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Cultural Competence and Health Education 239

accomplish this goal, health educators do not need to become experts on every racial,
ethnic, cultural, and diverse group residing in the United States, but they do need to be
cognizant of differences that may affect their ability to reach target populations, and

be proficient in using techniques to bridge cultural divisions (Luquis & P é rez, 2003).
Health educators can begin to acquire these abilities by pursuing some of the follow-
ing strategies.
First, health educators must learn to recognize the importance of culture and

respect diversity. Culture influences many aspects of our lives, our families, and our
communities, and also how we operate in society. Culture may be characterized by fac-
tors such as national origin; customs and traditions; length of residency in the United
States; language; age; generation; gender and sexual orientation; religious beliefs;
political beliefs; perceptions of family and community; perceptions of health, well -
being, and disability; physical ability or limitations; socioeconomic status; educational
level; geographical location; and family and household composition ( USDHHS, 2003).
Thus health educators need to understand all the factors surrounding culture and diver-
sity and how they affect different groups ’ views of health and health education. For

example, the REACH initiative has identified culture and history as one of its key prin-
ciples in the development of effective community - based strategies and interventions
(CDC, 2007).

Second, health educators should maintain a current profile of the cultural composition
of their community of interest. One of the most important steps in the development of
health education programs is performing the needs assessment. By maintaining a cur-

rent profile of the population they serve (see the case study in Chapter One , for exam-
ple), health educators will be prepared to identify the specific, culturally related needs

of the community, such as learning style and education, language and interpreter ser-
vices needed, level of health literacy, housing availability, and other health - related
services. Information included in this community profile should be updated fre-

quently, because given ongoing demographic changes, such data can change rapidly
(USDHHS, 2003).
Third, health organizations, community - based organizations, schools, worksites,
and other health - related agencies should provide ongoing cultural and linguistic com-
petence training to health educators and other health staff. As stated throughout this
book, the development of cultural and linguistic competence is an essential element in
the professional preparation of health educators. In previous studies the chapter authors
found that health educators who had attended cultural diversity training or education
programs had achieved a higher level of cultural competence than those who had not
attended such programs (Luquis & P é rez, 2005, 2006). This training should include
basic cultural competence principles, concepts, terminology, and frameworks and also
discussion about cultural values and traditions, family values, linguistics and literacy,
help - seeking behavior, and cross - cultural outreach techniques and strategies, among
other issues (USDHHS, 2003).
Fourth, health educators must involve cultural brokers from the targeted racial and
ethnic groups during the development of health education programs. These cultural

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