Advertisement

Multilevel Cultural Competence Intervention Implementation and Evaluation Framework

  • Crystal Jongen
  • Janya McCalman
  • Roxanne Bainbridge
  • Anton Clifford
Chapter
Part of the SpringerBriefs in Public Health book series (BRIEFSPUBLIC)

Abstract

As demonstrated in previous chapters, cultural competence is a broad intervention approach that includes diverse practices operating on multiple levels of health systems. Health systems and the cultural competence approaches they take are situated in complex community, social, cultural, political and economic contexts. Because of the inherent complexities, we argue that a multilevel systems approach is necessary for the advancement of cultural competence outcomes in healthcare. Multilevel interventions aim to improve intervention effectiveness by addressing multiple levels of a relevant social system and capitalising on the synergistic effects of interacting intervention components. In this chapter, we present the first evidence-based, peer-reviewed framework for multilevel interventions to improve cultural competence in healthcare systems. We also discuss some key issues in the design and evaluation of multilevel interventions.

References

  1. 1.
    T.L. Cross et al., Towards a Culturally Competent System of Care: A Monograph on Effective Services for Minority Children Who Are Severely Emotionally Disturbed (Georgetown University, Child Development Center, Washington, DC, 1989)Google Scholar
  2. 2.
    L. Horvat et al., Cultural competence education for health professionals. Cochrane Database Syst. Rev. 5, CD009405 (2014)Google Scholar
  3. 3.
    J. McCalman, C. Jongen, R. Bainbridge, Organisational systems’ approaches to improving cultural competence in healthcare: a systematic scoping review of the literature. Int. J. Equity Health 16, 78 (2017)CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    E.B. Ferlie, S.M. Shortell, Improving the quality of health care in the United Kingdom and the United States: a framework for change. Milbank Q. 79(2), 281–315 (2001)CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    F.M. Harris et al., Exploring synergistic interactions and catalysts in complex interventions: longitudinal, mixed methods case studies of an optimised multi-level suicide prevention intervention in four European countries (OSPI-Europe). BMC Public Health 16, 268 (2016)CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    J.J. Schensul, E. Trickett, Introduction to multi-level community based culturally situated interventions. Am. J. Community Psychol. 43(3), 232–240 (2009)CrossRefPubMedGoogle Scholar
  7. 7.
    M. Chatterji, Evidence on “What Works”: an argument for extended-term mixed-method (ETMM) evaluation designs. Educ. Res. 33(9), 3–13 (2004)CrossRefGoogle Scholar
  8. 8.
    B.K. Nastasi, J. Hitchcock, Challenges of evaluating multilevel interventions. Am. J. Community Psychol. 43(3), 360–376 (2009)CrossRefPubMedGoogle Scholar
  9. 9.
    M. Dyehouse et al., A comparison of linear and systems thinking approaches for program evaluation illustrated using the Indiana Interdisciplinary GK-12. Eval. Program Plann. 32(3), 187–196 (2009)CrossRefPubMedGoogle Scholar
  10. 10.
    D. Cabrera, L. Colosi, C. Lobdell, Systems thinking. Eval. Program Plann. 31(3), 299–310 (2008)CrossRefPubMedGoogle Scholar
  11. 11.
    R. Atun, Health systems, systems thinking and innovation. Health Policy Plan. 27(Suppl 4), iv4–iv8 (2012)CrossRefPubMedGoogle Scholar
  12. 12.
    N.C. Campbell et al., Designing and evaluating complex interventions to improve health care. BMJ 334(7591), 455–459 (2007)CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    P. Craig et al., Developing and evaluating complex interventions: the new medical research council guidance. BMJ 337(7676), 979–983 (2008)Google Scholar
  14. 14.
    P.G. Foster-Fishman, B. Nowell, H. Yang, Putting the system back into systems change: a framework for understanding and changing organizational and community systems. Am. J. Community Psychol. 39(3), 197–215 (2007)CrossRefPubMedGoogle Scholar

Copyright information

© The Author(s) 2018

Authors and Affiliations

  • Crystal Jongen
    • 1
  • Janya McCalman
    • 1
    • 2
  • Roxanne Bainbridge
    • 1
    • 2
  • Anton Clifford
    • 3
  1. 1.Centre for Indigenous Health Equity Research, School of Health, Medical and Applied SciencesCentral Queensland UniversityCairnsAustralia
  2. 2.The Cairns InstituteJames Cook UniversitySmithfieldAustralia
  3. 3.School of Public HealthThe University of QueenslandBrisbaneAustralia

Personalised recommendations