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Published in: Administration and Policy in Mental Health and Mental Health Services Research 2/2011

01-03-2011 | Original Paper

The Nathan Kline Institute Cultural Competency Assessment Scale: Psychometrics and Implications for Disparity Reduction

Authors: Carole E. Siegel, Gary Haugland, Eugene M. Laska, Lenora M. Reid-Rose, Dei-In Tang, Joseph A. Wanderling, Ethel D. Chambers, Brady G. Case

Published in: Administration and Policy in Mental Health and Mental Health Services Research | Issue 2/2011

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Abstract

The NKI Cultural Competency Assessment Scale measures organizational CC in mental health outpatient settings. We describe its development and results of tests of its psychometric properties. When tested in 27 public mental health settings, factor analysis discerned three factors explaining 65% of the variance; each factor related to a stage of implementation of CC. Construct validity and inter-rater reliability were satisfactory. In tests of predictive validity, higher scores on items related to linguistic and service accommodations predicted a reduction in service disparities for engagement and retention outcomes for Hispanics. Disparities for Blacks essentially persisted independent of CC scores.
Literature
go back to reference Bond, G. R., Evans, L., Salyers, M. P., Williams, J., & Kim, H. W. (2000). Measurement of fidelity in psychiatric rehabilitation. Mental Health Services Research, 2(2), 75–87.PubMedCrossRef Bond, G. R., Evans, L., Salyers, M. P., Williams, J., & Kim, H. W. (2000). Measurement of fidelity in psychiatric rehabilitation. Mental Health Services Research, 2(2), 75–87.PubMedCrossRef
go back to reference Campinha-Bacote, J. (1998). Inventory for assessing the process of cultural competence (IAPCC) among health care professionals. Cincinnati, OH: Transcultural C.A.R.E. Associates. Campinha-Bacote, J. (1998). Inventory for assessing the process of cultural competence (IAPCC) among health care professionals. Cincinnati, OH: Transcultural C.A.R.E. Associates.
go back to reference Cook, B. L., McGuire, T. G., Meara, E., & Zaslavsky, A. M. (2009). Adjusting for health status in non-linear models of health care disparities. Health Services Outcomes Research Method, 9, 1–21.CrossRef Cook, B. L., McGuire, T. G., Meara, E., & Zaslavsky, A. M. (2009). Adjusting for health status in non-linear models of health care disparities. Health Services Outcomes Research Method, 9, 1–21.CrossRef
go back to reference Cross, T., Bazron, B., Dennis, K., & Isaacs, M. (1989). Towards a culturally competent system of care, vol I. Washington, DC: Georgetown University Child Development Center, CASSP Technical Assistance Center. Cross, T., Bazron, B., Dennis, K., & Isaacs, M. (1989). Towards a culturally competent system of care, vol I. Washington, DC: Georgetown University Child Development Center, CASSP Technical Assistance Center.
go back to reference Cruz, M., & Pincus, H. A. (2002). Research on the influence that communication in psychiatric encounters has on treatment. Psychiatric Services, 53(10), 1253–1265.PubMedCrossRef Cruz, M., & Pincus, H. A. (2002). Research on the influence that communication in psychiatric encounters has on treatment. Psychiatric Services, 53(10), 1253–1265.PubMedCrossRef
go back to reference DHHS. (2003). President’s new freedom commission on mental health. Achieving the promise: Transforming mental health care in America (DHHS Publication No. SMA-03–3832). MD: Rockville. DHHS. (2003). President’s new freedom commission on mental health. Achieving the promise: Transforming mental health care in America (DHHS Publication No. SMA-03–3832). MD: Rockville.
go back to reference Doorenbos, A. Z., Schim, S. M., Benkert, R., & Borse, N. N. (2005). Psychometric evaluation of the cultural competency assessment instrument among healthcare providers. Nursing Research, 54(5), 324–331.PubMedCrossRef Doorenbos, A. Z., Schim, S. M., Benkert, R., & Borse, N. N. (2005). Psychometric evaluation of the cultural competency assessment instrument among healthcare providers. Nursing Research, 54(5), 324–331.PubMedCrossRef
go back to reference Duan, N., Meng, X.-L., Lin, J. Y., Chen, C.-N., & Alegria, M. (2008). Disparities in defining disparities: Statistical conceptual frameworks. Statistics in Medicine, 27, 3941–3956.PubMedCrossRef Duan, N., Meng, X.-L., Lin, J. Y., Chen, C.-N., & Alegria, M. (2008). Disparities in defining disparities: Statistical conceptual frameworks. Statistics in Medicine, 27, 3941–3956.PubMedCrossRef
go back to reference Goode, T. D., & Tawara, D. (2002). Self-assessment checklist for personnel providing services and supports to children with special health needs and their families. Washington, DC: Georgetown University Center for Child and Human Development. Goode, T. D., & Tawara, D. (2002). Self-assessment checklist for personnel providing services and supports to children with special health needs and their families. Washington, DC: Georgetown University Center for Child and Human Development.
go back to reference Hampton, M. D. (2007). The role of treatment setting and high acuity in the over diagnosis of schizophrenia in African Americans. Archives of Psychiatric Nursing, 21(6), 327–335.CrossRef Hampton, M. D. (2007). The role of treatment setting and high acuity in the over diagnosis of schizophrenia in African Americans. Archives of Psychiatric Nursing, 21(6), 327–335.CrossRef
go back to reference Harper, M., Hernandez, M., Nesman, T., Mowery, D., Worthington, J., Isaacs, M. (2006). Organizational cultural competence: A review of assessment protocols (Making children’s mental health services successful series, FMHI pub. No 240-2). Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Institute, Research and Training Center for Children’s Mental Health. Harper, M., Hernandez, M., Nesman, T., Mowery, D., Worthington, J., Isaacs, M. (2006). Organizational cultural competence: A review of assessment protocols (Making children’s mental health services successful series, FMHI pub. No 240-2). Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Institute, Research and Training Center for Children’s Mental Health.
go back to reference Institute Of Medicine (IOM). (2002). Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington, DC: National Academics Press. Institute Of Medicine (IOM). (2002). Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington, DC: National Academics Press.
go back to reference Kraemer, H. C. (1976). The small sample non-null properties of Kendalls’s coefficient of concordance for normal populations. Journal of the American Statistical Association, 71(335), 608–613.CrossRef Kraemer, H. C. (1976). The small sample non-null properties of Kendalls’s coefficient of concordance for normal populations. Journal of the American Statistical Association, 71(335), 608–613.CrossRef
go back to reference Lucas, T., Michalopoulou, G., Falzarano, P., Menon, S., & Cunningham, W. (2008). Healthcare provider cultural competency: Development and initial validation of a patient report measure. Health Psychology, 27(2), 185–193.PubMedCrossRef Lucas, T., Michalopoulou, G., Falzarano, P., Menon, S., & Cunningham, W. (2008). Healthcare provider cultural competency: Development and initial validation of a patient report measure. Health Psychology, 27(2), 185–193.PubMedCrossRef
go back to reference Mason, J. L. (1995). Cultural competence self-assessment questionnaire: A manual for users, research and training center on family support and children’s mental health. Portland, OR: Portland State University. Mason, J. L. (1995). Cultural competence self-assessment questionnaire: A manual for users, research and training center on family support and children’s mental health. Portland, OR: Portland State University.
go back to reference Mcguire, T. G., Alegria, M., Cook, B. L., Wells, K. B., & Zaslavsky, A. M. (2006). Implementing the Institute of Medicine definition of disparity: An application to mental health care. Health Services Research, 41(5), 1979–2005.PubMedCrossRef Mcguire, T. G., Alegria, M., Cook, B. L., Wells, K. B., & Zaslavsky, A. M. (2006). Implementing the Institute of Medicine definition of disparity: An application to mental health care. Health Services Research, 41(5), 1979–2005.PubMedCrossRef
go back to reference New York State Office of Mental Health. (1998). Cultural competence performance measures for managed behavioral healthcare programs. NY: Albany. New York State Office of Mental Health. (1998). Cultural competence performance measures for managed behavioral healthcare programs. NY: Albany.
go back to reference Nunnally, J. C., & Bernstein, I. H. (1994). Psychometric Theory, 3, 232. New York NY: McGraw-Hill. Nunnally, J. C., & Bernstein, I. H. (1994). Psychometric Theory, 3, 232. New York NY: McGraw-Hill.
go back to reference Roper, W., & Mays, G. (2000). Performance measurement in public health: Conceptual and methodological issues in building the scientific base. Journal of Public Health Management and Practice, 6(5), 66–77.PubMed Roper, W., & Mays, G. (2000). Performance measurement in public health: Conceptual and methodological issues in building the scientific base. Journal of Public Health Management and Practice, 6(5), 66–77.PubMed
go back to reference Shrout, P. E., & Fleiss, J. L. (1979). Intraclass correlations: Uses in assessing rater reliability. Psychological Bulletin, 86(2), 420–428.PubMedCrossRef Shrout, P. E., & Fleiss, J. L. (1979). Intraclass correlations: Uses in assessing rater reliability. Psychological Bulletin, 86(2), 420–428.PubMedCrossRef
go back to reference Siegel, C., Chambers, E. D., Haugland, G., Bank, R., Aponte, C., & McCombs, H. (2000). Performance measures of cultural competency in mental health organizations. Administration and Policy in Mental Health, 28(2), 91–106.PubMedCrossRef Siegel, C., Chambers, E. D., Haugland, G., Bank, R., Aponte, C., & McCombs, H. (2000). Performance measures of cultural competency in mental health organizations. Administration and Policy in Mental Health, 28(2), 91–106.PubMedCrossRef
go back to reference Siegel, C., Haugland, G., & Chambers, E. D. (2003). Performance measures and their benchmarks for assessing organizational cultural competency in behavioral health care service delivery. Administration and Policy in Mental Health, 31(2), 141–170.PubMedCrossRef Siegel, C., Haugland, G., & Chambers, E. D. (2003). Performance measures and their benchmarks for assessing organizational cultural competency in behavioral health care service delivery. Administration and Policy in Mental Health, 31(2), 141–170.PubMedCrossRef
go back to reference Siegel, C., Haugland, G., & Schore, R. (2005). In R. E. Drake, M. R. Merrens, & D. W. Lynde (Eds.), The interface of cultural competency and evidence based practices. Chap. 12 evidence-based mental health practice: A textbook. New York: WW Norton. Siegel, C., Haugland, G., & Schore, R. (2005). In R. E. Drake, M. R. Merrens, & D. W. Lynde (Eds.), The interface of cultural competency and evidence based practices. Chap. 12 evidence-based mental health practice: A textbook. New York: WW Norton.
go back to reference Siegel, C., Laska, E., Wanderling, J., Baker, S., Harrison, G., Rank, R., et al. (2007). Study methodology, Chap. 2. In K. Hopper, G. Harrison, J. Aleksander, & N. Sartorius (Eds.), Recovery from Schizophrenia—An international perspective. New York, NY: Oxford University Press Inc. Siegel, C., Laska, E., Wanderling, J., Baker, S., Harrison, G., Rank, R., et al. (2007). Study methodology, Chap. 2. In K. Hopper, G. Harrison, J. Aleksander, & N. Sartorius (Eds.), Recovery from Schizophrenia—An international perspective. New York, NY: Oxford University Press Inc.
go back to reference Sue, D. W., Arredondo, P., & McDavis, R. J. (1992). Multicultural counseling competencies and standards: A call to the profession. Journal of Counseling and Development, 70(4), 477–483. Sue, D. W., Arredondo, P., & McDavis, R. J. (1992). Multicultural counseling competencies and standards: A call to the profession. Journal of Counseling and Development, 70(4), 477–483.
go back to reference USPHS (2001). United States Public Health Service, Office of the Surgeon General. Mental Health: Culture, Race and Ethnicity: A Supplement to Mental Health: A Report of the Surgeon General. Rockville, MD. Department of Health and Human Services, US Public Health Service. USPHS (2001). United States Public Health Service, Office of the Surgeon General. Mental Health: Culture, Race and Ethnicity: A Supplement to Mental Health: A Report of the Surgeon General. Rockville, MD. Department of Health and Human Services, US Public Health Service.
go back to reference Whaley, A. L. (2001). Cultural mistrust of White mental health clinicians among African Americans with severe mental illness. American Journal of Orthopsychiatry, 7(2), 252–256.CrossRef Whaley, A. L. (2001). Cultural mistrust of White mental health clinicians among African Americans with severe mental illness. American Journal of Orthopsychiatry, 7(2), 252–256.CrossRef
Metadata
Title
The Nathan Kline Institute Cultural Competency Assessment Scale: Psychometrics and Implications for Disparity Reduction
Authors
Carole E. Siegel
Gary Haugland
Eugene M. Laska
Lenora M. Reid-Rose
Dei-In Tang
Joseph A. Wanderling
Ethel D. Chambers
Brady G. Case
Publication date
01-03-2011
Publisher
Springer US
Published in
Administration and Policy in Mental Health and Mental Health Services Research / Issue 2/2011
Print ISSN: 0894-587X
Electronic ISSN: 1573-3289
DOI
https://doi.org/10.1007/s10488-011-0337-0

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