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Adm Policy Ment Health (2011) 38:120130 DOI 10.1007/s10488-011-0337-0
ORIGINAL PAPER
The Nathan Kline Institute Cultural Competency Assessment Scale: Psychometrics and Implications for Disparity Reduction
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 online: 18 February 2011 Springer Science+Business Media, LLC 2011
Abstract The NKI Cultural Competency Assessment Scale measures organizational CC in mental health out-patient 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.
Keywords Cultural competency Organizational level
measurement Mental health Disparities Cultural groups
Introduction
Substantial inequities in mental health care to the cultural groups of African Americans, Latinos, Asian Americans, Pacic Islanders and Native Americans were highlighted in
the Supplement to Mental Health of the 2001 Surgeon Generals report (USPHS 2001). Cultural groups at risk for differential mental health treatment more broadly include those whose societal standing, world view or values might impede their access to and receipt of services, and are the groups of concern in this report. While there is no universally endorsed denition of cultural competency (CC), one that is broad and commonly cited describes it as the set of congruent behaviors, attitudes and skills, policies and procedures that come together in a system, agency or individual, to enable mental health caregivers to work effectively and efciently with cultural groups (New York State Ofce of Mental Health 1998, adapted from Cross et al. 1989). Underlying most denitions is the premise that as CC increases in a health care environment, members of cultural groups will experience better outcomes (DHHS 2003), and service inequities will decline.
Over the past 15 years, efforts have been made by federal, state and various cultural group organizations to specify the personal attributes of individual providers and the policies and procedures of mental health organizations that...