New Directions in Capacity Building: Incorporating Cultural Competence into the Interactive Systems Framework

Abstract

The UMBC Psychology Department's Center for Community Collaboration (CCC) provides training and support for capacity building to promote substance abuse and mental health treatment as well as adherence improvement in community agencies funded through the Ryan White Act serving persons living with HIV/AIDS. This article describes an approach to dissemination of Evidence Based Practices (EBPs) for these services that uses the Interactive Systems Framework (ISF) and incorporates a collaborative process involving trainer cultural competence, along with a comprehensive assessment of organizational needs, culture, and climate that culminates in tailored training and ongoing collaboration. This article provides: (1) an overview of the CCC's expanded ISF for the effective dissemination of two EBPs-motivational interviewing and the stages of change perspective; (2) an examination of the role of trainer cultural competence within the ISF framework, particularly attending to organizational culture and climate; and (3) case examples to demonstrate this approach for both general and innovation-specific capacity building in two community based organizations.

EPA guidance on cultural competence training

“…Cultural competence should be considered at both the individual/clinical level as well as at the institutional level [18,40,43,90,91,102,129].…”

Selling Innovations Like Soap: The Interactive Systems Framework and Social Marketing

“…Given its comprehensive and multi‐stakeholder approach, the Interactive Systems Framework has been widely utilized as a guide for the effective dissemination and implementation of various types of innovations within complex community systems (Flaspohler, Lesesne, et al., ; Noonan et al., ; Tabak et al., ). The ISF has been applied to efforts addressing issues like violence prevention (Wandersman et al., ), substance abuse (Firesheets, Francis, Barnum, & Rolf, ; Florin et al., ; Livet, Courser, & Wandersman, ), cancer prevention and control (Fernández et al., ; Rapkin et al., ), mental health (Flaspohler, Anderson‐Butcher, & Wandersman, ; Gregory et al., ), teen pregnancy prevention (Lesesne et al., ; Ray, Wilson, Wandersman, Meyers, & Katz, ), and chronic diseases and disabilities prevention/management (Lane et al., ; Nápoles, Santoyo‐Olsson, & Stewart, ). Given the complexity of such problems, the ISF has proved to be a useful tool in identifying and addressing relevant system perspectives, influences, and actions related to the dissemination and implementation of supportive interventions and research evidence.…”

“…The current body of ISF literature confirms this claim, with only a handful of the prominent applications of the ISF directly addressing the PSTS – the system within which communication and marketing efforts occur. Furthermore, the majority that do address the PSTS describe all three systems, and provide little explanation or investigation of the PSTS specifically (e.g., Collins et al., ; Florin et al., ; Gregory et al., ; Lane et al., ; Nápoles et al., ; Rapkin et al., ). While these articles do offer some useful discussion and direction for the PSTS, to be discussed later in this paper, it is challenging to find applications or examinations of the ISF that focus solely on the PSTS (see Lewis et al., ; Thigpen, Puddy, Singer, & Hall, for exceptions).…”

“…In the current ISF literature, the discussion of capacities or supportive factors for synthesis and translation within the PSTS is limited to vague references to external frameworks (see Taylor, Weist, & DeLoach, for reference to the Getting to Outcomes framework) and murky speculation about isolated factors that should be considered when synthesizing research evidence like cultural context (Gregory et al., ) or usability of end products (Thigpen et al., ). For example, while the suggestion of collaboration with the user to more accessibly translate information and make the products more useable is a good start, there is a lack of direction regarding how to engage in this collaboration.…”

A Framework for Testing and Promoting Expanded Dissemination of Promising Preventive Interventions That Are Being Implemented in Community Settings

“…For example, research staff members involved in the program modification effort may need to develop and implement the initial training and coaching protocols. Introduction of modified programming into routine practice also requires careful consideration of the cultural climate of the organization, ensuring a match between the innovations and providers’ expectations and needs (Gregory et al, 2012). …”