like the health care system. As a result, cultures are constantly undergoing change. Yet cultural processes remain central to the health promotion and health delivery system.
This requires a different approach to cultural competence that includes respect for the identity of individuals and communities with attention to the politicized nature of individuals and interactions with collectives, both local and global. This cultural identity must be understood with regard to multiple networks of communities and the larger society.
Chapter Practice Exercises
There are two practice exercises for this chapter. The first exercise calls on you to discuss issues of ethics in your own research study. The second exercise asks you to discuss issues in cultural competence. For each exercise, you will imagine a research study that you might undertake, and you will reflect on selected issues with regard to that study. At the end of the first exercise, you will have demonstrated competence in recognizing ways to ensure that you are adhering to key ethical issues in the use of human subjects in research. At the end of the second exercise, you will have demonstrated competence in the inclusion of issues in cultural competence in various tasks in the research process.
Practice Exercise 1: Ethics for Your Study
In this exercise, you will think of a research study that you might undertake. With regard to various tasks in the research process, you will be asked to consider several ethical issues in the use of human subjects in research.
Competencies Demonstrated by Practice Exercise 1
1 The ability to recognize what ethical issues in research are most likely to be problematic with regard to a given research study
2 The ability to recognize how to address the ethical issue of potential harm that may be caused to human subjects by a research study
3 The ability to recognize how to address the ethical issue of privacy in a research study
4 The ability to recognize how to address the ethical issue of voluntary participation in a research study
5 The ability to recognize how to address the ethical issue of justice in a research study
Activities for Practice Exercise 1
1 You will briefly describe a research study that you would like to undertake. This study can be descriptive, explanatory, evaluative, or exploratory. Indicate which of these types of study you will undertake, the research question you will pursue, the study sample you would employ, and the tools you might use to measure the study variables.Example 1: I will conduct an evaluative study. The research question is as follows: Is a social support group experience effective in the reduction of the level of anxiety experienced by victims of rape? The study subjects will be rape victims currently being served by the Family Services Center of Oak Hill. These clients will be asked to complete an anxiety scale both at the beginning of the group experience and again at the end of the experience.Example 2: I will conduct a descriptive study of the needs of the current clients of the Hampton Behavioral Health Center. I will ask a sample of current clients to indicate which of a series of our current services they find most helpful and what new services they would like for us to offer. For each question, they will be given a list of services they can check. They will also be given an open-ended question that asks how we can better serve them. In addition, the variables of race, gender, and income level will be measured in this study.Example 3:I will conduct an explanatory study of the causes of depression for adult females being serviced by the Hampton Behavioral Health Center. The study subjects will be asked to complete a survey that measures their depression and asks questions that identify potential causes of depression such as (a) whether they are currently having family difficulties, (b) whether they are having financial problems, (c) whether they are in good physical health, and (d) whether they have recently been the victim of assault of any kind
2 Describe how you would recruit and employ human subjects in this research study.Example:The current clients of the tutoring class at Rondale Middle School will be asked to participate in this study. The nature of the study will be explained, and they will be given the instructions on how to participate. Because they are minors, their parents will be asked to give consent to this participation.
3 Is there any reason for people to believe that participating in this study will cause harm? If so, indicate how you will address this issue so as to prevent harm.Example 1: These clients will be asked to respond to an anxiety scale. This is the only research activity that calls for their participation. I am not aware of any type of harm that would normally come from such an experience.Example 2: These study subjects will be asked to respond to a questionnaire that asks whether they have been sexually abused by a parent and to reflect on this experience in several ways. It seems logical to expect that some people will be emotionally upset by this experience.
4 How will you protect the privacy of these study subjects?Example 1: These clients will be asked to respond to the anxiety scale anonymously.Example 2: These clients will be asked to discuss their experiences as a victim of sexual abuse by a parent. Given the possibility that study subjects will be emotionally upset by this experience, a social worker will be present to offer assistance.
5 How will you ensure voluntary participation?Example 1: These clients will be informed that their participation in this study is voluntary. They will be told that they can turn in a blank copy of the anxiety scale in the envelope being distributed for their completed forms so that their participation will not be known.Example 2: The behavior of study subjects will be observed while a person fakes a heart attack on a busy street in a city. Their participation cannot be voluntary because the intent of the study is to describe behaviors of people who witness people in crises on a street in a city. If they know that the heart attack is fake, they will not behave in their typical ways to a real crisis. Because some people may be upset by this experience, a social worker will be present to offer help.
6 Do you have any reason to believe that the issue of justice should be scrutinized for this study?Example: The types of people who will benefit from the results of this study are the same as the study participants (victims of rape who are being treated for anxiety); therefore, justice is not an issue that requires special scrutiny for this study.
What You Will Report From Practice Exercise 1
Your report for Practice Exercise 1 will be your answers to the six questions given in the description of activities presented above.
Practice Exercise 2: Demonstrating Cultural Competence for Your Research Study
In this exercise, you are asked to reflect on issues of cultural competence with regard to the study you would like to undertake. It can be the same study as you described in Exercise 1 or it can be different.
Competencies Demonstrated by Practice Exercise 2
1 The ability to demonstrate cultural competence in the determination of a research question
2 The ability to demonstrate cultural competence in the development of research methods
3 The ability to demonstrate cultural competence in the analysis of data
4 The ability to demonstrate cultural competence in the drawing of conclusions for a research study
Activities for Practice Exercise 2
