Beth Bonniwell, MSW
Emma Duer, MPH
Lauren Villalba, MPA

• What is culture?
▫ “Culture has been defined in a number of ways, but most simply, as the learned and shared behavior of a community of interacting human beings.”
• What is diversity?
▫ “The term ‘diversity’ is used broadly to refer to many demographic variables, including, but not limited to, race, religion, color, gender, national origin, disability, sexual orientation, age, education, geographic origin, and skill characteristics.”
• What is cultural competence/sensitivity/humility?
▫ “Cultural [competence] is a developmental process that evolves over an extended period. Both individuals and organizations are at various levels of awareness, knowledge and skills along the
[cultural competence] continuum.”
Sources:
Useem, J., & Useem, R. (1963). Human Organizations, 22(3).
U.S. Department of the Interior
National Center for Cultural Competence

• Style of dress
• Ways of greeting people
• Beliefs about hospitality
• Importance of time
• Values
• Beliefs about child raising
• Attitudes about personal space & privacy
• Beliefs about responsibilities
• Gestures to show you understand something
• Holiday customs
• Music, dance, art, literature
• Celebrations
• Concept of fairness
• Nature of friendship
• Ideas about clothing
• Foods
• Greetings
• Facial expressions and hand gestures
• Concept of self
• Work ethic
• Religious/spiritual beliefs & rituals
• Concept of beauty
• Rules of polite behavior
• Attitudes toward age
• The role of the family
• General worldview
• Etc.
Source: Building Bridges, A Peace Corps Classroom Guide to Cross-Cultural Understanding

Source: Diverse Team.
Lee, Gardenswartz, and
Rowe. Burr Ridge, IL:
Irwin Professionals, 1994.

• Cultural Competence/Sensitivity/Humility:
“Incorporating these capacities into all aspects of policy making, administration, practice, service delivery; systematically involving consumers, stakeholders, and communities.”
Source: National Center for Cultural Competence

“Diversity Pie” Activity
1.
Make a list of your cultural identity elements (e.g., gender, race, country of origin, SES, language, sexual orientation, religion/spirituality, age, disability, etc.).
2.
Draw a pie chart using these elements for each slice of the pie. Change the size of the slices to reflect the strength or importance of each element to you.
Source: Cox Self-Identity Exercise (Pie Chart) as it appears in: Cox, Taylor Jr. (1994) Cultural
Diversity in Organization: Theory, Research, and Practice. San Francisco, CA: Berrett-
Koehler Publishers, Inc., Pg. 49. (Adapted by
The Cultural Imperative)

• Limited research/discussion specific to DVFR
• Both sides of the mirror:
▫ Examining and interpreting case facts
▫ Assessing team values and procedures
• Multiple layers, from individuals to organizations and beyond

• Social-ecological model

• Henrico County, Virginia

• 1999 VA Code 32.1-283.3
• Important team dates
• Membership
• Type of cases reviewed
▫ VA Code 16.1-228 – family or household members
• Total cases reviewed July 1997- present
▫ IPV - 26
▫ Child deaths - 6
▫ DV - 9

• Sex includes options for transgender M2F, F2M, other, unknown
• Options to capture complex relationship classifications
▫ Assisted death, love triangles, desired but unrequited love, law enforcement officer involved
▫ Adopted or foster care options, day care client, nursing home or residential care client
• Integrated instruments
▫ DA, P&C Wheel, ACE Study, timelines, family trees
• Religious affiliation and activity
• Tattoos
• Information from media sources
• Information from electronic social networks

• Overall decline in family violence fatal events
• Majority of fatal events IPV
• Seven DV fatal events between 2003-2010

Alleged Offender
Education
Employment
Mental Health most dropped out of high school
4 of 7 working at time of fatal event
4 of 7 had diagnoses
Housing none had stable housing or housing of their own
Substance Abuse 6 of 7 abused; 4 of 7 abused at time of fatal event
Primary Decedent
Education most completed high school or college
Employment 5 of 7 working at time of fatal event; 1 retired
Mental Health
Housing
3 of 7 had diagnoses
5 of 7 owned homes; 2 leased
Substance Abuse 2 of 7 abused; 1 of 7 abused at time of fatal event

• Findings unlike IPV and child death cases
IPV Cases
General Findings fatal injuries: mostly gun shot wounds or stabbing history of domestic violence and threats to kill infidelity and recent separations in relationships prior history of stalking behaviors
Child Deaths fatal injuries: mostly heat exposure or blunt force trauma issues related to childcare / affordable childcare primary decedents mostly under the age of 1
• How do we prevent DV fatal events?
• Different assessment and intervention for DV cases

• Miami-Dade County, Florida
▫ County history and DVFR Team make-up
▫ Selection of cases
 3 ways
 Adult and child cases
▫ 2014 statistics
 8 H, 3 S, 7 H/S
▫ DFVRT process

• Social media
• Unique local Latino culture
▫ Language barriers
▫ Awareness of laws
▫ Undocumented violence
▫ “The Cultural Divide”
▫ Machismo
• LGBTQ population
▫ Family structure, fear of “coming out”
▫ Social media/stalking
▫ Lack of support, resources

• Recent findings and trends from recent reviews
• Pilot program

• Commonwealth of Virginia
▫ Statewide Needs Assessment
 Who is underserved?
1.
Immigrant/LEP (71%)
2. Older Adults (20%)
3. African Americans (10%)
 Also: LGBTQ, College Students, Men

• Multiple, complex, and overlapping cultural identities
• Barriers are similarly complex and often intersect/interact
• Multiple layers of barriers or challenges due to their cultural identity, as well as identity as a victim of sexual or domestic violence (SDV)

• Distrust of the SDV Response System due to adverse personal or historical experiences with service providers
• Lack of coordinated, consistent, reliable, accessible, affordable, comprehensive, and culturally appropriate services to ensure access to timely and accurate information about SDV, victims’ rights, and available services
• Perceived or actual consequences for disclosing SDV result in pressure not to disclose or seek help
• Community, familial, and/or provider minimization of
SDV

• New & updated trainings and resources across the state and across service sectors
▫ Resources and training for DVFRTs on cultural competence/sensitivity/humility in fatality review
 What is the role of culture in DVFR?
 What are the benefits?
 What are the barriers/challenges?

• As a team
• In your processes
• In your reporting/community actions
 Every level/stage of the DVFR process (socialecological model)

• The wheel represents continuous opportunities to enhance cultural competence in DVFR
• Each spoke is an aspect of DVFR that can be assessed and improved to enhance cultural competence:
▫ Written Policies & Procedures
▫ Team Structure & Capacity
▫ Case Review Process
▫ Findings & Recommendations
▫ Reports & Community Action
• Inner and outer rings of the wheel demonstrate that through awareness and education, DVFRTs can provide culturally relevant solutions for their community

• How does your team’s world view reflect a commitment to cultural competence?
• In what ways is this commitment reflected in organizational practices and policies?
Slides 25-34 adapted from: Goode, et al. (2009). Cultural and Linguistic Competence
Organizational Assessment Instrument for Fetal and Infant Mortality Review Programs.
National Center for Cultural Competence, Georgetown University Center for Child and Human
Development

• The team’s commitment to cultural competence is explicitly written in vision/mission/guiding principles
• The team holds meetings at a time and place that allows participation of a diverse membership

• What skills and knowledge do team members have to support cultural and linguistic competence?
• How does your team nurture diversity through membership or ad hoc advisors?

• Membership includes permanent or ad hoc cultural experts or “context providers”
• All team members receive continuing education and current datum on cultural contexts relevant to their community
• All team members possess skills related to cultural diversity that allow them to present and discuss case facts in an accurate and unbiased manner

• How does cultural competence apply to the case review process, including case selection, data collection, and team discussions?
• How is culturally specific information used in case review?

• Case selection/identification of cases: avoid
“cherry-picking”; team reviews all cases allowable by law
• Team develops a consistent method for collecting culturally related information pertaining to cases
• Team intentionally discusses culturally specific information in each case
• Team interviews family/friends or cultural navigators/key informants

• How are case facts analyzed and interpreted to provide cultural context to your team’s findings and recommendations?
• In what ways are recommendations culturally relevant to the communities impacted?

• Addresses possible biases in team members’ perspectives and interpretation of case facts
• Makes recommendations that address the culturally diverse needs of at-risk community members
• Discusses culturally relevant findings and how the finding can be used to reduce future domestic violence fatalities

• How does your team present its findings in a way that is accessible and engaging to diverse communities?
• In what ways does your team collaborate with a wide range of stakeholders to effect change?

• Disseminates reports to the diverse communities impacted by the review
• Takes into account diverse forms of communication in disseminating findings & recommendations (e.g. language, modality, etc.)
• Seeks to partner with diverse community support/advocacy organizations in order to implement recommendations
• Cultivates participation from natural, informal supports in the community i.e. community elders, cultural leaders, and faith/spiritual representatives in order to sustain recommendations
• Promotes culturally relevant action plans to accompany recommendations

• Broadening our definition and understanding of culture
• From competence to awareness/sensitivity
▫ Emphasis on self-reflection
• Tools and resources for organizational selfassessment
• Cultural competence in DVFR?

• Continue the conversation
• Provide feedback on our model for Culturally
Competent DVFR
• Take these ideas back to your team/community

• Beth Bonniwell, MSW
Henrico County Police Division
Senior Management Specialist
Co-Chair, Henrico County Family Violence Fatality Review Team
(Virginia) bon@henrico.us
/ 804-501-5732
• Emma Duer, MPH
Virginia Department of Health, Office of the Chief Medical Examiner
State Coordinator, Virginia Domestic Violence Fatality Review emma.duer@vdh.virginia.gov
/ 804-205-3858
• Lauren Villalba, MPA
Data Analyst, Fatality Review Team
Miami-Dade County Domestic Violence
Administrative Office of the Courts lvillalba@jud11.flcourts.org
/ 305-349-5789