title: Organizational  characteristics  that  foster  early  adoption  of  cultural  and  linguistic competence  in  outpatient  substance  abuse  treatment  in  the  United  States.
abstract: Recent years have seen an increased interest in developing culturally and linguistically responsive systems of care in substance abuse treatment in the United States. This study examines the extent to which external and internal organizational pressures contributed to the degree of adoption of culturally and linguistically responsive practices in the nation's outpatient substance abuse treatment system early in the period of development of this system of care. Findings show that a higher degree of adoption of culturally competent practices was most likely in treatment programs with high dependence on external funding and regulation. Internally, programs with a larger number of professionals were associated with the lowest degree of adoption, while managers' cultural sensitivity contributed significantly to a high degree of adoption of these responsive practices. Considering the passage of recent legislation enforcing the use of cultural and linguistic competence in health care, implications of these baseline findings on early adoption patterns are discussed for future research and health care policy evaluation.
authors.affiliation: School of Social Work, University of Southern California, Los Angeles, CA 90089, USA. erickgue@usc.edu
authors.forename: Erick  G
authors.initials: E
authors.lastname: Guerrero
mesh_terms: D000223:Adaptation, Psychological; D000553:Ambulatory Care / Q000458:organization & administration; D002983:Clinical Competence; D054521:Cultural Competency / Q000193:education / Q000458:organization & administration*; D018864:Cultural Diversity; D016208:Databases, Factual; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008037:Linguistics / Q000458:organization & administration*; D008297:Male; D016134:Organizational Policy; D017063:Outcome Assessment, Health Care; D016320:Substance Abuse Treatment Centers / Q000458:organization & administration*; D019966:Substance-Related Disorders / Q000208:ethnology / Q000628:therapy*; D014481:United States