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236 Cultural Competence in Health Education and Health Promotion

promotion programs and interventions ” (p. 5). Although this definition provides a

basic understanding of the concept, it does not go beyond defining the capability of the

individual to work with the existing racially, ethnically, and culturally diverse popula-

tion. Some of the chapter authors for this book have provided other definitions of cul-

tural competence. Here is another definition, from Cross, Bazron, Dennis, and Isaacs

(1989), who define cultural competence as “ a set of congruent behaviors, attitudes,
and policies that come together in a system, agency, or among professionals that
enables this system, agency, or those professionals to work effectively in cross - cultural

situations ” (p. 4). Thus, in keeping with these definitions, Luquis and P é rez (2003)

have suggested that in the field of health education we define cultural competence as
“ the capacity of an individual and organization to understand, behave, and respect the
values, attitudes, and beliefs of different cultural groups, and to incorporate these dif-
ferences in the development and implementation and evaluation of policies and health
education and promotion programs ” (p. 113).
Health educators must also realize that the process of becoming culturally compe-
tent does not happen overnight; it is a lifelong journey. At the organizational level
the process of acquiring cultural competence requires a comprehensive and coordi-

nated plan that specifies interventions at many levels: policymaking, infrastructure
building, program administration and evaluation, the delivery of service and enabling
support, and the individual (Goode & Sockalingam, 2000). At the personal level, the
individual must examine both his or her own cultural values and his or her awareness
and acceptance of the cultural values and beliefs among other diverse groups. In addi-
tion the individual must make a commitment to honor and respect the beliefs and values
of other cultures. Working toward cultural competence must also include acquiring the
ability to develop, adapt, and implement practices and skills that fit the cultural con-

text of the individuals being served. Therefore, given the cultural diversity of the
United States, developing cultural competence must be seen as a complex process
rather than an end point, and it is unrealistic for an organization to expect to serve all
cultural groups in a competent manner; rather, it must create an environment that sup-
ports an ongoing process of becoming culturally competent.

ACQUIRING LINGUISTIC COMPETENCE
Health educators need to understand the intricacy of linguistic competence in order to
become linguistically competent. The NCCC (2006) defi nes linguistic competence as
“ the capacity of an organization and its personnel to communicate effectively, and
convey information in a manner that is easily understood by diverse audiences includ-

ing persons of limited English proficiency, those who have low literacy skills or are
not literate, and individuals with disabilities ” (para. 9).
Linguistic competence includes, but is not limited to, the use of (1) “ bilingual/bicul-
tural or multilingual/multicultural staff ” ; (2) “ cross - cultural communication approaches ” ;
(3) “ foreign language interpretation services including distance technologies ” ; (4) “ sign
language interpretation services ” ; (5) “ multilingual telecommunication systems ” ; (6) “ print
materials in easy to read, low literacy, picture and symbol formats ” ; (7) “ materials in

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