Page 76 - Cultural Competence in Health Education

54 Cultural Competence in Health Education and Health Promotion
a mutually agreeable solution that maximizes the children ’ s success in school,
provides a morning nutrition source, promotes limits on television watching and on
selection of programs, and sets a reasonable bedtime hour. In this example, cultural
competence is the ability to see the whole problem and to apply the appropriate skills
to engage the whole family in its own solution.

ISSUES, CONCERNS, AND STRATEGIES IN
MULTICULTURAL TRAINING
The need for cultural competence is apparent in a variety of health education settings,
but what are the concerns and strategies when it comes to training people for that com-
petence? The issues surrounding the ongoing lack of cultural competence and the
strategies for achieving that competence appear to be global and individual, respec-
tively. Globally, there appears to be a perception that cultural competence is important
and needed; yet resources for achieving cultural competence are limited, as pointed
out in a national survey by Redican, Stewart, Johnson, and Frazee (1994), conducted
more than a decade ago. Of the college and university professional preparation pro-
grams in health education responding to the survey, slightly more than half offered
training in cultural competence. This training, they reported, was provided by individ-
ual faculty or occurred during an internship experience. Redican et al. (1994) sug-
gested that this finding indicated benign neglect toward providing these educational

opportunities. Two other surveys have followed Redican et al. ’ s research. Doyle, Liu,
and Ancona (1996) conducted a similar study, and their results suggested that the com-
mitment by the professional preparation programs of colleges and universities to
course - based cultural diversity was weak and that cultural competence training was
particularly lacking.
More recently, Luquis, P é rez, and Young (2006) conducted a similar survey dis-
tributed to about 255 college and university professional preparation programs in
health education. About 27 percent reported offering a course entirely directed toward
cultural competence, 88 percent reported that cultural competence was addressed in
core courses, and 82 percent reported that cultural competence training was offered
through instructional activities. Oddly enough, 87 percent of the reporting programs
referred students to other departments or programs for courses dealing with topics
related to cultural competence. Almost as high a percentage (88 percent) of these pro-
grams indicated that they did not provide cultural competence training to the faculty.
The benign neglect characterized by Redican et al. (1994) has seemingly continued to
the present day.
On the individual level, numerous strategies exist through which the health educa-
tor can attempt, almost alone, to gain the experiences, skills, and resources that will
lead to a higher level of personal cultural competence. Yet a review of the models of
Sue (2001) and Betancourt et al. (2003) or of the basic principles for planning or prac-
ticing cultural competence shows that having support from within the work environ-
ment is consistently advocated. Working individually, the health educator is limited by

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