Context for Public Health
Nutrition Practice:
Cultural Competence
Coalitions/Collaboration
Community-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_c
an_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/02-0806_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?