Evaluating a Cultural Competency Curriculum for Disaster Preparedness and
Crisis Response
Guadalupe Pacheco, MSWHHS Office of Minority
Health
Eileen HanrahanHHS Office for Civil Rights
Overview• Disasters and Federal Civil Rights Laws
• Disasters and Cultural Competency
• Cultural Competency Curriculum for Disaster Preparedness and Crisis Response
• Conclusion
Federal Civil Rights Laws Apply to Emergency Planning, Response and
Recovery• Title VI of the Civil Rights Act of 1964 (Title VI)
prohibits discrimination on the basis of race, color, or national origin by recipients of Federal financial assistance.
• Section 504 of the Rehabilitation Act of 1973 prohibits discrimination on the basis of disability by recipients of Federal financial assistance.
• Title II of the Americans with Disabilities Act of 1990 prohibits discrimination on the basis of disability by public entities, whether or not they receive Federal financial assistance.
Persons Protected under Title VI
• Persons of every race, color, and national origin
• Limited English proficient persons
Experience of People from Racially and Ethnically Diverse Cultures and
LEP Persons in Emergencies• Historically, emergency preparedness activities
have lacked sufficient focus on these individuals.
• As a result, these populations often:– Did not receive important information about emergencies;– Failed to receive needed services, including medical
assistance.– Experienced poorer outcomes, generally
• Many Hurricane Katrina “lessons learned” reports noted the importance of including “special needs populations” in planning, response, and recovery efforts for those efforts to be successful.
Regulations and Guidance Issued under Title VI
• General nondiscrimination obligation
• Requirement to take reasonable steps to provide Limited English proficient (LEP) persons meaningful access to the program– Number or proportion of LEP individuals likely
to be served– Frequency of contact– Nature or importance of the service– Resources available and costs
How Does Title VI Apply to an Emergency
• Recipients must provide equal access to their emergency preparedness programs– Integration into planning activities– Communication programs– Equal access to services, including health care– Evaluations, drills and exercises
• Recipients may need to provide interpreter services or translate documents
The Office for Civil Rights Enforces Title VI and Other Civil Rights Statutes and Initiatives
Promoting Equal Access to Emergency Preparedness Programs
• Persons from diverse racial and ethnic cultures are protected under civil rights laws that prohibit discrimination on other bases.
• OCR investigates discrimination complaints, conducts compliance reviews and provides technical assistance.
• OCR has two National Initiatives that support equal access for these populations.– State medical education curriculum on health
disparities and cultural competence– Effective communication for LEP individuals and
persons with disabilities in hospitals
Cultural Competency
• Effectively providing services to people of all cultures, races, ethnic backgrounds and religions in a manner that respects the worth of the individual and preserves their dignity.
Cultural competency concepts in disaster and emergency scenarios:
• Services• Communication• Organization
Cultural Competency in Disasters
The human element• Improve the experiences of diverse
cultural communities• Help eliminate health disparities
The bottom line• Improve health outcomes• Quality assurance• Increased effectiveness and efficiency
of services
Cultural Competency in Disasters: Rationale
Cultural Competency Curriculum for Disaster Preparedness
and Crisis Response• Part of Think Cultural Health, an HHS
Office of Minority Health initiative
• Free, online continuing education course launched July 2009
• Equips disaster personnel with the knowledge, awareness, and skills needed to provide emergency health care services to diverse populations
Development ProcessEnvironmental Scan
National Project Advisory Committee
Consensus Building
Concept Papers
1st Draft
Pilot Testing *5 sites *July-August 2008
Revisions
Accreditation & Launch
July 2009
Needs Assessment Focus Groups
Field Testing
*5 sites
*February 2009
Revisions
Final Draft
Cultural Competency Curriculum for Disaster Preparedness
and Crisis Response
But What if I’m Deported?: Providing Culturally Competent Care and Language Access Services During Recovery
Video Case Study
Curriculum Evaluation
Programmatic evaluation to determine:– How the program is received– Impact of program on participants’
knowledge and attitudes regarding cultural competency
Behavior change evaluation to determine:– Impact of cultural competency training
on participants’ behavior
Evaluation Methodology
Programmatic Methods– Qualitative Analysis: focus groups,
evaluation questionnaires, potential follow-up interviews
– Quantitative Analysis: registration questionnaires, evaluation questionnaires, follow-up surveys, pre- and posttest scores
Programmatic Evaluation: Results
• Preliminary results indicate the program has been well received
– Over 1,500 registrants and 5,300 credits awarded– Focus group comments include:
“This has been both a great refresher course on previously acquired knowledge and a source of new information to consider and apply when planning for and working with the cultural needs of disaster victims.”
• Follow-up survey preliminary results are strong– All respondents “strongly agree” that the program
equipped them with awareness & knowledge to provide culturally appropriate services to the individuals they serve
– Over 70% indicate having made changes to their interactions with diverse populations
Behavior Change Evaluation
• Behavior Change Methods– Qualitative Analysis: in-
depth interviews, evaluation questionnaires
– Quantitative Analysis: registration questionnaires, evaluation questionnaires, behavior change questionnaires, cultural competency assessment
• Recruitment and interviews start Fall 2010
Summary• Federal civil rights laws, such as Title VI and
others enforced by the Office of Civil Rights, are applicable to disaster preparedness and crisis response.
• Cultural and linguistic competency plays a large role in disaster preparedness and crisis response.
• OMH’s disaster curriculum offers an adaptable framework for cultural competency training and improving care for culturally and linguistically diverse populations.
• The Curriculum also can help emergency personnel comply with Federal civil rights laws.
Guadalupe Pacheco, MSWHHS Office of Minority [email protected]
For More Information:
Eileen HanrahanHHS Office for Civil [email protected]