NIATx in New Places: Building Cultural Intelligence and Health Equity

By: Alfredo Cerrato, Senior Cultural and Workforce Development Officer,

NIATx has been a vehicle for innovation since introducing process improvement tools and techniques to substance use disorder treatment organizations in 2003. The five NIATx principles combined with the essential NIATx tools have transformed approaches to treatment access and retention for countless organizations across the nation.

That spirit of innovation endures as NIATx breaks ground in new service areas and settings. One exciting new area where we’re field-testing the NIATx approach is in organizational efforts to build cultural intelligence and health equity.

The growing diversity of the U.S. population requires a culturally-informed behavioral health workforce that can provide culturally and linguistically appropriate services.

NIATx tools and techniques can help a team identify and remove access barriers for underserved communities, such as those with limited English proficiency or low health literacy. The NIATx tools can be adapted to target equity and inclusion aims. For example:

·       The walk-through strategy can identify areas where cultural responsiveness is lacking, such as inadequate language assistance services or culturally appropriate materials. By involving clients (NIATx Principle #1) and staff from diverse backgrounds in the walk-through process, agencies can pinpoint barriers to care and spark ideas for improvement that prioritize cultural responsiveness.

·       The nominal group technique can generate and prioritize ideas for improving cultural competence among staff and better tailoring services to diverse populations. Engaging staff from diverse backgrounds in the brainstorming process helps ensure that the needs and perspectives of diverse communities are represented.

·       Flowcharting can map out the steps in a process from the perspectives of clients from diverse backgrounds, focusing on identifying areas where cultural responsiveness is lacking. As a result, flowcharting can help identify gaps in care and test targeted improvements to ensure that services are tailored to the unique needs of diverse populations.

·       PDSA Cycles can test new approaches to promoting cultural competence and addressing disparities in care. In addition, teams can use data from PDSA cycles to evaluate their effectiveness and make informed decisions about scaling up or modifying their approach.

In addition, we’re exploring ways that the NIATx approach can help organizations align their processes with the National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care. Learning about the CLAS standards is one thing but implementing them presents a challenge.

NIATx Change Leader Academy/CLAS Standards

In April 2023, we’re offering a one-hour session titled Using NIATx to Strengthen Your Workforce: Implementing CLAS Standards for Recruiting, Hiring, Retaining, and Promoting (RHRP) Staff. This interactive training will teach participants about the CLAS Standards and why they’re vital to improving care, reducing disparities, and advancing health equity. We will also cover strategies for implementing the CLAS standards, including the important role of the change leader. This session is part of a five-part series designed to help participants prepare for a follow-up NIATx Change Leader Academy.

The integration of the NIATx model and the CLAS standards provides a powerful framework for promoting cultural responsiveness and equity in behavioral health services. By emphasizing the importance of a systematic approach to quality improvement and cultural and linguistic competence, this approach can help ensure that every step of the process is tailored and measured to meet the unique needs and preferences of diverse populations, whether they are a client or an employee. This can lead to better patient outcomes, improved workforce retention, and ultimately, a more effective and equitable healthcare system.

The NIATx model continues to evolve in response to the changing behavioral health care landscape. As new challenges and opportunities arise, the model adapts and expands to incorporate the latest research and best practices. Through ongoing innovation and collaboration with stakeholders across the behavioral health care landscape, NIATx is helping to transform the way we deliver care, improve outcomes, and promote health equity for all individuals.

About the author:

Alfredo Cerrato is the Senior Cultural and Workforce Development Officer for the Center for Health Enhancement Systems Studies at the UW–Madison. He currently manages Intensive Technical Assistance projects for the Great Lakes ATTC, MHTTC, and PTTC. He is a subject matter expert and trainer of trainers for the National Standards for Culturally and Linguistically Appropriate Services (CLAS). Alfredo specializes in the relationship between the CLAS Standards and process improvement, focusing on organizational change, cultural communications, worldview dynamics, and conflict resolution. He has 25 years of international relations experience and has conducted advocacy, policy, and disaster relief work in collaboration with multiple governments across the globe.

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