News Studies

Factors Related to Implementing More Culturally Competent Practices in Addiction Services

Erick Guerrero
An important innovation in addiction health programming has been to redesign policies, practices and services to recognize and respond to the service needs of culturally and linguistically diverse populations, termed “culturally competent” practices. These practices involve improving an organization’s knowledge, connections, linkages, and resources in racial and ethnic minority communities, as well as culturally responsive policies, procedures, and staffing practices. Cultural competency can reduce the health disparities among racial and ethnic minorities that are well established in the United States and can also help providers create evidence-based care required by upcoming changes in health care reform. In a study published in the Evaluation and Program Planning journal, Dr. Erick Guerrero and mentored doctoral student contribute towards the scholarship on improving cultural competent practices. They do so by exploring the relationship between three different sets of characteristics of an organization and the cultural competency of addiction services provided by these organizations:
  1. Organizational structure: Public funding, regulations, and professional accreditation among organizations.
  2. Leadership: Transformational leadership among program directors can promote a culture of inclusivity associated with a culturally diverse staff.
  3. Readiness for change: An organization’s capacity to implement new technologies or innovative practices through program resources and staffs’ motivation for change.
The evaluation was done by surveying 122 addiction health providers that serve predominantly Latino and African-American residents of Los Angeles County. To make sure the measures from the surveys were accurate, the research team also: 1) reviewed information reported by the providers to the funding organization (LA Department of Public Health); 2) interviewed counselors and clinical supervisors in 30 of the programs; and 3) reviewed printed material available at each provider site. To measure an organization’s cultural competence (i.e. the outcome of interest), the survey asked questions that can be categorized into: 1) knowledge of; 2) outreach to; and 3) personal involvement in racial and ethnic minority communities; 4) development of resources and linkages to serve racial and ethnic minorities; 5) development of policies and procedures to effectively respond to the service needs of racial and ethnic minority patients; and 6) hiring and retention of employees with racial and ethnic minority backgrounds. To measure the first set of characteristics and organizational structure, the researchers relied on measures of public funding, state license and professional accreditation. Secondly, staff were asked about their program directors’ transformation leadership traits. Finally, organizational readiness for change was measured using four dimensions (resources, staffing, climate and motivation for change) shown to represent higher perceptions of a program’s readiness for change. A statistical technique was used to test the relationship between the three sets of organizational characteristics and cultural competence. A separate analysis was done for each of the six measures of cultural competence, and variables measuring each of the three sets of characteristics were included in each analysis based on a preliminary correlational analysis. The main findings from the survey responses, separated into the three sets of characteristics the research team predicted would increase cultural competency, were:
  1. Organizational structure: Accepting Medi-Cal and receiving more public funding were positively associated with one measure of cultural competency, policies and procedures that better serve minority communities.
  2. Leadership: Directorial leadership was positively associated with outreach to minority communities and development of diverse staff.
  3. Readiness for change: One measure of readiness for change, organizational climate (based on survey questions regarding mission, cohesion, autonomy, communication, stress, and change), was associated with policies and procedures that better serve minority communities.
The authors note that these relationships partially support the hypotheses that each of the three sets of organizational characteristics are positively associated with cultural competency in addiction health services. Public resources, such as Medicaid, may pressure community-based programs to develop policies that comply with expectations of culturally competent care. Additionally, leadership efforts to promote staff development are instrumental in tailoring service delivery practices to the needs of minority communities. Finally, the leadership style and perceived climate for change in an organization are critical to the implementation of cultural competence. To view the study in its entirety, please click here. Source: “Organizational structure, leadership and readiness for change and the implementation of organizational cultural competence in addiction health services”, Evaluation and Program Planning

Other Articles

Key Leadership & Workforce Characteristics Tied to Successful, Diverse OSAT Programs
High Impact Scholarship
Racial and Ethnic Disparities in Substance Abuse Treatment Completion