Chapter 7
Cultural Competency and Assessment
Learning Objectives
Understand assessment in terms of health care
Explain the relevance of measuring attitudes of health service administrators, board members, providers and staff and public health practitioners serving diverse populations
Discuss the importance of establishing reliability and validity of cultural competency assessment tools.
Determine the usefulness of data in traing and other plans for organizations.
Key Terms
Alternative form reliability
Construct validity
Content validity
Convergent validity
Criterion validity
Divergent validity
Face Validity
Key Terms Continued
Internal consistency
Lack of clarity
Lack of complexity
Reliability
Test-retest reliability
Validity
Introduction
Focus of chapter is to focus on assessment and cultural competence.
Assessment determines the cultural competence preparedness of individuals who work in health service/public health organizations.
Reliability and validity of assessment tools is discussed.
Attitudes
Assessment of attitudes at every level of the organization is necessary including the Board, Administrators, providers, staff and public health practitioners.
Carefully designed reliable and valid attitudinal measurement instruments should be used.
Assessment
Ensure that the survey tool measures what it is intended to measure.
Reliability- stability and equivalence of measures over time or across methods of gathering data.
Reliability is assessed using test-retest reliability, alternative form reliability and internal consistency.
Assessment cont…
Validity refers to the consistency of the results of the measure.
Lack of complexity refers to how easy the instrument is to measure and lack of clarity refers to whether nor not the survey questions are vague or ambiguous.
Test-Retest Reliability
Tests whether the instrument measures what it is purported to measure from time 1 to time 2.
Instrument is given to respondents once and then a second time within no more than 2 weeks.
Statistical measures: correlation coefficients
Are results stable from time 1 to time two.
Alternative Form Reliability
Utilization of differently worded items to measure the same attribute.
A Second instrument is produced that is similar but not identical to the first.
Statistical measure: Correlation coefficients.
Internal Consistency Reliability
An examinations of the questions or items of the instrument pertaining to a given construct/concept to determine whether the results are consistent.
Measures used are inter-item correlation , average item total correlation, split-half reliability and Chronbach’s alpha.
Validity
Four types:
Face-Show survey to individuals and ask them what they think of it.
Content-two types which are predictive and construct.
Criterion-examines the systemic relationship between scores n a given scale and other scores it should predict.
Construct-two forms which are convergent and divergent validity.
A Cultural Competence Assessment Tool
Appendices I to III are cultural competence surveys developed by the author of this text.
The surveys were designed to assess the board of directors, executive team, managers, providers and staff.
Based on a liker t format of Strongly Agree, Agree, Strongly Disagree, Disagree and NA.
Importance of Valid and Reliable Assessment Tools
Must be valid and reliable
Provides insights into the attitudes and perspectives of their members.
Enables identification of areas of weakness for training.
Conclusions
Surveys must be valid and reliable.
Upon review of the survey data , training sessions can be developed to address areas of attitudinal weakness, in terms of cultural competence for all levels of healthcare and public health organizations.
