The need for cultural competence in making services more responsive to the diverse needs of patients has been highlighted by many authors (NCCC, 2004b; Geiger,2001; Philleo and Brisbane, 1997; Ehrmin, 2005). Philleo and Brisbane (1997)argued that at a time of increasing globalisation and international communication,cultural competency is as important as computer literacy. This means that to be considered a competent professional, such as a nurse, drug worker, youth worker or social worker, one needs to take into account the wider cultural context of the person who is coming for help. A cultural dialogue, where the healthcare worker is able to communicate with people from a different cultural group, should be part of professional approach. With regard to the treatment of substance use problems,Philleo and Brisbane (1997) pointed out that a competent professional must know more than the harm alcohol and drugs can do to the body. Substance problems call for cultural solutions and a cultural dialogue, otherwise professionals are unlikely to achieve a change in their patients' behaviour. The need for better quality services for people from different cultural backgrounds has been recognised in a number of UK government policies, for example the Race Relations (Amendment) Act 2000 (RR(A)A 2000) (The Home Office (HO), 2000). These policies have pressurised organisations into promoting anti-racism and equal opportunities for both service users and staff, and to provide more accessible and culturally competent services. There has been much debate since the 1980s about how to make services more culturally aware and many training initiatives have been developed. Yet, there has been much confusion abuiot the focus of training such as, what needs to be addressed more: racism, discrimination, equal opportunity or diversity? There has been little discussion on the effectiveness of these training activities. Few have been evaluated to measure their impact, such as change in knowledge, attitude and behaviour of those trained, or their organisation's performance towards clients (Papadopoulos et al., 2004; Bhui et al., 2007). Consequently there is little evidence concerning the success of these educational activities. This PhD wants to make an original contribution to the debate surrounding cultural competence and educational practice by evaluating the effectiveness of an educational module to enhance the cultural competence of staff dealing with people with drug and alcohol problems. This study also includes an evaluation of the teaching and learning strategy used.

abstract: Collegiate recovery programs (CRPs) are university-sanctioned initiatives for students in recovery from alcohol and other drug addiction. Given the ever-rising rates of alcohol and opioid use and misuse, a great need exists to understand how to provide support for those who are considering recovery or who choose a recovery lifestyle in college. The purpose of this action research study was to examine peer-to-peer support for students in recovery. The development of two training innovations, Recovery 101 and Recovery Ally, were delivered to health and wellness peer educators called the Well Devil Ambassadors (WDAs) with the goal of equipping them to better support their peers in recovery. Learning objectives for the training were to gain knowledge about addiction and recovery and to enhance positive attitudes toward students in recovery, which could thereby increase self-efficacy and behavior intention to work with their peers in recovery. Mindfulness was included in the trainings to enhance the WDAs’ experience and provide tools for a self-care skillset. Quantitative data included pre, post, and follow-up surveys for the Recovery 101 training. Qualitative data included short-answer questions following Recovery 101 training and in-depth interviews following Recovery Ally training. Findings indicated that the information provided in Recovery 101 built the WDAs’ knowledge on the topics of addiction and recovery; hearing multiple perspectives from students in recovery allowed the WDAs to increase empathy toward students in recovery; and the building of knowledge, empathy, and mindfulness allowed the WDAs to gain self-efficacy and behavior intention when supporting their peers in recovery. / Dissertation/Thesis / Doctoral Dissertation Leadership and Innovation 2018

Problematic substance use is a pressing global health problem, and dissemination and implementation of accurate health information regarding prevention, treatment, and recovery are vital. In many nations, especially the US, many people are involved in religious groups or faith communities, and this offers a potential route to positively affect health through health information dissemination in communities that may have limited health resources. Health information related to addiction will be used as the backdrop issue for this discussion, but many health arenas could be substituted. This article evaluates the utility of commonly used health communication theories for communicating health information about addiction in religious settings and identifies their shortcomings. A lack of trusting, equally contributing, bidirectional collaboration among representatives of the clinical/scientific community and religious/faith communities in the development and dissemination of health information is identified as a potential impediment to effectiveness. The Substance Abuse and Mental Health Services Administration's (SAMHSA) tenets of trauma-informed practice, although developed for one-on-one use with those who have experienced trauma or adversity, are presented as a much more broadly applicable framework to improve communication between groups such as organizations or communities. As an example, we focus on health communication within, with, and through religious groups and particularly within churches.