Academic journal article American Journal of Health Education

The Impact of Service-Learning on Health Education Students' Cultural Competence

Academic journal article American Journal of Health Education

The Impact of Service-Learning on Health Education Students' Cultural Competence

Article excerpt


Background: Development of cultural competence in future health educators is often mentioned as a goal of health education preparation programs; however research demonstrating evidence-based methods for development of cultural competence is limited. Purpose: To determine the impact of a service-learning project on development of cultural competence and health education skills among health education students. Methods: All students in the community health courses completed the Cultural Competence Assessment (CCA ) survey at the beginning of the courses; then, 17 students participated in a three-week service-learning project with members of a low-income community. Students repeated the CCA at the end of the course and CCA scores were compared to measure the impact of the service-learning project; additionally, students completed weekly reflective narratives regarding their experiences. Results: Analysis of data indicated that students participating in the service-learning project scored significantly higher on the cultural competence behavior post-test than those that did not; there was a strong association between service-learning participation and cultural competence behavior; and students had increased perceived self-efficacy and cultural competence.

Discussion: Service-learning activities can improve health education students' cultural competence. Translation to Health Education Practice: Students completing health education preparation programs having developed cultural competence are better prepared to design and implement culturally appropriate interventions.


Cultural Competence

The composition of the United States population continues to become more diverse with the continued introduction of individuals from various racial, ethnic and cultural backgrounds. According to the United States Census Bureau, non-Hispanic whites comprise 65.6% of the population, and Hispanic, African American, Asian/ Pacific Islander, Native American/Alaskan Native, and other racial and ethnic groups will continue to increase over the next few decades. (1) The continued diversification of the U.S. population mandates that culturally and economically appropriate methodologies be utilized in planning, implementation and evaluation of health education and promotion programs. Training and education of pre-service health educators should address the concepts of cultural competence. (2)

Cultural competence in community health education and promotion has been defined as, "The ability of an individual to understand and respect values, attitudes, beliefs and mores that differ across cultures, and to consider and respond appropriately to these differences in planning, implementing, and evaluating health education and promotion programs and interventions." (3) The definition offered by the Joint Terminology Committee for Health Education and Promotion also encompasses cultural awareness (gaining descriptive knowledge about cultural norms and practices) and cultural sensitivity (respecting the values and beliefs that shape those norms and practices. (4) Luquis and Perez (2) have argued that cultural competence also includes, "organizational policies governing the development, implementation, and evaluation of health education and promotion programs."

Some authors have suggested that many pre-service students have vague notions and limited experience with non-white, economically-disadvantaged individuals that comprise a large portion of the U.S. population. (5,6) Others have suggested that while several studies addressing the relationships between culture and health, multicultural issues in health education, and cultural sensitivity and competence, there remains limited information on the degree to which health educators have attained cultural competence. (7-9) For health educators to be effective, health education preparation programs must equip students not only with an understanding of the dominant culture and its history, but also with the knowledge and skills to work effectively with individuals from diverse backgrounds. …

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