Thesis (Ph. D.)--Ohio State University, 2009. / Title from first page of PDF file. Includes vita. Includes bibliographical references (p. 166-178).

People with disabilities from culturally and linguistically diverse (CLD) backgrounds experience discrimination related to their multiple cultural identities. Complex organizational responses and workforce training are needed to effectively address the resulting inequalities they experience. Yet, there is little guidance about effective practices for organizations serving people with disabilities from CLD backgrounds. Similarly, little research exists about effective cultural and linguistic competence (CLC) training provided by such organizations. Chapter 1 details a scoping review study that identified 29 documents related to CLC for organizations supporting people with disabilities from CLD backgrounds. Frequency counts and a qualitative thematic analysis were used to describe those documents and their recommendations. Although 24 themes were identified that provide relevant organizational CLC recommendations, few of the reviewed documents attended to the intersection of disability and race/ethnicity, exhibited methodological rigor, or included perspectives of diverse people with disabilities. Often, recommendations in the identified documents lacked clarity and detail, and were therefore not easily translatable into interventions. In most documents, little attention was paid to standards or methods that could be used to evaluate the recommended CLC initiatives. A series of tables present the documents, their qualities, and 24 recommendation themes. Chapter 2 is an exploratory, holistic, and retrospective single-case study of CLC training provided by an interdisciplinary leadership training program. Multi-source interviews and review of archival data were used to research evidence of the presence of activities, content, and structure of infused CLC training in a year-long training program designed to develop leadership abilities in an interdisciplinary group of disability-serving professionals and advocates. Interviews were conducted with three course faculty and three trainees of the 2015-2016 training year. Archival data from the 2015-2016 training year contributed triangulation across type of data. Qualitative analysis and interpretation were performed by a diverse research team. The results and discussion are presented via thick description and illustrate a model of CLC training that seeks to acculturate trainees to a collaborative culture of humility, inclusion, and social justice via a learning community mechanism.

This mixed methods case study sought to understand cultural competency in the students of a service-learning based course, “Citizenship and Social Activism (HDFS 310),” taught at North Dakota State University in Fargo, North Dakota. Cultural competency refers to how people interact with those who are of different cultural groups. For the purposes of this study, cultural competency was also defined by four components: attitudes, knowledge, awareness, and skills. Using a pre- and post-test survey, the participants showed statistically significant changes in the levels of self-reported cultural competency in the overall scores and in the subsection scores that correspond to the four components. Survey data was complemented by qualitative data collected by coding participants’ reflective journals. The qualitative data provided situation-specific information about what levels of cultural competency participants were demonstrating; additionally, the journals provided information about how participants define, perceive, and struggle with the concept of cultural competency.

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Based on fourteen months of ethnographic fieldwork conducted in Israel between 2013 and 2016, this dissertation examines how clinicians and patients deal with the issues of cultural difference and diversity in Israel’s mental health care settings, which are increasingly called upon to practice “cultural competence.” In 2010s, the Israeli Ministry of Health started to design and execute policy measures intended to target inter-group health disparities and introduce cultural competence in health care institutions. Although modest in scope, these policies are also emblematic of the much larger tectonic shifts that have been reshaping Israeli society over the last three decades, including a neoliberal restructuring of Israeli economy and a decline of the secular Ashkenazi hegemony in political and cultural spheres. In this context, the Ministry of Health measures may be understood as a reaction of a particular segment of the Israeli political elite to the new realities and as an attempt to address mounting public anxieties, while also working within the existing neoliberal and largely non-pluralist political-economic framework. The specific discourses of the cultural competence policies construe culture as a property of individual patients that individual clinicians and institutions should learn to accommodate, without attending to structural or political considerations. And yet, the actual implementation of the governmental agenda in the sphere of cultural competence training is almost never a mere passive reflection of the official discourses: While echoing some of the essentializing and implicitly hierarchical rhetoric of the official policies, the training also smuggles in quietly subversive approaches to cultural difference and recognition. The impact of this training on actual clinical practice is, unsurprisingly, very limited, and clinicians themselves rarely find the discourses of “cultural competence” resonant or relevant. At the same time, they are constantly engaged in complex moral reasoning and ethical decision-making over the nature and limits of empathy and recognition in the face of cultural alterity and political difference. This dissertation contributes to an interdisciplinary literature on the so-called “psy” or psychological disciplines (psychiatry, psychology, psychoanalysis etc.) by proposing an approach that is informed by the anthropology of ethics and morality.

The 2015 U.S. Census predicts that over the next 30 years, the population of the United States will be increasingly diverse (United Stated Census Bureau, 2015). Understanding how this diversity influences healthcare, and more specifically the practice of occupational therapy, has become increasingly important. Occupational therapy practitioners encounter cultural factors when assessing a client’s occupational needs yet 91% of OT programs surveyed reported barriers to teaching multi-cultural curricula (Brown, Muñoz, & Powell, 2011), and more than half of practicing OTs surveyed want to learn more about cultural competence skills (Hildebrand et al., 2013). Evidence supports that there is a gap between what is currently being taught and that practitioners need to know. Project H.O.P.E. is an evidence-based, theory-driven service-learning course designed to increase cultural competence in OT students. It includes assignments, activities, reading and lectures to facilitate short term service learning projects promoting healthy occupations in the underserved community. Students are guided to be self-aware of their own cultural attributes as a starting point to learning about culture in a wider context of history, healthcare and society. This material is presented first in the classroom in lecture format, then used in small groups and eventually applied while working on short term programs within Head Start programs, homeless shelters and after school adolescent programs in the underserved community. Project H.O.P.E. provides a way to define and measure student self-assessment of cultural competence, and to prepare OT students to work in today’s diverse clinical settings.

No / Aim: To develop a culturally sensitive occupation-based health promotion intervention for older Hispanic adults who live alone. Methods: We used a mixed method design for the content validation of the intervention and the Ecological Validity Model (EVM) to culturally center the intervention. In the quantitative phase, aging experts as well as community members from two activity centers for the elderly in Puerto Rico completed a content validity ratio exercise. In the qualitative phase, we conducted three focus groups with these participants. Data analysis included content validity ratio and a directed content analysis. Results: This resulted in a working version of the intervention protocol addressing the eight dimensions of the EVM. Conclusions: The EVM can be used to culturally center preventive interventions to other ethnic minority groups to augment the external validity and cultural competence of interventions. Future research must test the feasibility of this new intervention. / This publication was supported by National Institute of Health (NIH), National Institute of Minority Health and Health Disparities (NIMHD), Clinical Research Education and Career Development (CRECD) [R25RR017589] in collaboration with Puerto Rico Clinical and Translational Research Consortium (PRCTRC) [8U54 MD 007587-03] and the National Center for Research Resources (NCRR) [8U54RR026139-01A1]. The second author was supported by the National Institute of Drug Abuse (NIDA) (1K02DA035122-01A1). Its content is solely the responsibility of the authors and do not necessarily represent the official views of the NIH, NIMHD, or NCRR.

No / This article explores the need for a framework that will assist social workers to identify when religion and belief are significant in the lives and circumstances of service users and how to take sufficient account of these issues in specific pieces of practice. It outlines the Furness / Gilligan framework and suggests that such frameworks should be used as a part of any assessment, while also being potentially useful at all stages of intervention. It reports on feedback gathered by the authors from first and final MA Social Work students who were asked to pilot the framework. It analyses their responses, in the context of national and international literature. It concludes that such a framework provides the necessary structure and challenge to assist social workers in acknowledging and engaging with issues arising from religion and belief that otherwise may remain overlooked, ignored or avoided, regardless of how significant they are to service users.

Cultural competence is defined as having the knowledge, skills, and attitudes to interact and assist people from culturally and ethnically diverse backgrounds (Sue, 2001). People who are culturally competent are aware of their own cultural background and the backgrounds of groups that are different. These individuals understand and appreciate a variety of cultures. Much of the research on cultural competence has focused on practitioners or graduate students in medicine, psychology, education, and social work (Eunice, 2004). Primarily, this research has looked at the training that these individuals have received and their attitudes about interacting with diverse groups. Howard-Hamilton, Richardson, and Shuford (1998) proposed that a set of competencies be developed for college students similar to those created for practitioners. Examples of those competencies include an understanding the cultural backgrounds of other groups, being able to interact with diverse individuals, an appreciation for diversity and valuing social justice for all cultural groups, etc. Research on cultural competence and college students has primarily focused on attitudes of college students towards diverse individuals (Hu & Kuh, 2005; Nelson-Laird, Engberg, & Hurtado; 2005; Pascerella & Terenzini, 2005; Pacerella, Edison, Nora, Hagedorn, & Terenzini, 1996; Whitt, Edison, Pascerella, Terenzini, & Nora, 2001). Students' in and out-of-class experiences give them a holistic education in which they develop an appreciation of individuals whose cultures are different (Kuh, 1995). Yet, very little research has focused on students' experiences learning about and interacting with individuals from other cultures. The purpose of this study was to gain insight from students participating in a cultural awareness program regarding their experiences before and during college that shape their cultural competence. Specifically, I examined students' perspectives on pre-college and college experiences that influence their values and beliefs about their own and others' racial/ethnic culture. The participants of the study were college students who participate in a cultural awareness grant program. This study is phenomenological by nature. Data was obtained from interviews, field notes, and students' journals. Three interviews were conducted with each of the participants. In the first interview, the students were asked about their backgrounds and how they describe their racial or ethnic culture. In second interview, the participants were asked about their interactions and experiences with other racial or ethnic groups on campus. The third interview focused on students' opinions about learning about issues of race and ethnicity. The data were analyzed using constant comparative analysis (Strauss & Corbin, 1998), inductive analysis (Patton, 2002) and open coding (Rossman & Rallis, 2003). Profiles of the participants were created from the interview transcripts and field notes (Seidman, 2006). The background, experiences, and perspectives of students were described in narrative form. Results of this study indicate that four factors have an impact on participants becoming culturally competent: (a) family influences, (b) formal learning, (c) encounters with others, and (d) personal interests. / Ph. D.

In the counseling profession, clinical supervision is utilized to facilitate the personal and professional development of counselors in training (Bernard and Goodyear, 2014). Within this supervisory relationship, supervisors must adhere to the 2015 ACA Code of Ethics, which describes the need for infusing cultural competence into both counseling and supervision practices. This emphasis is warranted; as the population of the United States is growing more diverse and cultural sensitivity in counseling will be needed in order to best serve clients. Both qualitative and quantitative research in various allied fields and settings suggest that supervisor cultural competence positively impacts the supervision working alliance (i.e., Ladany, Brittan-Powell and Pannu, 1997; Ancis and Marshall, 2010; Wong, Wong and Ishiyama, 2013). However, research conducted from the perspective of supervisors working in community settings is limited. This study sampled 78 community supervisors to address the dearth in the counselor education literature concerning the relationships between supervisor cultural competence and the working alliance. Results indicated an overall positively correlated relationship between supervisor multicultural competence and the working alliance. Additionally, the results suggested that supervisor cultural knowledge and supervisor cultural skills are the greatest predictors of a strong working alliance, while supervisor multicultural relationship and supervisor multicultural awareness accounted for some additional variance. The results support the trend away from a competency-based model of cultural sensitivity and attention in counseling and toward a model of cultural humility. / Ph. D.