Page 68 - Cultural Competence in Health Education

46 Cultural Competence in Health Education and Health Promotion
DEFINING CULTURAL COMPETENCE

Full consensus on a definition for cultural competence does not exist. The meaning of
the term may vary with a user ’ s perspective. Luquis and P é rez (2003) explore several

professional organizations ’ definitions of this term. Their identification of key terms
within their sample of definitions helps to show both the commonalities and contrasts

in the meaning and usage of this term.
An example from a professional organization is that the 2000 Joint Committee on
Health Education and Promotion Terminology of the AAHE (Joint Committee on Health
Education and Promotion Terminology, 2002) has added this term to its updated termi-
nology list and has defined cultural competence as “ the ability of an individual to under-

stand and respect values, attitudes, beliefs, and mores that differ across cultures, and to
consider and respond appropriately to these differences in planning, implementing, and
evaluating health education and promotion programs and interventions ” (p. 5).
More commonly, the term is defined from a racial or culture - specifi c perspective.

Defining cultural competence from this perspective involves a simplistic view. That is,

an individual with cultural competence is the person who looks, talks, and acts like
health education program clients (students, patients, and other participants) and who
shares, understands, and respects their culture, history, values, preferences, and social
status and their community. This person is a translator and is seen as “ one of us, ”
invited and welcomed, and received and valued by the participant, the group, and the
community.

In contrast, cultural competence may be defined from the more universal vantage
point of an institution or system. From this perspective a culturally competent health
service delivery institution or system is one that “ acknowledges and incorporates —
at all levels — the importance of culture, assessment of cross - cultural relations, vigi-
lance toward the dynamics that result from cultural differences, expansion of cultural
knowledge, and adaptation of services to meet culturally unique needs ” (Betancourt,
Green, Carillo, & Ananeh - Firempong, 2003, p. 294). In this organizational context,
cultural competence is the ability to serve multicultural populations. This perspective

implies that cultural competence can be defined as a set of values, behaviors, attitudes,
practices, and policies within an organization or program or among staff that enables
people to work effectively with diverse groups. From a practical view, greater consen-
sus and commonality are found when cultural competence is expansively and collec-
tively viewed from a multidimensional perspective that includes knowledge of the
health beliefs, values, preferences, practices, and skills involved and also general
knowledge of the race, ethnic group, individuals, communities, systems, and organiza-
tions involved.

Multiple Dimensions of Cultural Competence
The dimensions of cultural competence may vary across multidimensional models. How-
ever, some of the more complex models actually combine the simplistic view of cultural
competence with a more universal and system perspective. Even from a simplistic view,

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