545495
research-article2014
TCNXXX10.1177/1043659614545495Journal of Transcultural NursingIm
Guest Editorial
What Makes an Intervention Culturally Competent?
Journal of Transcultural Nursing 2015, Vol. 26(1) 5 © The Author(s) 2014 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/1043659614545495 tcn.sagepub.com
Eun-Ok Im, PhD, MPH, RN, CNS, FAAN1 With an increasing need to support underserved populations from diverse racial/ethnic groups, the number of studies developing and testing culturally tailored interventions has drastically increased in recent years (Whittemore, 2007). Furthermore, with the recent emphasis on intervention studies by the National Institutes of Health funding mechanisms, the interests on culturally tailored interventions have recently increased. However, the literature rarely provides directions on what are essential components of culturally competent interventions that need to be considered in the design and development of the interventions. Cultural competence in nursing research and practice has been emphasized during the past several decades. Many nursing scholars have made propositions for essential components of cross-cultural research, but the suggestions are for descriptive studies rather than for intervention studies. The most frequently discussed issues related to cultural competence are methodological concerns related to foreign language translation processes, specifically the conceptualization of words/terms that do not exist in a specific culture (Angel, 2013; Khalaila, 2013). Difficulties in operationalizing culture have also been discussed because culture cannot be easily quantified into a few variables and accurately assessed using an instrument (Salant & Lauderdale, 2003). However, little has been discussed on methodological issues in developing culturally tailored interventions, and very few guidelines for developing culturally tailored interventions have been proposed. Since intervention studies are methodologically distinct from descriptive cross-cultural studies, there would be many additional methodological issues/concerns that need to be considered. For example, it would be important to determine if an intervention is culturally acceptable or relevant to their target populations. Maybe, some widely accepted practice may not be working for specific cultural groups, and some cultural groups may not be interested in the intervention at all (e.g., shelter service for Korean American elderly experiencing intimate partner violence, etc.; Shim & NelsonBecker, 2009). Also, flexibility of using multiple language versions of an intervention would be essential if the specific target cultural group uses multiple languages (e.g., Cantonese-speaking Chinese, Mandarin-speaking Chinese). Indeed, in most studies evaluating culturally tailored interventions, language tailoring is the essential component, and multiple languages are adopted for the interventions. Translators and/or cultural liaisons/brokers are frequently
included in the interventions. Despite these potentially important components in culturally tailored interventions, little guidance is available for development of culturally tailored interventions. Researchers working with culturally diverse populations need to inquire what components need to be considered in planning, developing, and implementing culturally competent interventions for their target populations. Researchers working with diverse cultural groups also need to be continuously open for unexpected challenges in cross-cultural intervention studies. Through our future efforts in cross-cultural nursing research, I hope we could provide concrete directions for development of culturally competent interventions that would help empower various cultural groups and facilitate health promotion and disease prevention of the specific populations. Since several decades have passed while focusing on understanding diverse needs of different cultural groups, this would be the right time to move forward to interventions studies that would directly link our cross-cultural knowledge to our practice. References Angel, R. J. (2013). After Babel: Language and the fundamental challenges of comparative aging research. Journal of CrossCultural Gerontology, 28, 223-238. doi:10.1007/s10823-0139197-2 Khalaila, R. (2013). Translation of questionnaires into Arabic in cross-cultural research: Techniques and equivalence issues. Journal of Transcultural Nursing, 24, 363-370. doi:10.1177/ 1043659613493440 Salant, T., & Lauderdale, D. S. (2003). Measuring culture: A critical review of acculturation and health in Asian immigrant populations. Social Science & Medicine, 57, 71-90. Shim, W. S., & Nelson-Becker, H. (2009). Korean older intimate partner violence survivors in North America: Cultural considerations and practice recommendations. Journal of Women & Aging, 21, 213-228. doi:10.1080/08952840903054773 Whittemore, R. (2007). Culturally competent interventions for Hispanic adults with type 2 diabetes: A systematic review. Journal of Transcultural Nursing, 18, 157-166. doi:10.1177/ 1043659606298615 1
University of Pennsylvania, Philadelphia, PA, USA
Corresponding Author: Eun-Ok Im, School of Nursing, University of Pennsylvania, 418 Curie Blvd., Claire M. Fagin Hall, Philadelphia, PA 19104, USA. Email: [email protected]
Downloaded from tcn.sagepub.com at UCSF LIBRARY & CKM on April 13, 2015
research-article2014
TCNXXX10.1177/1043659614545495Journal of Transcultural NursingIm
Guest Editorial
What Makes an Intervention Culturally Competent?
Journal of Transcultural Nursing 2015, Vol. 26(1) 5 © The Author(s) 2014 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/1043659614545495 tcn.sagepub.com
Eun-Ok Im, PhD, MPH, RN, CNS, FAAN1 With an increasing need to support underserved populations from diverse racial/ethnic groups, the number of studies developing and testing culturally tailored interventions has drastically increased in recent years (Whittemore, 2007). Furthermore, with the recent emphasis on intervention studies by the National Institutes of Health funding mechanisms, the interests on culturally tailored interventions have recently increased. However, the literature rarely provides directions on what are essential components of culturally competent interventions that need to be considered in the design and development of the interventions. Cultural competence in nursing research and practice has been emphasized during the past several decades. Many nursing scholars have made propositions for essential components of cross-cultural research, but the suggestions are for descriptive studies rather than for intervention studies. The most frequently discussed issues related to cultural competence are methodological concerns related to foreign language translation processes, specifically the conceptualization of words/terms that do not exist in a specific culture (Angel, 2013; Khalaila, 2013). Difficulties in operationalizing culture have also been discussed because culture cannot be easily quantified into a few variables and accurately assessed using an instrument (Salant & Lauderdale, 2003). However, little has been discussed on methodological issues in developing culturally tailored interventions, and very few guidelines for developing culturally tailored interventions have been proposed. Since intervention studies are methodologically distinct from descriptive cross-cultural studies, there would be many additional methodological issues/concerns that need to be considered. For example, it would be important to determine if an intervention is culturally acceptable or relevant to their target populations. Maybe, some widely accepted practice may not be working for specific cultural groups, and some cultural groups may not be interested in the intervention at all (e.g., shelter service for Korean American elderly experiencing intimate partner violence, etc.; Shim & NelsonBecker, 2009). Also, flexibility of using multiple language versions of an intervention would be essential if the specific target cultural group uses multiple languages (e.g., Cantonese-speaking Chinese, Mandarin-speaking Chinese). Indeed, in most studies evaluating culturally tailored interventions, language tailoring is the essential component, and multiple languages are adopted for the interventions. Translators and/or cultural liaisons/brokers are frequently
included in the interventions. Despite these potentially important components in culturally tailored interventions, little guidance is available for development of culturally tailored interventions. Researchers working with culturally diverse populations need to inquire what components need to be considered in planning, developing, and implementing culturally competent interventions for their target populations. Researchers working with diverse cultural groups also need to be continuously open for unexpected challenges in cross-cultural intervention studies. Through our future efforts in cross-cultural nursing research, I hope we could provide concrete directions for development of culturally competent interventions that would help empower various cultural groups and facilitate health promotion and disease prevention of the specific populations. Since several decades have passed while focusing on understanding diverse needs of different cultural groups, this would be the right time to move forward to interventions studies that would directly link our cross-cultural knowledge to our practice. References Angel, R. J. (2013). After Babel: Language and the fundamental challenges of comparative aging research. Journal of CrossCultural Gerontology, 28, 223-238. doi:10.1007/s10823-0139197-2 Khalaila, R. (2013). Translation of questionnaires into Arabic in cross-cultural research: Techniques and equivalence issues. Journal of Transcultural Nursing, 24, 363-370. doi:10.1177/ 1043659613493440 Salant, T., & Lauderdale, D. S. (2003). Measuring culture: A critical review of acculturation and health in Asian immigrant populations. Social Science & Medicine, 57, 71-90. Shim, W. S., & Nelson-Becker, H. (2009). Korean older intimate partner violence survivors in North America: Cultural considerations and practice recommendations. Journal of Women & Aging, 21, 213-228. doi:10.1080/08952840903054773 Whittemore, R. (2007). Culturally competent interventions for Hispanic adults with type 2 diabetes: A systematic review. Journal of Transcultural Nursing, 18, 157-166. doi:10.1177/ 1043659606298615 1
University of Pennsylvania, Philadelphia, PA, USA
Corresponding Author: Eun-Ok Im, School of Nursing, University of Pennsylvania, 418 Curie Blvd., Claire M. Fagin Hall, Philadelphia, PA 19104, USA. Email: [email protected]
Downloaded from tcn.sagepub.com at UCSF LIBRARY & CKM on April 13, 2015
