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Cultural Competence and the SPF

Applying cultural competence to every step of the Strategic Prevention Framework (SPF) should result in a positive relationship with the community you serve.

Prevention practitioners who apply cultural competence to each step of SAMHSA’s Strategic Prevention Framework (SPF) benefit from an increased awareness about the unique challenges and advantages within the communities they serve. Your relationship with members of the community also improves when you affirm cultural perspectives.

Assess Needs

Prevention practitioners who are culturally competent look inward. Aim to assess the influence of your own values, perceptions, opinions, knowledge, and social position on interactions with others. Understand that cultural competence is not theoretical, but must be reflected in everyday attitudes and interactions. Infuse cultural competence into SPF Step 1: Assess Needs by:

  • Identifying and using a culturally-competent program evaluator
  • Deciding how to measure cultural competence and collecting cultural competence-related information and data
  • Identifying change from a community perspective
  • Gaining community approval for data collection methods, analysis, and the final product
  • Creating a process for identifying culturally-relevant risk and protective factors and underlying conditions

Build Capacity

Culturally competent professionals learn how to be an ally to groups that experience prejudice and discrimination in the community. This, in turn, helps people learn how to be an ally within and outside of their own cultural groups. Encouraging cultural self-awareness and affirming other people’s cultural perspectives are key to building capacity. Infuse cultural competence into SPF Step 2: Build Capacity by:

  • Assessing community resources and readiness in the community
  • Providing a safe and supportive environment for all participants
  • Ensuring cultural representation (for example, language, gender, age)
  • Developing policies to improve cultural competence through staff recruitment, retention, and training
  • Seeking community input on problems and possible solutions
  • Identifying and mobilizing mutually acceptable program goals and objectives


Culturally competent professionals make community representation in the planning process a priority. Along with these community stakeholders, consider how the program would fit into the community culture, what existing prevention efforts are in place, and the community’s past history when selecting programs and strategies.

Learn how to embrace new and unpredictable situations. When misunderstandings arise, be persistent in keeping communication lines open. Encouraging skills-building in cross-cultural interactions and communication is important to program planning.

Learn more about SPF Step 3: Plan.


A culturally competent professional understands that people may choose to participate in different ways, and that they may also have different learning styles when it comes to understanding the program. Build on community members’ strengths and draw upon their diverse perspectives and experiences. Encourage community involvement in the implementation of the strategic plan.

Learn more about SPF Step 4: Implement.


Culturally competent professionals understand that large related studies or surveys can often serve as a starting place for community comparison research. However, if these studies do not have a diverse participant pool or represent members of your target population, the results may not be accurate or reflective of the outcomes of your excluded or underrepresented target group. Understand that all cultures have their own integrity, validity, and coherence and deserve respect.

Learn more about SPF Step 5: Evaluation.

Be Respectful and Responsive

Prevention practitioners are culturally competent when they can function effectively within the context of a community’s cultural beliefs, behaviors, and needs. Being respectful and being responsive are two ways you can show cultural competence.

Being respectful means recognizing and valuing cultural differences, such as the health beliefs, practices, and linguistic needs of diverse populations.

Being responsive means:

  • Knowing something about the culture of the group that the interventions focus on
  • Customizing prevention and promotion in a way that respects and fits within the group’s culture
  • Involving people from the targeted cultural group in assessing needs, developing resources, planning and implementing interventions, and evaluating their effectiveness

In the context of a prevention program, being respectful and responsive can help bring about positive health outcomes.

Cultural Competence Continuum

Developing cultural competence is an evolving, dynamic process that takes time and occurs along a continuum. The National Center for Cultural Competence at Georgetown University’s Center for Child and Human Development describes the six stages of this continuum in Infusing Cultural and Linguistic Competence in Health Promotion Training: Group Activity – Understanding the Cultural Competence Continuum – 2005 (PDF | 88 KB):

  • Cultural destructiveness. This stage is characterized by attitudes and practices (as well as policies and structures in organizations) that are destructive to a cultural group.
  • Culture incapacity. This stage reflects the lack of capacity systems and organizations necessary to effectively respond to the needs and interests of diverse groups. This can include institutional or systemic bias, practices that may result in discrimination in hiring and promotion, or disproportionate allocation of resources that may benefit one group over another. This can also include subtle messages that certain groups aren’t valued or welcomed.
  • Cultural blindness. This stage describes a philosophy of “fairness” that views and treats all people as the same. This philosophy, however, can be problematic because people are different and have different needs. People deserve approaches that acknowledge and celebrate differences, while addressing these needs. Cultural blindness can in fact, negatively influence system policies by encouraging assimilation, ignoring cultural strengths, fostering institutional attitudes that blame consumers for their circumstances, and failing to hire a diverse workforce.
  • Cultural pre-competence. This stage highlights the growing awareness of strengths (and areas for improvement) to respond effectively to culturally and linguistically diverse populations.
  • Cultural competence. In this stage, acceptance and respect for culture becomes consistently demonstrated in policies, structures, practices, and attitudes. This can include an organization’s commitment to human and civil rights, hiring practices that reflect a diverse workforce, and increased efforts to improve service delivery for racial, ethnic, or cultural groups.
  • Cultural proficiency. In stage six, culture is held in high esteem and used as a foundation to guide all endeavors. Organizations that do this successfully continue to add to their knowledge base. They support and mentor other organizations seeking to improve their cultural competence and they advocate with and on behalf of populations who are traditionally underserved or not served at all. They also partner with other diverse constituency groups to help reduce and eventually eliminate racial and ethnic disparities.

Related Resources

Access more CAPT tools and other learning resources.

Last Updated: 09/25/2015