Assessment of Linguistically and Culturally Appropriate Community Health Promotion Programs in Local Health Departments

Baseline data for Healthy People 2000 objective 8.11 (By the year 2000, increase to at least 50% the proportion of counties that have established culturally and linguistically appropriate community health promotion programs for racial and ethnic minority populations) has been unavailable to date due to definitional problems with "culturally and linguistically appropriate community health promotion programs" and lack of a data source. This project supported efforts by the National Association of County and City Health Officials (NACCHO) to include in their regularly conducted stratified sample surveys of local health departments (LHDs) questionnaire items that would provide data that can be used as a proxy baseline for this objective. Through key informant interviews, a set of questions were formulated and included in a NACCHO survey of the nature and extent of the interventions under study being provided by a random sample of LHDs serving communities with 10 percent or more racial/ethnic minority populations. The study found that most LHDs provide some sort of culturally sensitive and linguistically appropriate intervention in the areas of health promotion and preventive services. However, these culturally and linguistically appropriate interventions do not necessarily constitute formal, structured "community health promotion programs" and, in any event, fall far below the 50 percent target set in the Healthy People objective. This study provides the baseline to measure the objective and sets the stage for additional contextual research to be conducted on the provision of cultural and linguistic services to racially and ethnically diverse populations.

AGENCY SPONSOR: Office of Minority Health

FEDERAL CONTACT: Pacheco, Guadalupe
301-443-5084

PIC ID: 6798

PERFORMER: National Association of County and City Health Officials NACCHO
Washington, DC

Cultural and Linguistic Competence Standards and Research Agenda Project (Parts I and II)

This project was designed to: (1) support the examination of completed and ongoing efforts that measure culturally and linguistically appropriate services (CLAS) in health care and that link such measurement to patient and/or health outcomes, and (2) propose a research agenda to strengthen the science in support of CLAS health care. An analytical review was conducted of key CLAS-related laws, regulations, contracts and standards currently in use by Federal and State agencies and other national organizations. This review--coupled with input from a national advisory committee of policymakers, health care providers and researchers with expertise in cultural competency--resulted in the development of 14 proposed standards for CLAS in health care which largely reflect current policies, regulations and practice in this area. Written commentary is provided in Part I of the final report that addresses each proposed standard and its relationship to existing laws, regulations, standards, etc. Recommendations are also offered for implementation and oversight. Information and research needed to relate these standards to health impacts and outcomes, along with key research areas and questions, are presented in Part II. An attempt is also made to set the stage for an ongoing discussion of research concerns surrounding CLAS, including general issues, methodological concerns, potential research approaches and agenda setting. Existing research examined relating CLAS to health outcomes generally indicates that lack of attention to cultural issues leads to less than optimal health care, and that use of certain CLAS interventions leads to improved outcomes. However, it also reflected a clear need for more and better research in this regard. Additional support will be needed to establish the draft standards as national "model standards" for cultural competency and to develop a robust research agenda to strongly link CLAS to health outcomes.

AGENCY SPONSOR: Office of Minority Health

FEDERAL CONTACT: Pacheco, Guadalupe
301-443-5084

PIC ID: 6675

PERFORMER: Center for the Advancement of Health
Washington, DC