Developing a Self-Assessment Toolfor Culturally - Office of Minority ...

communicate with, and clearly understand, the concerns and needs of the consumers beingserved, as well as provide instructions, interventions, treatment modalities, and otherrecommended actions in a manner and context that will optimize consumer receptivity andcompliance.In sum, although issues of “cultural competence” or “cultural and linguisticappropriateness” in health care often are framed as “minority” issues, they are, in fact,human issues affecting all people. Everyone has a culture and a cultural background thatshapes one’s views about health and illness. Similarly, everyone has a language andlanguage needs. However, because some cultural and linguistic needs are met while othersare not, the issue becomes yet another of disparity in addressing the health needs of certaingroups—most often racial and ethnic minorities. This disparity directly affects the abilityto access and utilize high-quality health services.Given that: 1) disparities in health status and health care services are welldocumentedamong racial, ethnic, cultural, and linguistic minority groups; 2) cultural andlanguage differences may contribute to these gaps; and 3) the increasing racial, ethnic, andlinguistic diversity in the U.S., OMH set out to assist LPHAs by developing a CLAS selfassessmenttool for monitoring and improving health care quality.2.1.5 Defining CLASAt the project’s inception, the term “culturally appropriate” was seldom referenced inthe literature, while “cultural competence” was a more widely used term. Exhibit 2-1provides an overview of various definitions (in the literature at that time) for “culturallyappropriate health care services.” Most often, these services were described in terms of aset of skills related to understanding, and effectively communicating with, persons whohave diverse cultural backgrounds (McManus 1998; Tirado 1996). The term “culturalcompetence” was also described in the context of developing and using these skills(Andrulis 1997; California Department of Health Services 1993; Orlandi 1995). Otherdefinitions of cultural competence positioned the term in the health care context byemphasizing awareness and integration of three population-specific issues: health-relatedbeliefs and cultural values, disease incidence and prevalence, and treatment efficacy(Adams 1995; Lavizzo-Mourey and Mackenzie 1996).Linguistically appropriate services include programs, services, and interventions thatmeet the specific language needs of the service population (OMH 1996). Such servicesinvolve communicating with patients in their primary languages and providing languageassistance at key points of service throughout the health care continuum (AAPCHO1996b).COSMOS Corporation, December 2003 2-6