Context for Public Health Nutrition Practice: 

Cultural Competence

Coalitions/CollaborationCommunity-based

I. Cultural Competence

• “Brings together cultural knowledge, awareness and sensitivity –and adds operational effectiveness”

• “A culturally competent organization has the capacity to bring into its system many different behaviors, attitudes and policies and work effectively in cross-cultural settings to produce better outcomes.”

http://ctb.ku.edu/en/

Understanding the Concept

• Cultural competence is an ongoing process

• Concerted change effort by individuals and organizations

Cultural Competence: Why do we care?

• Diversity is reality

• Creativity through new perspectives & ideas

• Builds trust and cooperation

• Heads off unwanted surprises

• Increases participation and involvement

Guiding Principals• Value Diversity• Conduct Self-assessment – ability to:

– Be involved and comfortable with people from different cultures and backgrounds

– Show genuine respect for others who are different. – Work effectively with people from different cultures and

backgrounds. – Link to networks of people and groups from different

cultures and backgrounds.

• Understand of the dynamics of difference• Purposely work toward inclusion (integrating

perspectives and opinions)

Cultural Competence Starting Points (Fieldstone Alliance)

1. Understand the concept

2. Decide what cultural competence means for your organization

3. Ask Questions

4. Establish the right structure

Decide what cultural competence means for your organization

• Across the organization: outreach, evaluation, administration, strategy and planning, quality assurance, consumer involvement, HR, marketing, linguistic competence

Right Structure

• Diverse staff at all levels

• Identify each participants’ content expertise

• Ensure representation from communities served

• Leader with appropriate skills and content expertise

• Accountability measures

II. Coalitions

• A coalition is a temporary alliance or partnering of groups in order to achieve a common purpose or to engage in joint activity

Coalitions work when…

• goals are similar and compatible,

• working together enhances collaborators’ abilities to reach their goals, and

• the benefits of coalescing are greater than the costs.

Coalitions and Collaborations: Why do we care?

• A coalition of organizations can win on more fronts than a single organization working alone – more people who have a better understanding of your

issues & more people advocating for your side.

• A coalition can bring more expertise and resources to bear on complex issues– physical and financial resources – expertise– each group gains access to the contacts,

connections, and relationships established by other groups.

http://www.beyondintractability.org/essay/coalition_building/

Coalitions and Collaborations: Why do we Care? (cont)

• The activities of a coalition are likely to receive more media attention than those of any individual organization.

• A coalition can build a lasting base for change. Once groups unite, each group's vision of change broadens and it becomes more difficult for opposition groups to disregard the coalition's efforts as dismissible or as special interests.

Building Diverse Community Based Coalitions

• Recruitment plan: choice of partners sends a message to the community, not necessarily most prominent members, use “go-betweens”

• Partners: concerned enough about the core issues to make a solid commitment, consider risk in getting involved

• Fully integrate and share power • Assure accessibility to newcomers

Three Strategies for “Nimble” Collaboration

• Focus on Results

• Shape Relationships

• Structure for Resilience

http://www.fieldstonealliance.org/client/client_pages/tools_you_can_use/07-25-07_nimble_collab.cfm

10 Principals of Resilience for Collaboration

1. The leadership of each participating agency energetically supports the results the collaboration aims to achieve.

2. There is equity—not equality—of organizational power in the collaboration.

3. Systems are changed as individual organizations change themselves internally.

4. Leadership is shared among organizations.5. Conflict is expected and is managed effectively.

Confronting Conflict

• The key to moving through the tough times is keeping the focus on concrete, work related issues.

• “leave room for different styles of expression and try to not take it personally.”

Principles of Resilience, cont.

6. Collaboration is transparent and does not create a new level of bureaucracy.

7. Each agency in a collaboration is accountable to its own leadership and its own constituents.

8. Decision making becomes faster and more effective as power to make decisions is delegated to appropriate subgroups.

9. Collaborations are usually impermanent.10.Documentation supports resilience.

Community-Based

• “Community-based participatory research in health is a collaborative approach to research that equitably involves all partners in the research process and recognizes the unique strengths that each brings.”

• “CBPR begins with a research topic of importance to the community with the aim of combining knowledge and action for social change to improve community health and eliminate disparities.”

W. K. Kellogg Foundation

9 Key CBPR Principles: Barbara Israel 1. Recognize community as a unit of identity; 2. Build on strengths and resources within the community; 3. Facilitate collaborative, equitable partnership in all phases

of the research;4. Promote co-learning and capacity building among all

partners; 5. Integrate and achieve a balance between research and

action for mutual benefit of all partners; 6. Emphasize relevance of public health problems and

ecological perspectives that recognize and attend to the multiple determinants of health and disease;

7. Involve systems development through a cyclical and iterative process;

8. Disseminate findings and knowledge gained to all partners in a manner that involves all partners;

9. Involve long-term process and commitment.

How do leaders make it happen?

• Frame ideas—the capacity to define opportunities and issues in ways that lead to effective action. Through framing, a group understands and decides what needs to be done, how it is to be done, and why it is important.

• Build social capital—the capacity to develop and maintain relationships that allow people to work together and share resources.

• Mobilize resources—the capacity to organize and engage enough people, financial resources, votes, and organizations to make the project a reality.

http://www.fieldstonealliance.org/client/client_pages/tools_you_can_use/02-08-06_cmty_leadership.cfm

Group Work

1. What groups, organizations and individuals will you bring together in coalition or collaboration?

2. How will you build culturally competent “right structure?”

3. How will you apply CBPR principals to the evaluation of your initiative?