In February 2004, the Center for Health and Health Care in Schools posted a survey on its Web site entitled “Caring Across Cultures: Achieving Cultural Competence in a School Health Setting.” From February to June 2004, 143 surveys were filled out and this report summarizes the results from these surveys.

Forty percent of the respondents described themselves as school nurses,10% were health educators, 10% were health organization administrators, and 10% identified themselves as school nurse supervisors. The remaining twenty-eight percent of respondents identified themselves as teachers (9%), nurse practitioners (6%), psychologists (1%), social workers (1%), health aides (1%), nutritionists (1%), and 9% chose the “other” category for this question.

The respondents described their ethnicity as white (85%), Hispanic or Latino (10%), African American or black (9%), Asian or Pacific Islander (6%), American Indian (5%), and other (5%). Seven percent of respondents are of multiethnic backgrounds.1

While 39% of respondents were located at elementary schools, 29% were in middle or junior high schools and 30% were in high schools. Six percent described themselves as located in K-8 schools, and 15% were in K-12 schools. Twelve percent were from alternative schools and 20% described their locale as “other.”

Responses suggest that there is a broad range of experience in terms of the impact of cross-cultural communication on school-based practice. Over 40% of the respondents reported that their health program has been affected by cross-cultural communication difficulties. (Table 1).

Table 1

Question Answers 1 = Yes, a lot;  5 = No, not much
To what extent has your program been affected by cross cultural communication difficulties? (n=142) 1 2 3 4 5
18% 23% 32% 19% 8%

Of the 139 persons responding to the question concerning the cross-cultural issues with the greatest impact on their services, 88% identified language as the primary issue, 53% noted “different attitudes toward behavioral or mental health issues,” 48% named “trust in the provider by patient or patient’s family,” and 42% indicated “different attitudes towards Western medicine.”

Eighty-seven percent of respondents reported that cross-cultural issues had affected their health practice such that they had taken steps in response. The leading responses included: providing written materials in other languages (82%), arranging for interpreter services (73%), consulting with school administrators or other community resources (62%), and talking with parents and community members (50%).

The leading challenges to addressing cross-cultural issues include: Identifying the barriers (66%), overcoming financial barriers (55%), and finding staff who reflect and/or are knowledgeable about ethnic and racial groups represented in the school (50%).

When asked what advice the respondents would give to others who confront similar challenges, they advise the following:

  • Provide written materials in all appropriate languages and literacy levels (77%)
  • Hire staff members who reflect the community served (61%)
  • Collaborate with interpreter services to assist with important conversations with parents (59%)
  • Develop a parent/community advisory committee to provide feedback and suggestions (44%)
  • Develop training sessions for staff (43%)
  • Use outreach workers to connect with new communities (36%)
  1. For questions 2, 3, 5, 7, 8 & 9, respondents had a choice of selecting more than one answer resulting in the total percent for each question to exceed 100%.

For more details, see the complete questionnaire results in PDF format. Future updates will be provided as additional surveys are received.