Page 80 - Cultural Competence in Health Education

58 Cultural Competence in Health Education and Health Promotion
In stage four the progress toward cultural competence is measured by health
educators ’ ability to validate the worldview of others while blending their own training
and direct experiences to form a new self - identity. Training in stage four requires super-
vision that supports autonomous decisions. The goal at this stage is to assist health edu-
cators in making autonomous decisions about their newly altered and emerging personal
and professional identities. The field experiences should match the level of cultural

competence attained by a health educator. It is at the end of stage four and the begin-

ning of stage five that health educators may seek to change policies and procedures that
represent the old way of working with dissimilar cultural groups.
In the last stage, the thrust of a health educator ’ s efforts is to seek action that repre-
sents a new way of addressing diversity and embracing the values of social equality
and cultural pluralism. Carney and Kahn (1984) suggest that the training needs of stage
fi ve can be met by using mentors or professional coaches to guide health educators in
exploring their effectiveness as change agents. The mentors or coaches provide a sup-
portive environment, allowing health educators to process the experiences and encour-
aging them to continue their development of a cultural knowledge base, personal
assessments, and skills in working with cultural groups.

Prerequisites to Cultural Competence
Three prerequisites aid in achieving cultural competence: cultural desire, cultural
awareness, and cultural sensitivity. Prerequisite to addressing the concerns and needs
of a culturally dissimilar client, classroom, small group, or large community audi-

ence in a culturally competent way is cultural desire, a term defined by Campinha -
Bacote (1999) as a “ want to ” to engage in the process of becoming culturally aware,
culturally knowledgeable, and culturally skillful. Further, seeking cultural encoun-
ters leads to awareness of and sensitivity to clients ’ racial, ethnic, or cultural back-

grounds. As defined by Redican et al. (1994) cultural awareness is being conscious
of cultural similarities and differences and cultural sensitivity is the knowledge that
cultural differences as well as similarities exist. Possession of these three prerequi-
sites allows the development of credibility and trust that promotes a working rela-
tionship that can achieve the outcomes and goals set by both the health educator
and the dissimilar client, group, or audience. Following the basic principles (Sue,
2001) that should guide the development of cultural competence, and proceeding
with respect and consideration, the health professional will find that trust, sensitivity,

and credibility will minimize and make resolvable any unintentional errors that result
from any lingering cultural incompetence.
In spite of the limited training opportunities that exist in cultural sensitivity and
cultural competence (Doyle et al., 1996; Luquis, P é rez, & Young, 2006) and the atti-
tude of benign neglect in college and university health education preparation programs
(Redican et al., 1994), “ health educators hold an inherent responsibility in assisting
organizations to comply with standards and best practices supported by federal funds
and in becoming leaders in the development and implementation of programs which

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