the East Side Village Health Worker Partnership as a case study of an initiative that seeks to reduce the disproportionate health risks experienced by residents of Detroit’s east side. The Partnership is a community-based participatory research and intervention collaboration among academia, public health practitioners, and the east side Detroit community. The Partnership is guided by a steering committee that is actively involved in all aspects of the research, intervention, and dissemination process, made up of representatives of five community-based organizations, residents of Detroit’s east side, the local health department, a managed care provider, and an academic institution. The major goal of the East Side Village Health Worker Partnership is to address the social determinants of health on Detroit’s east side, using a lay health advisor intervention approach. Data collected from 1996 to 2001 are used here to describe improvements in research methods, practice activities, and community relationships that emerged through this academicpractice- community linkage.”

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