Community Support

Notes from a Roundtable on Conceptualizing and Measuring Cultural Competence

Synthesis of Next Steps (By Dr. Francis Lu)

Using the analogy of launching a satellite with a three-stage rocket, Francis Lu provided his synthesis of ideas presented at the roundtable for arriving at a plan of implementation.

Analogy/Vision: To launch a satellite that will be of enduring value to behavioral healthcare systems, agencies, individual providers, and consumers to measure concretely existing core cultural competence standards and indicators.

Envision a three-stage rocket to launch the satellite.

First Stage (completed):

WICHE/CMHS Core Cultural Competence Standards in Managed Mental Health Care for Four Underserved/Underrepresented Racial/Ethnic Groups - WICHE leadership linked with CMHS.
Four cultural competence panels of underserved/underrepresented racial/ ethnic groups, focusing on:
- Four cultural competence panel co-chairs (leadership).
- Four existing cultural competence panels.
- Broad-based consumers, families, providers, community organizations, academia to assure credibility and legitimacy.

Second Stage

Specify and refine measures that can utilize state data sources.
Assess feasibility of obtaining information, conceptual validity of measures for markers of indicators (e.g., literature, expert opinion).
Enfold New York Office of Mental Health (NYOMH) Project as participant in the second stage focus groups of consumers and expert panels to refine measures. There is a need for the NYOMH Project to be reviewed by the four Cultural Competence Panels because NY did not use only the WICHE Standards; they also used others.
Use paradigm to specify/refine remaining measures and make revisions to the four Cultural Competence Panel documents.

Third Stage

Develop specific instruments based on the measures/indicators for the Core Cultural Competence Standards. The focus should be on the measures as refined in the second stage above using NYOMH Project materials.
Instrument development involves pilot testing for reliability and validity. Need to prioritize among systems, agency, individual providers. Also review existing databases for data that can be dropped into measures to the extent that these data can be used. Incorporate other instruments, (e.g., MHSIP Report Card with cultural competence items.)

Satellite

Pilot tested, reliable, validated instruments of measures, indicators of Core Cultural Competence Standards. These instruments would be used for further research as well as ongoing CQI evaluation. Synergistic collaboration between:
- Four cultural competence panels.
- Evaluation experts (HSRI, NYOMH, others).
- State and county mental health directors (involve in measure, instrument development, and pilot testing).
- NIMH minority mental health research centers, e.g. Asian, Hispanic, Black, Native American, Psychobiology (i.e., Keh-Ming Lin); psychopharmacology as aspect of cultural competence.

Implementation Steps

1. Form synergistic collaboration.

HSRI

Other Evaluation Experts

WICHE

State Directors	NYOMH	Four Cultural Competence Panels
County Directors	Other	NIMH Minority Research Centers
IAPSRS
Consumer Groups

2. Submit proposal to CMHS to get funding for comprehensive evaluation package.

Vision/Three Stage Rocket Analogy
Concrete Steps
- 18-Month Plan
- 3-Year Plan

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