Cultural Competence in
Community Work
Noel Chrisman, PhD, MPH
University of Washington School of Nursing
Cultural Competence
Distinguish between activities that are culturally
appropriate and cultural competence.
Appropriate: there is a fit between the project
(assessment, intervention, evaluation) and
community culture.
Cultural competence: individual & organizational
ability and experience to work productively cross
culturally.
HSERV 576/NURS 557, Chrisman, Jan 15, 05
Cultural Competence
Distinguish between CBPR and cultural
competence.
CBPR: a style of doing community work that
requires working together, power sharing, and
capacity building.
Cultural competence: individual & organizational
ability and experience to work productively cross
culturally.
HSERV 576/NURS 557, Chrisman, Jan 15, 05
Cultural Competence
The researcher and organization should be culturally
competent to carry out any kind of community work.
Any community project is improved with culturally
appropriate activities.
A CBPR intervention has a higher likelihood of
carrying out the project in culturally appropriate ways
because of all the joint planning.
It is easier to collaborate with community
organizations and members when the researcher and
the organization are culturally competent.
HSERV 576/NURS 557, Chrisman, Jan 15, 05
Cultural Competence
Professional Attitudes,
Practice Skills, and
System Savvy for Cross
Cultural Situations.
Chrisman & Zimmer, 2000
CULTURAL
COMPETENCE
Needed to gain access to and
to sustain community
relationships.
 And to develop culturally
appropriate interventions,
designs, and data gathering
techniques.

HSERV 576/NURS 557, Chrisman, Jan 15, 05
Respect is an attitude toward others
that is grounded theoretically in an
acceptance of shared participation in
a common moral community, or, at
least, of a common humanity. . . A
respectful attitude values the core of
humanity in the ‘other’ without
necessarily admiring or even
approving of the beliefs or other
differences. Lenburg et al., 1995
Culture vs. Cultures
 Culture:
“the total lifeways of a
human group. It consists of learned
patterns of values, beliefs, customs,
and behaviors that are shared by a
group of interacting individuals...a
set of rules or standards for
behavior.” (Tripp-Reimer)
 Cultures: Groups of people who
share a common culture.
HSERV 576/NURS 557, Chrisman, Jan 15, 05
Culture vs. Cultures:
Implications
Behaviors might be cultural with norms
and values supporting the behaviors at
home. (Vs. psychological with less
support.)
 To know customs or values from
specific cultures allows you to work with
and within the cultural patterns of the
community.

HSERV 576/NURS 557, Chrisman, Jan 15, 05
Central Elements of
Culture: Custom
•
•
Assess for
customs.
Ensure that
customs such as
interaction style
are included in
the plan.
HSERV 576/NURS 557, Chrisman, Jan 15, 05
•
Central Elements of
Culture: Custom
Assess for
customs.
• Ensure that
customs such
as diet, are
included in the
plan.
HSERV 576/NURS 557, Chrisman, Jan 15, 05
Central Elements of
Culture: Custom
•
•
Assess for
customs.
Ensure that
customs such as
religious practices
are included in
the plan.
HSERV 576/NURS 557, Chrisman, Jan 15, 05
Central Elements of
Culture: Custom
• Assess for
customs.
• Ensure that
customs such
as
organizational
patterns are
included in the
plan.
HSERV 576/NURS 557, Chrisman, Jan 15, 05
Central Elements of
Culture: Beliefs
•
•
Assess for
beliefs.
Ensure that
community
activities are
congruent with
beliefs in the
supernatural.
HSERV 576/NURS 557, Chrisman, Jan 15, 05
Central Elements of
Culture: Beliefs
• Assess for
beliefs.
• Ensure that
community
activities are
congruent with
beliefs: about
causes of illness,
about healthy
behaviors.
HSERV 576/NURS 557, Chrisman, Jan 15, 05
•
•
Central Elements of
Culture: Values
Assess for values.
Ensure that
community activities
reflect people’s
values; e.g.,
interdependence,
family solidarity,
nature of men and
women.
HSERV 576/NURS 557, Chrisman, Jan 15, 05
Principles of Cultural Competence
in Community Partnerships

Listen for and
integrate
community
concerns.
HSERV 576/NURS 557, Chrisman, Jan 15, 05
Principles of Cultural Competence
in Community Partnerships

Understand and
integrate
community values
HSERV 576/NURS 557, Chrisman, Jan 15, 05
Principles of Cultural Competence
in Community Partnerships

Learn and
integrate cultural
perspectives
(beliefs) on health
problems.
HSERV 576/NURS 557, Chrisman, Jan 15, 05
Principles of Cultural Competence
in Community Partnerships

Recognize and integrate institutional and geographic
expressions of concerns, values, and beliefs.
HSERV 576/NURS 557, Chrisman, Jan 15, 05
Principles of Cultural Competence
in Community Partnerships

Identify and work
closely with
community leaders.
HSERV 576/NURS 557, Chrisman, Jan 15, 05
Principles of Cultural Competence
in Community Partnerships

Identify and
work closely
with
community
leaders.
Common Organizational Schemes
for Community Feedback

Advisory
Board/Steering
Committee
-offers advice
-range of
power and
control
HSERV 576/NURS 557, Chrisman, Jan 15, 05
Common Organizational Schemes
for Community Feedback
 Broker,
like Seattle Partners
 Grass roots committee
 Focus groups/surveys/other
assessment
HSERV 576/NURS 557, Chrisman, Jan 15, 05
Common Organizational Schemes
for Community Feedback
Town
Meetings
HSERV 576/NURS 557, Chrisman, Jan 15, 05
Examples of Strategies for Cross
Cultural Community Practice
Community or Organizational Board.
 Partner with Community Organizations and
Agencies (e.g., churches, grocery stores,
ethnic health agencies, newspapers).
 Recruit Researchers who are Linguistically,
Culturally, and Ethnically Similar to the Study
Population.
 Local Health Advisors.

HSERV 576/NURS 557, Chrisman, Jan 15, 05
Examples of Strategies for Cross
Cultural Community Practice
Create Awareness Campaigns, Health
Education Materials, and Media Approaches in
the Local Language.
 Use or Create Local Literature (e.g.,
cookbooks, activity maps, resource lists)
 Incorporate Cultural Symbols in ALL Research
Documents and Offices.

 You
Must have a Culturally Competent
HSERV 576/NURS 557, Chrisman, Jan 15, 05
Organization!
ORGANIZATIONAL
CULTURAL COMPETENCE
Multicultural
Mission/Goals
Diversity in Hiring, Retention,
Promotion
Valuing and Managing Diversity
Permeable Boundaries with the
Community
Chrisman & Schultz, 1997
Workshops for Organizational
Cultural Competence
Visioning a Multicultural
Organization
Managing Diversity for Administrators
and Managers
Clinical Cultural Competence for
Clinicians and Interventionists
Valuing Diversity Workshops for All
Community and Interorganizational Partnerships
Noel Chrisman 2002
MULTICULTURAL
COMPETENCIES

Understand and value diversity.

Ability to manage workforce diversity.

Clinical cultural competence.

Community partnership skills
(communities and organizations).
HSERV 576/NURS 557, Chrisman, Jan 15, 05
Colin Judson Chrisman Age 1 ½.
HSERV 576/NURS 557, Chrisman, Jan 15, 05