Implementation of culturally and linguistically competent policies by state Title V Children with Special Health Care Needs (CSHCN) programs.
OBJECTIVE
This descriptive study was intended to identify actual actions, steps and processes of Children with Special Health Care Needs (CSHCN) programs to develop, implement, sustain and assess culturally and linguistically competent policies, structures and practices.


METHODS
An online 52-item mixed format survey of Maternal and Child Health (MCH) CSHCN directors was conducted. In April 2003 and May 2004, 59 directors were solicited to participate in the survey and 42 (86%) responded. Standard quantitative and qualitative analyses of the data were conducted to address key questions linked to the study's overall objective.


RESULTS
Findings indicated that almost all respondents are implementing some actions to provide culturally and linguistically competent services including adapting service practices, addressing workforce diversity, providing language access, engaging communities and including requirements in contracts. These individual actions were less often supported by processes such as self-assessment and creating an ongoing structure to systematically address cultural and linguistic competence. Programs are challenged to implement cultural and linguistic competence by state agency organization and budget restrictions.


CONCLUSIONS
The results of the study indicate a continued need for support within state MCH CSHCN programs in order to maintain or enhance the systematic incorporation of culturally and linguistically competent efforts.
Telfair
Joseph
J
Department of Public Health Education, School of Health and Human Performance, University of North Carolina at Greensboro, Greensboro, NC 27402-6170, USA. j_telfai@uncg.edu
Bronheim
Suzanne M
SM
Harrison
Sharonlyn
S
D001741:Black or African American; D002648:Child; D054521:Cultural Competency; D019988:Children with Disabilities; D019538:Health Care Surveys; D006291:Health Policy; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D006630:Hispanic or Latino; D006801:Humans; D020407:Internet; D008430:Maternal-Child Health Centers / Q000458:organization & administration* / Q000592:standards; D009936:Organizational Innovation; D011368:Professional-Family Relations; D044465:White People
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