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Implementation of Culturally and Linguistically Competent Policies by State Title V Children with Special Health Care Needs (CSHCN) Programs

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Abstract

Objective This descriptive study was intended to identify actual actions, steps and processes of Children with Special Health Care Needs (CSHCN) programs to develop, implement, sustain and assess culturally and linguistically competent policies, structures and practices. Methods An online 52-item mixed format survey of Maternal and Child Health (MCH) CSHCN directors was conducted. In April 2003 and May 2004, 59 directors were solicited to participate in the survey and 42 (86%) responded. Standard quantitative and qualitative analyses of the data were conducted to address key questions linked to the study’s overall objective. Results Findings indicated that almost all respondents are implementing some actions to provide culturally and linguistically competent services including adapting service practices, addressing workforce diversity, providing language access, engaging communities and including requirements in contracts. These individual actions were less often supported by processes such as self-assessment and creating an ongoing structure to systematically address cultural and linguistic competence. Programs are challenged to implement cultural and linguistic competence by state agency organization and budget restrictions. Conclusions The results of the study indicate a continued need for support within state MCH CSHCN programs in order to maintain or enhance the systematic incorporation of culturally and linguistically competent efforts.

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References

  1. Sullivan, L. W. (2004). Missing persons: Minorities in the health professions. Sullivan Commission.

  2. Institute of Medicine. (2004). In the Nation’s compelling interest: Ensuring diversity in the healthcare workforce. Washington: National Academies Press.

    Google Scholar 

  3. National Healthcare Disparities Report. (2003). Full Report. Rockville, MD: Agency for Healthcare Research and Quality. http://www.ahrq.gov/qual/nhdr03/fullreport/.

  4. Several Authors. (2003). Cultural competence: Special theme articles. Academic Medicine, 78(6), 547–653.

    Google Scholar 

  5. President’s New Freedom Commission on Mental Health. (2003). President’s New Freedom Initiative Final Report. Rockville, MD: U.S. Department of Health Resources and Services Administration, DHHS.

  6. Association of University Centers on Disabilities Network Diversity Survey. (2004). AUCD Network Diversity Survey.

  7. U.S. Census Bureau. American Community Survey. Accessed December 18, 2007 from http://factfinder.census.gov/servlet/DatasetMainPageServlet?_program=ACS&_submenuId=datasets_2&_lang=en.

  8. U.S.Census Bureau. Language Spoken at Home. Accessed December 19, 2007 from http://factfinder.census.gov/servlet/STTable?_bm=y&-geo_id=01000US&-qr_name=ACS_2006_EST_G00_S1601&-ds_name=ACS_2006_EST_G00_.

  9. US Census Bureau. American Fact Finder. Accessed December 18, 2007 from http://factfinder.census.gov/home/saff/main.html?_lang=en.

  10. Day, J. C. (1996). Population projections of the United States by age, sex, race, and Hispanic origin: 1995 to 2050 (Vol. P25). Washington: U.S. Census Bureau, United States Government Printing Office.

    Google Scholar 

  11. Cohen, E., & Goode, T. D. (2003, revised). Policy brief 1: Rationale for cultural competence in primary care. Washington, DC: National Center for Cultural Competence, Georgetown University Center for Child and Human Development.

  12. Institute of Medicine Board on Health Sciences Policy. (2003). Unequal treatment: Confronting racial and ethnic disparities in health care. Institute of Medicine.

  13. van Ryn, M., & Fu, S. S. (2003). Paved with good intentions: Do public health and human service providers contribute to racial/ethnic disparities in health? American Journal of Public Health, 93(2), 248–255.

    Article  PubMed  Google Scholar 

  14. Kaiser Family Foundation. Racial and ethnic disparities in women’s health coverage and access to care. http://www.kff.org/womenshealth/7018.cfm. Accessed November 3, 2004.

  15. Bach, P. B., Pham, H. H., Schrag, D., Tate, R. C., & Hargraves, J. L. (2004). Primary care physicians who treat blacks and whites. The New England Journal of Medicine, 351(6), 575–584. doi:10.1056/NEJMsa040609.

    Article  PubMed  CAS  Google Scholar 

  16. Wolff, M., Bates, T., Beck, B., Young, S., Ahmed, S. M., & Maurana, C. (2003). Cancer prevention in underserved African American communities: Barriers and effective strategies—a review of the literature. Wisconsin Medical Journal, 102(5), 36–40.

    PubMed  Google Scholar 

  17. Saha, S., Komaromy, M., Koepsell, T. D., & Bindman, A. B. (1999). Patient-physician racial concordance and the perceived quality and use of health care. Archives of Internal Medicine, 159(9), 997–1004. doi:10.1001/archinte.159.9.997.

    Article  PubMed  CAS  Google Scholar 

  18. Lieu, T. A., et al. (2004). Cultural competence policies and other predictors of asthma care quality for Medicaid-insured children. Pediatrics, 114(1), e102–e110. doi:10.1542/peds.114.1.e102.

    Article  PubMed  Google Scholar 

  19. Lee, L. J., Batal, H. A., Maselli, J. H., & Kutner, J. S. (2002). Effect of Spanish interpretation method on patient satisfaction in an urban walk-in clinic. Journal of General Internal Medicine, 17(8), 641–645. doi:10.1046/j.1525-1497.2002.10742.x.

    Article  PubMed  Google Scholar 

  20. Lasater, L. M., Davidson, A. J., Steiner, J. F., & Mehler, P. S. (2001). Glycemic control in English- vs. Spanish-speaking Hispanic patients with type 2 diabetes mellitus. Archives of Internal Medicine, 161(1), 77–82. doi:10.1001/archinte.161.1.77.

    Article  PubMed  CAS  Google Scholar 

  21. Siegel, C., Haugland, G., & Chambers, E. D. (2003). Performance measures and their benchmarks for assessing organizational cultural competency in behavioral health care service delivery. Administration and Policy in Mental Health, 31(2), 141–170. doi:10.1023/B:APIH.0000003019.97009.15.

    Article  PubMed  Google Scholar 

  22. Kehoe, K. A., Melkus, G. D., & Newlin, K. (2003). Culture within the context of care: An integrative review. Ethnicity and Disease, 13(3), 344–353.

    PubMed  Google Scholar 

  23. Holland, L., & Courtney, R. (1998). Increasing cultural competence with the Latino community. Journal of Community Health Nursing, 15(1), 45–53. doi:10.1207/s15327655jchn1501_5.

    Article  PubMed  CAS  Google Scholar 

  24. Underwood, S. M., Powe, B., Canales, M., Meade, C. D., & Im, E. O. (2004). Cancer in U.S. ethnic and racial minority populations. Annual Review of Nursing Research, 22, 217–263.

    PubMed  Google Scholar 

  25. Simpson, L. (2004). Lost in translation? Reflections on the role of research in improving health care for children. Health Affairs (Project Hope), 23(5), 125–130. doi:10.1377/hlthaff.23.5.125.

    Article  Google Scholar 

  26. Brach, C., & Fraser, I. (2002). Reducing disparities through culturally competent health care: An analysis of the business case. Quality Management in Health Care, 10(4), 15–28.

    PubMed  Google Scholar 

  27. Betancourt, J. R., Green, A. R., Carrillo, J. E., & Ananeh-Firempong, O., I. I. (2003). Defining cultural competence: A practical framework for addressing racial/ethnic disparities in health and health care. Public Health Report, 118(4), 293–302.

    Google Scholar 

  28. Bero, L. A., Grilli, R., Grimshaw, J. M., Harvey, E., Oxman, A. D., & Thomson, M. A. (1998). Closing the gap between research and practice: An overview of systematic reviews of interventions to promote the implementation of research findings. The Cochrane Effective Practice and Organization of Care Review Group. British Medical Journal, 317(7156), 465–468.

    PubMed  CAS  Google Scholar 

  29. Child and Adolescent Health Measurement Initiative. National Survey of Children with Special Health Care Needs. http://cahmi.org/pages/Home.aspx. Accessed November 4, 2007.

  30. Maternal and Child Health Bureau. Maternal and Child Health Bureau Strategic Plan: FY 2003–2007. ftp://ftp.hrsa.gov//mchb/stratplan03-07.pdf. Accessed November 4, 2004.

  31. Cohen, E., & Goode, T. D. (1999). Policy brief 1: Rationale for cultural competence in primary care. Washington, DC: National Center for Cultural Competence, Georgetown University Center for Child and Human Development.

  32. Dunne, C., Goode, T., & Sockalingham, S. (2003). Planning for cultural and linguistic competence in state Title V programs serving children and youth with special health care needs and their families. Washington, DC: National Center for Cultural Competence, Georgetown University Center for Child and Human Development.

  33. Version, S.P.S.S. (2002). 11.0 [computer program]. Version. Chicago.

  34. Strauss, A. L. (1987). Qualitative analysis for social scientists. Cambridge: Cambridge University Press.

    Google Scholar 

  35. Miles, M., & Huberman, M. (1994). Qualitative analysis: An expanded sourcebook (2nd ed.). Thousand Oaks: Sage Publications.

    Google Scholar 

  36. Kirk, J., & Miller, M. L. (1985). Reliability and validity in qualitative research. Newbury Park: Sage Publications.

    Google Scholar 

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Acknowledgments

Eileen Miller, BS, the staff of the National Center for Cultural Competence and the State CSHCN Directors, without all of whom this study would have not been possible. This study was funded through Cooperative Agreement #U93-MC-00145 from the Maternal and Child Health program (Title V, Social Security Act), HRSA, DHHS.

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Correspondence to Joseph Telfair.

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Telfair, J., Bronheim, S.M. & Harrison, S. Implementation of Culturally and Linguistically Competent Policies by State Title V Children with Special Health Care Needs (CSHCN) Programs. Matern Child Health J 13, 677–686 (2009). https://doi.org/10.1007/s10995-008-0407-4

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  • DOI: https://doi.org/10.1007/s10995-008-0407-4

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