Cultural Competency


Cultural Competency

In addition to the five steps of the SPF process, there are also two overarching goals that cut across the entire process and which must be considered at each of the five steps. These are cultural competency and sustainability. Cultural competence refers to the ability of organizations, programs, interventions, and staff to serve communities in ways that resonate with their cultural values and beliefs. If a prevention program, intervention, or evaluation fails to be culturally relevant to the target community, then it is highly likely to fail in all other respects as well. Therefore, when assessing community resources and needs, when building community capacity for prevention efforts, and when planning, selecting, implementing, and evaluating programs it is imperative that every effort is made to consider the cultural priorities and values of the target population(s).

Often when thinking about cultural competency, it is important to focus on how to choose a good program, and then if and how to adapt that program so that it makes sense and is meaningful to the target population. One way to think about how a program may match a cultural value system or not is to look at both the surface structure and the deep structure of the program:

Surface structure: The parts of the program which are most visible and most easily changed are referred to as the surface structure of that program. Surface structure can include things such as the language used, the names and labels used during examples, the look of any visual aids or illustrations, and the types of materials and activities shown or used. For example, using Native Hawaiian or local names and phrases, such as 'ohana and pono, are examples of ways that programs can change their surface structure to reflect local culture.

Deep structure: The parts of the program which may be less visible, but which reflect the essence of the values and goals of the program are known as the deep structure of that program. Deep structure is harder to change than surface structure, but it is very important to make sure that the deep structure resonates with the target population. In other words, it is important to either choose a program or adapt a program so that its deep structure elements match the values and goals of the people in the community. For example, just using the words 'ohana and pono in a casual way is likely to be less effective that incorporating the full significance and meaning of these concepts into the very structure of the program in a way that harnesses their meaningfulness. 

This is often a complex and difficult consideration for many community interventions, largely because most communities are diverse and include many different perspectives, values, and beliefs. Collaboration among many different groups and sectors of a community, therefore, becomes critically important. It only is through dialogue, collaboration, and the genuine inclusion of many perspectives that culturally resonant prevention programming is achieved. While choosing and adapting programs to be culturally relevant tends to be a strong focus for many prevention efforts, this kind of inclusion and attention to cultural values needs to be present from the very beginning and throughout the SPF process.

SPF in Hawai'i: Cultural Competency

During the SPF-SIG project, cultural competency was a major focus. Trainings related to cultural competency were made available and organizations and agencies were strongly encouraged to consider culture when selecting and adapting their prevention programs. In fact, most (28 out of 32, 88%), of the prevention education providers implemented at least one form of cultural adaptation for their prevention programs. The remaining providers felt that their programs were already appropriate and did not require adaptation.




Resnicow, K., Baranowski, T., Ahluwalia, J.S., and Braithwaite, R.L. (1999). Cultural sensitivity in public health: defined and demystified. Ethnicity and Disease, 9 (1), 10-21.
SAMHSA. (2015, September 25). Cultural Competence. Retrieved from