From: The National Center for Cultural Competence, Georgetown University Child Development Center, University Center for Excellence in Developmental Disabilities Winter 2002.

The process of self-assessment is as important as the outcome. The National Center for Cultural Competency (NCCC) has found the following steps to be very beneficial to the self-assessment processes it has conducted with seven State Title V Maternal and Child Health/Children with Special Health Care Needs programs (MCH/CSHCN).

• Cultivating Leadership

It is incumbent upon leadership to establish a rationale for and to promote self-assessment as an organizational goal and priority. Cultivating leadership, in this instance, would encompass identifying members from all strata of an organization to fulfill leadership roles in the self-assessment process. Effective leadership usually involves relinquishing or sharing power at many levels? (Mahan, 1997). An emphasis should be placed on encouraging personnel to assume leadership roles at all levels of the organization. Shared power is an integral principle of leadership development (Kouzes & Posner, 1990; Covey, 1996; Melaville & Blank, 1991; Lipman-Blumen, 1996).

• Getting Buy-In

Establish a shared vision that conveys the importance of the self-assessment process to the overall organization, its personnel, the families/consumers and communities served. Sharing a view of the future represents the most important context for effecting change? (Roberts & Magrab, 1999). When individuals are involved in the generation and use of knowledge this enables different groups of people to act collectively based on informed decisions (Selener, 1990). A major benefit is the formation of a coalition of stakeholders, who are informed and prepared to affect and sustain change to improve the delivery of services and enabling supports.

• Assuring Community Collaborations & Partnerships.

A major principle of cultural competence involves working in conjunction with natural, informal, support and helping networks within diverse communities (Cross et al., 1989). From the inception of the self-assessment process, include community partners and key stakeholders in meaningful ways. Some examples are developing a shared vision, identifying leadership roles and responsibilities, distributing tasks equitably based on capacity, and allocating resources. It is important to recognize that individuals and groups will choose different levels of involvement and ways to participate. This may vary from serving on task forces or workgroups, participation in focus groups, making in-kind or other fiscal contributions, sub-contracting for specific services to providing meeting facilities and other accommodations. It is an essential to demonstrate that the contributions of each community partner are valued and respected.

• Structuring Support for the Process.

Convene a committee, work group or task force that will assume responsibility for the self-assessment process. The group should have representation from policy making, administration, service delivery, consumers and other community stakeholders. It should also reflect the diversity of the organization and the community at large. This group is the primary entity for planning and implementing the self-assessment process, and should have ready access to decision makers or have the ability to make decisions.

• Allocating Personnel and Fiscal Resources.

Conducting a self-assessment process is resource intensive. It requires a dedicated budget and level of effort for organizational personnel. This may also extend to community partners and key stakeholders involved in the process. Budgetary considerations may include subcontracts for the self-assessment process such as consultants/facilitators, meeting or conference facilities, and interpretation and translation services. There may be other associated costs for: stipends/honoraria for consumer participation and family supports; local/domestic travel reimbursement; and printing, mailing and other dissemination activities. Consideration should be given to the necessary level of effort for personnel who have responsibility for this process. This will entail delineating responsibilities and determining the duration and intensity of time required for personnel. It may require deferment or reassignment of current workload/duties. The self-assessment process depends on a well-crafted allocation of personnel and fiscal resources.

• Managing Logistics.

The ability to effectively coordinate numerous logistical tasks is vital to the self-assessment process. The task force or workgroup needs to insure sufficient time to plan and prepare, timely dissemination of information to all involved and the development of a calendar and schedule of activities (e.g. sites and times for regular meetings, teleconferences, focus groups, administering the self-assessment instrument, data collection and analysis and dissemination of results).

• Analyzing and Disseminating Data.

The active involvement of individuals, groups and communities is a highly valued and integral aspect of the self-assessment process. Task force and workgroup members need to plan their involvement in data collection (Census and program needs assessment data blended with the data from the self-assessment), analysis, interpretation, presentation and dissemination. This approach is commensurate with culturally competent and participatory action designs in research and evaluation (Brandt, 1999; Caldwell, et al, 1999; Goode & Harrison, 2000).

Taking the Next Steps

The self-assessment process can yield a wealth of information about organizational strengths and areas for growth. Careful consideration should be given to:

•     establishing organizational priorities
•     developing a strategic plan with goals and objectives to sustain strengths and address growth areas
•     allocating necessary resources to accomplish strategic plan goals
•     sustaining and maintaining partnerships with community stakeholders
•     incorporating self-assessment results into the state block grant planning and development process.

The self-assessment process may lead to changes in: organizational mission, policies, structures and procedures; staffing patterns; position descriptions and personnel performance measures; delivery of service and supports; outreach and dissemination approaches; composition of advisory boards and committees; professional development and in-service training activities; and management and information systems (MIS) and telecommunication systems. Achieving cultural competence is a long-term commitment. Remember that it is accomplished one step at a time.

The NCCC operates under the auspices of Cooperative Agreement # U93-MC-00145-06 and is supported in part from the Maternal and Child Health Program (Title V, Social Security Act), Health Resources and Services Administration (HRSA), Department of Health and Human Services (DHHS).

References

Brant, J. et al., Oncology nursing society multicultural outcomes: Guidelines for cultural competence (USA: The Oncology Press, 1999.)

Caldwell, C., Jackson, K., Tucker, B., and Bowman, P. (In press). Culturally Competent Research Methods in African American Communities: An Update.

Advances in African American Psychology: Theory, Paradigm Methodology, and Reviews, ed. R.L. Jones (Hampton, VA: Cobb and Henry Publishers.

Covey, S. (1996). Three roles of the leader in the new paradigm. The leader of the future: New visions, strategies and practices for the new era. In Hesselbein, F., Goldsmith, M., & Beckhard, R. (Ed.) San Francisco: Jossey-Bass.

Cross, T., Bazron, B., Dennis, K., and Isaacs, M. (1989). Towards a culturally competent system of care volume I. Washington, D.C.: Georgetown University Center for Child and Human Development (aka Georgetown University Child Development Center), CASSP Technical Assistance Center.

Goode, T. & Harrison, S. (2000).  Policy brief 3:Cultural competence in primary health care: Partnerships for a research agenda. Washington, D.C.: Georgetown University Center for Child and Human Development (aka Georgetown University Child Development Center).

Kouzes, J. M. & Posner, B.Z. (1990). The leadership challenge. San Francisco: Jossey-Bass.

Lipman-Blumen, J. (1996). The Connecting edge: Leading in an independent world. San Francisco: Jossey-Bass.

Magrab, P.R. (1999). The meaning of community. In Roberts, R. N. & Magrab, P.R. (Eds.), (pp. 3-29). Where children live: Solutions for serving children and their families. Stamford, CT: Ablex Publishing.

Mahan, C. (1997). Surrendering control to the locals. Journal of Public Health Management and Practice, Vol. 3(1).

Mason, J. (1996). Cultural competence self-assessment questionnaire. Portland, Oregon: JLM & Associates.

Melaville, A. & Blank, M. (1991). What it takes: Structuring interagency partnerships to connect children and families with comprehensive services. Washington, D.C.: Education and Human Services Consortium.

Selener, D. (1990). Participatory Evaluation. Peoples knowledge as a source of power. Networking Bulletin.

From:

The National Center for Cultural Competence, Georgetown University Child Development Center, University Center for Excellence in Developmental Disabilities Winter 2002. http://gucdc.georgetown.edu/nccc