CULTURALLY COMPETENT POLICIES AND SERVICE DELIVERY

As the population of young children in the United States becomes increasingly diverse, policy makers and service providers face the complex task of tailoring their efforts to build on the strengths and address the needs of a wide variety of constituencies. Central to this challenge is a recognition that significant cultural distance between providers and recipients of health and human services can make it difficult to build and sustain the kinds of relationships that often determine the short-term acceptability and ultimate success of an early childhood intervention or family support program. In an effort to respond to these new and growing challenges, the concept of “cultural competence” has been formulated to guide and evaluate professional performance in a broad range of service settings. Despite its intuitive appeal and theoretical validity, however, this concept has not been investigated empirically.

Multiple terms have been used to address the need for responsiveness to diversity, including “cultural sensitivity,” “cultural relevance,” and “cultural awareness,” among others. Unlike these alternatives, cultural competence has been popularized as a knowledge base and set of skills that go beyond the realm of simple respect and sensitivity. A culturally competent professional is defined as one who is able to facilitate mutually rewarding interactions and meaningful relationships in the delivery of effective services for children and families whose cultural heritage differs from his or her own (American Medical Association, 1994; Roberts, 1989). Notwithstanding its current salience in the domains of policy and practice, however, there is little scientific evidence to support this definition.

Beyond the level of individual practice, notions of cultural competence have also been applied to systems and programs that deliver responsive and accessible services to culturally diverse populations. Once again, although the following characteristics have not been evaluated systematically, a culturally competent service system: (1) monitors assessment procedures and evaluation instruments to assure their appropriateness and validity for the children and families who will be assessed; (2) identifies groups that are underserved and eliminates cultural barriers that interfere with service provision; (3) facilitates policy planning, staff training, and community participation in order to ensure the development, delivery, and maintenance of culturally competent services; (4) defines the location, size, characteristics, resources, needs, and ethnography of culturally diverse populations within its service area; (5) builds cross-cultural communication skills; and (6) helps a broad diversity of communities organize themselves to enhance the availability and utilization of needed services. In a culturally competent system of care, the family, as defined by the cultural



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