Cultural and Linguistic Competence

Cultural competence is an ongoing developmental process of refining, expanding, and updating an individual’s, organization’s, coalition’s, and/or community’s understanding of different cultures. A culturally competent individual or organization can interact effectively with people of different cultures.

Cultural competence requires a long-term commitment and multi-faceted, multi-level approaches. Effective culturally competent practices are based on recognizing diversity both within and between cultures. Such practices also recognize that different groups are best served and led by people who are part of and/or in tune with the culture of those groups, and who understand that building on the strengths and differences of various cultures enhances the capacity of all.

To produce positive change, prevention practitioners must understand the cultural context of their target community and have the willingness and skills to work within this context. This means drawing on community-based values, traditions, and customs, and working with knowledgeable persons from the community to plan, implement, and evaluate prevention activities. This will help to ensure that the needs of all community members are identified and addressed, thereby contributing to the effectiveness of your strategies.

Cultural and linguistic competence must be considered at each step of the SPF model.

What is Cultural Competence?

Cultural competence is the ability of an individual or organization to interact effectively with people from different cultures. Developing cultural competence is an evolving, dynamic process that takes time and occurs along a continuum.50 For your efforts to prevent or reduce substance misuse and abuse to be effective, you must understand the cultural context of your target community and have the required skills and resources for working within this context.

Although some people may think of culture solely in terms of race or ethnicity, there are many other elements to consider, such as age, educational level, socioeconomic status, gender identity, language(s), and cognitive and physical abilities and limitations.59 You must be respectful of and responsive to the health beliefs, practices, and cultural and linguistic needs of the diverse population groups in your target community. This means learning more about the community; drawing on community-based values, traditions, and customs; and working with persons from the community to plan, implement, and evaluate your strategies.

Cultural competence should be visibly interwoven throughout your intervention. A plan to increase your group’s cultural competence should do the following:

  • Include measurable goals and objectives with concrete timelines. For example, you might develop an outreach goal of contacting 30 different community organizations within six months, with the ultimate goal of recruiting 12 new partners.
  • Ensure that you are involving representatives from all sectors of the community in your prevention efforts. For example, if the aim of your logic model is to prevent NMUPD among high school-age youth, outline the steps your group will take to include high school-age youth from diverse backgrounds as full participants in your efforts, rather than solely as the target of your activities.
  • Indicate who is responsible for the proposed action steps, and outline some of the potential resources needed.

Be sure to review your cultural competence plan on a regular basis.

What Is Linguistic Competence?

Linguistic competence involves more than having bilingual staff; it refers to the ability to communicate with a variety of different cultural groups, including people with low literacy, non-English speakers, and those with disabilities. The National Center for Cultural Competence defines linguistic competence as follows:

The capacity of an organization and its personnel to communicate effectively, and convey information in a manner that is easily understood by diverse audiences including persons of limited English proficiency, those who have low literacy skills or are not literate, individuals with disabilities, and those who are deaf or hard of hearing. Linguistic competency requires organizational and provider capacity to respond effectively to the health and mental health literacy needs of populations served. The organization must have policy, structures, practices, procedures, and dedicated resources to support this capacity. (p. 1)60

You might consider some or all of the following approaches:

  • Hiring bilingual/bicultural or multilingual/multicultural staff
  • Providing foreign language interpretation services
  • Printing materials in easy-to-read, low-literacy, picture, and symbol formats
  • Offering sign language interpretation services
  • Using TTY and other assistive technology devices
  • Offering materials in alternative formats (audiotape, Braille, enlarged print, etc.)
  • Adapting how you share information with individuals who experience cognitive disabilities
  • Translating legally binding documents (such as consent forms and confidentiality and patient rights statements), signage, health education materials, and public awareness materials and campaigns
  • Using media targeted to particular ethnic groups and in languages other than English (television, radio, Internet, newspapers, periodicals, etc.)

National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care

The National CLAS Standards are a comprehensive series of guidelines that inform, guide, and facilitate practices related to culturally and linguistically appropriate health services.59 Originally developed by the HHS Office of Minority Health in 2000, the standards were updated and expanded in 2013 to address the importance of cultural and linguistic competence at every point of contact throughout the health care and health services continuum.

The 15 standards are organized into one Principal Standard and three themes:

Resources for implementing the National CLAS Standards are available from the Office of Minority Health’s Think Cultural Health website.