Page 190 - Cultural Competence in Health Education

168 Cultural Competence in Health Education and Health Promotion

of limitations on total degree program credit hours, accreditation - related requirements
for other competency - based and general education courses, and faculty work load
restrictions. These factors may compel decision makers to “ outsource ” their cultural
competence course requirements to other disciplines within their institutions. These
“ outside ” courses often cover basic relationships between culture and social issues but
may not include needed health education perspectives (Luquis et al., 2006).
Compounding the issues in the curriculum infusion discussion is the belief of
some university educators that integrating cultural competence perspectives within
existing courses is actually more effective than developing separate culture - based
courses (Morey & Kitano, 1997). Though most health educators would support adapt-
ing existing courses to include cultural competence perspectives, problems can arise
in this process. The degree to which cultural competence is truly infused and clearly
evident in a course that is designed to address a health education issue (for instance, a
stress management course) or health education competence (for instance, a program
evaluation course) is often highly dependent on the perspectives and abilities of indi-
vidual course instructors. When these instructors work independently of each other,
the depth and accuracy of culture - based coverage across courses can be inconsistent.
A call for a more organized and deliberate approach to including cultural compe-
tence in university health education degree programs has been issued (Luquis et al.,
2006). An important next step is to develop clear guidelines for accomplishing this
goal. Figure 9.1 contains a curriculum development model that can be used to inte-
grate cultural competence throughout a health education degree program. This model
for an integrated cultural competence curriculum (IC - 3 model) was created by this
chapter author to help degree program designers take a deliberate approach to address-
ing cultural competence in their programs. It is based on recommendations from the

field (Beatty & Doyle, 2000; Champagne, 2006; Doyle et al., 1996; Luquis & Pérez,
2003; Luquis et al., 2006; Redican, Stewart, Johnson, & Frazee, 1994).
The IC - 3 model was designed to help degree program designers capitalize on what
already exists in their current program while incorporating a clearly defi ned cultural
competence framework into that program. The goal is to capitalize on some common
degree program components: introductory, competency - based, and health topic or

group - specific courses; an internship and portfolio requirement; service learning oppor-
tunities; Eta Sigma Gamma membership; other social support mechanisms (alumni
e - lists, faculty - student socials); and evaluation feedback loops. Infused throughout the
model is a structure that is designed to make cultural competence a salient and constant
goal throughout the learning process.
The concentric circles in the IC - 3 model represent progressive levels of learning
that move the student from the inner circle of introductory courses outward toward a
culminating internship and eventual employment. These concentric layers are presented
in a progressively widening overlay format to illustrate integrated learning through
which students apply, expand, and refine what they learn about cultural competence in

the inner circles in increasingly application - focused learning experiences in the outer
circles. The model is not intended to dictate, for instance, that competency - based

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