Question

Explain the Australian government’s and community services processes and culture regarding advocacy and presentation.

Answer 1

Ans) Australian government’s and community services processes and culture regarding advocacy and presentation:

- First, there is no uniform definition or framework of cultural competence that is accepted across the spectrum of health contexts/settings either within or between countries. Many terms are used interchangeably with cultural competency (e.g. cultural safety, cultural awareness, cultural responsiveness).

- Second, there are many potential outcomes from cultural competency interventions, as indicated by the variety of measures.

- Third, a lack of methodological rigor is common amongst the studies included in reviews. Moreover, many of the studies rely on self-report, which is subject to a range of biases, while objective evidence of intervention effectiveness was rare.

Future reviews should be explicit about their definition or framework of cultural competency and what constitutes a culturally competent intervention, whether at the individual-level, organizational-level or systemic-level. Reviews should also examine multiple outcomes at all three levels where possible due to the multi-dimensional nature of cultural competency interventions and the complexities in translating cultural competency into practice. Further development and assessment of organizational cultural competency models and assessment tools is needed.

Multi-level interventions should consider the different contexts (e.g. government policy vs. community issues) and cultures (e.g. individual vs. organizational) that can affect the implementation and success of interventions to improve cultural competency. Issues related to organizational change and understanding the mechanisms by which health innovations are adopted should also be taken into account. There is also need for research to examine the time and resources required to implement interventions in addition to identifying the most feasible and effective approaches. This is particularly important for organizational or systemic approaches where cost-benefit/effectiveness is an important consideration.