Abstract
The NKI Cultural Competency Assessment Scale measures organizational CC in mental health outpatient settings. We describe its development and results of tests of its psychometric properties. When tested in 27 public mental health settings, factor analysis discerned three factors explaining 65% of the variance; each factor related to a stage of implementation of CC. Construct validity and inter-rater reliability were satisfactory. In tests of predictive validity, higher scores on items related to linguistic and service accommodations predicted a reduction in service disparities for engagement and retention outcomes for Hispanics. Disparities for Blacks essentially persisted independent of CC scores.
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Bond, G. R., Evans, L., Salyers, M. P., Williams, J., & Kim, H. W. (2000). Measurement of fidelity in psychiatric rehabilitation. Mental Health Services Research, 2(2), 75–87.
Campinha-Bacote, J. (1998). Inventory for assessing the process of cultural competence (IAPCC) among health care professionals. Cincinnati, OH: Transcultural C.A.R.E. Associates.
Cook, B. L., McGuire, T. G., Meara, E., & Zaslavsky, A. M. (2009). Adjusting for health status in non-linear models of health care disparities. Health Services Outcomes Research Method, 9, 1–21.
Cross, T., Bazron, B., Dennis, K., & Isaacs, M. (1989). Towards a culturally competent system of care, vol I. Washington, DC: Georgetown University Child Development Center, CASSP Technical Assistance Center.
Cruz, M., & Pincus, H. A. (2002). Research on the influence that communication in psychiatric encounters has on treatment. Psychiatric Services, 53(10), 1253–1265.
DHHS. (2003). President’s new freedom commission on mental health. Achieving the promise: Transforming mental health care in America (DHHS Publication No. SMA-03–3832). MD: Rockville.
Doorenbos, A. Z., Schim, S. M., Benkert, R., & Borse, N. N. (2005). Psychometric evaluation of the cultural competency assessment instrument among healthcare providers. Nursing Research, 54(5), 324–331.
Duan, N., Meng, X.-L., Lin, J. Y., Chen, C.-N., & Alegria, M. (2008). Disparities in defining disparities: Statistical conceptual frameworks. Statistics in Medicine, 27, 3941–3956.
Goode, T. D., & Tawara, D. (2002). Self-assessment checklist for personnel providing services and supports to children with special health needs and their families. Washington, DC: Georgetown University Center for Child and Human Development.
Hampton, M. D. (2007). The role of treatment setting and high acuity in the over diagnosis of schizophrenia in African Americans. Archives of Psychiatric Nursing, 21(6), 327–335.
Harper, M., Hernandez, M., Nesman, T., Mowery, D., Worthington, J., Isaacs, M. (2006). Organizational cultural competence: A review of assessment protocols (Making children’s mental health services successful series, FMHI pub. No 240-2). Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Institute, Research and Training Center for Children’s Mental Health.
Institute Of Medicine (IOM). (2002). Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington, DC: National Academics Press.
Isaacs, M.R., Huang L.N., Hernandez, M., Echo-Hawk, H. (2005). The road to evidence: The intersection of evidence-based practices and cultural competence in children’s mental health. Alliance of Multi-ethnic Behavioral Health Associations. http://systemsofcare.samhsa.gov/resourceguide/docs/Road%20to%20Evidence.pdf.
Kraemer, H. C. (1976). The small sample non-null properties of Kendalls’s coefficient of concordance for normal populations. Journal of the American Statistical Association, 71(335), 608–613.
Lucas, T., Michalopoulou, G., Falzarano, P., Menon, S., & Cunningham, W. (2008). Healthcare provider cultural competency: Development and initial validation of a patient report measure. Health Psychology, 27(2), 185–193.
Mason, J. L. (1995). Cultural competence self-assessment questionnaire: A manual for users, research and training center on family support and children’s mental health. Portland, OR: Portland State University.
Mcguire, T. G., Alegria, M., Cook, B. L., Wells, K. B., & Zaslavsky, A. M. (2006). Implementing the Institute of Medicine definition of disparity: An application to mental health care. Health Services Research, 41(5), 1979–2005.
New York State Office of Mental Health. (1998). Cultural competence performance measures for managed behavioral healthcare programs. NY: Albany.
Nunnally, J. C., & Bernstein, I. H. (1994). Psychometric Theory, 3, 232. New York NY: McGraw-Hill.
Roper, W., & Mays, G. (2000). Performance measurement in public health: Conceptual and methodological issues in building the scientific base. Journal of Public Health Management and Practice, 6(5), 66–77.
Shrout, P. E., & Fleiss, J. L. (1979). Intraclass correlations: Uses in assessing rater reliability. Psychological Bulletin, 86(2), 420–428.
Siegel, C., Chambers, E. D., Haugland, G., Bank, R., Aponte, C., & McCombs, H. (2000). Performance measures of cultural competency in mental health organizations. Administration and Policy in Mental Health, 28(2), 91–106.
Siegel, C., Haugland, G., & Chambers, E. D. (2003). Performance measures and their benchmarks for assessing organizational cultural competency in behavioral health care service delivery. Administration and Policy in Mental Health, 31(2), 141–170.
Siegel, C., Haugland, G., & Schore, R. (2005). In R. E. Drake, M. R. Merrens, & D. W. Lynde (Eds.), The interface of cultural competency and evidence based practices. Chap. 12 evidence-based mental health practice: A textbook. New York: WW Norton.
Siegel, C., Laska, E., Wanderling, J., Baker, S., Harrison, G., Rank, R., et al. (2007). Study methodology, Chap. 2. In K. Hopper, G. Harrison, J. Aleksander, & N. Sartorius (Eds.), Recovery from Schizophrenia—An international perspective. New York, NY: Oxford University Press Inc.
Sue, D. W., Arredondo, P., & McDavis, R. J. (1992). Multicultural counseling competencies and standards: A call to the profession. Journal of Counseling and Development, 70(4), 477–483.
USPHS (2001). United States Public Health Service, Office of the Surgeon General. Mental Health: Culture, Race and Ethnicity: A Supplement to Mental Health: A Report of the Surgeon General. Rockville, MD. Department of Health and Human Services, US Public Health Service.
Whaley, A. L. (2001). Cultural mistrust of White mental health clinicians among African Americans with severe mental illness. American Journal of Orthopsychiatry, 7(2), 252–256.
Acknowledgments
This work was supported by NIMH Grant R34 MH071489-01A1 and the New York State Office of Mental Health Nathan S. Kline Institute Center of Excellence in Culturally Competent Mental Health.
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Siegel, C.E., Haugland, G., Laska, E.M. et al. The Nathan Kline Institute Cultural Competency Assessment Scale: Psychometrics and Implications for Disparity Reduction. Adm Policy Ment Health 38, 120–130 (2011). https://doi.org/10.1007/s10488-011-0337-0
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DOI: https://doi.org/10.1007/s10488-011-0337-0