Johnson & Johnson Notes on NursingAdvancing Culturally Competent Care

Supporting Diverse Communities Through Culturally Competent Care

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Many parents across the U.S. struggle with challenging behaviors in their young children, and they may not be aware of the array of strategies that can help them deal with their children’s behavior. What if some of these behavioral issues could be addressed by affording parents access to parenting information that is not readily available in their communities? This question led three nurse researchers – Deborah Gross, DNSc, RN, FAAN, Christine Garvey, PhD, RN, and Wrenetha Julion, PhD, MPH, RN, FAAN – to develop the Chicago Parent Program at the Rush University College of Nursing in Chicago, Ill.

The Chicago Parent Program (CPP) is a 12-session, evidence-based program created for parents of young children (between two and five years old) that is designed to meet the needs of a culturally and economically diverse audience. Gross, Garvey and Julion are still involved with the program to this day, alongside Susie Breitenstein, PhD, RN, FAAN, who joined the team officially in 2009.

Founded in 2002, the program, which is supported by rigorous research, and is listed on the the California Evidence-Base Clearinghouse for Child Welfare (CEBC), is guided by a theory that early intervention and training based on sound parenting principles that align with parents’ cultures can have a lasting and positive impact on children’s behavior.

CPP relies on group leaders to facilitate parent group sessions by providing parents with evidence-based strategies to help them best fulfill the program’s principles, structure, and content. The CPP has been implemented in agencies and school systems across the country, including the Harlem Children’s Zone in New York, N.Y., Baltimore City Public Schools in Baltimore, Md., and Head Start , a program of the United States Department of Health and Human Services that provides comprehensive early childhood education, health, nutrition, and parent-involvement services to low-income children and their families.

Group leaders use more than 160 video scenes of parents raising children in the real world – managing challenging situations at home and in public – to help guide parent group discussions and problem-solve different ways to handle common parenting problems. Importantly, CPP is structured in a way that is respectful to parents’ ideas and values specific to the communities served. Parents ultimately decide which parenting strategies fit best with their own beliefs and values.

“Parents raising young children in urban poverty are particularly vulnerable,” said Dr. Gross. “Whereas all parents struggle with managing young children’s defiant or difficult behavior, parents who are overwhelmed with problems related to poverty, adversity, and their own wellbeing are in particular need of our help and support.”

With a focus on finding ways to provide support to parents from various ethnic, racial, and economic backgrounds who are working to raise children with limited resources, the authors worked in collaboration with an advisory board of African-American and Latino families to design a program that directly meets the needs of parents and children in these communities.

“We discovered that families of color struggled without prior interventions, many of which they perceived as not developed with them in mind. This is how the idea of the CPP was born,” said Dr. Julion. “We worked to develop a program that our families and parents could relate to, and included content that was highly relevant to them and takes the contexts of their lives into consideration.”

Driven by the disparities in numbers of nurses of color who are prepared to care for and understand ethnically diverse families on a deeper level, Dr. Julion believes cultural competency is something that can help health professionals, as well as educators, communicate in ways that are inclusive and accepting of varying perspectives.

“All nurses must be able to care for patients, families and communities appropriately, and cultural competency is a key element that enables appropriate caregiving,” said Dr. Julion. “Care providers can exhibit subtle disparities in caring for patients because their beliefs about patients, communities and students can be grounded in unconscious beliefs based upon individuals’ past experiences. Raising awareness on this issue is an important first step.”

To learn more about the Chicago Parent Program, visit the program website .

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