The Cultural Broker The Cultural Broker ModelModel

From Paper to PracticeFrom Paper to Practice

The Cultural Broker ModelThe Cultural Broker Model

Role StrainRole Strain

↓↓

Bi-Cultural CompetenceBi-Cultural Competence

↓↓

Cultural BrokerCultural Broker

Bi-Cultural CompetenceBi-Cultural Competence

Professional CultureProfessional Culture

++Community/Family CultureCommunity/Family Culture

Cultural Broker: Cultural Broker: Key Role of Home VisitorKey Role of Home Visitor

Professional CultureProfessional Culture

↕↕↕↕↕↕↕↕Community/Family CultureCommunity/Family Culture

Successful Site Characteristics Successful Site Characteristics

HVs ProfessionalismHVs Professionalism HVs accept NFN model and parenting HVs accept NFN model and parenting

curriculacurricula HVs “do curriculum”HVs “do curriculum” HVs trust that supervisors share a deep HVs trust that supervisors share a deep

concern for familiesconcern for families HVs strive to achieve bi-cultural HVs strive to achieve bi-cultural

competence competence HVs express willingness to embrace cultural HVs express willingness to embrace cultural

broker modelbroker model

Recommendations from ReportRecommendations from Report

““Generalist” v. “Specialist” role of HVs Generalist” v. “Specialist” role of HVs From role strain to cultural brokerFrom role strain to cultural broker Organizational channels for HVs to Organizational channels for HVs to

participate in decision makingparticipate in decision making Substance abuse, domestic violence Substance abuse, domestic violence

and poor mental healthand poor mental health Strengthen supervisionStrengthen supervision Career LaddersCareer Ladders

Study CirclesStudy Circles

What is it? What is it? A democratic dialogue rooted in A democratic dialogue rooted in

basic principles of action research basic principles of action research designed to foster small group designed to foster small group deliberation around common issues. deliberation around common issues.

Program staff asked to volunteer: Program staff asked to volunteer: 94% participated94% participated

Recommendations provided to: Recommendations provided to:

Professionalize the home visitor roleProfessionalize the home visitor role More clearly define and develop the More clearly define and develop the

supervisor rolesupervisor role Expand parenting curricula Expand parenting curricula Include home visitors in program Include home visitors in program

decision-making decision-making Better accommodate mothers’ Better accommodate mothers’

schedules, especially working moms schedules, especially working moms

OutcomesOutcomes

Resulted in staff network meetings Resulted in staff network meetings and CQIand CQI

Curricula ExpandedCurricula Expanded Clinical SupervisorClinical Supervisor Home Visitor Training IncreasedHome Visitor Training Increased Eliminated credentialing and left Eliminated credentialing and left

Healthy FamiliesHealthy Families

Revisiting the Cultural Revisiting the Cultural Broker ModelBroker Model

Focus Group StudyFocus Group Study

November and December, November and December, 20072007

BackgroundBackground

New developmental stage & period of New developmental stage & period of growthgrowth

New policies, training, curricula, New policies, training, curricula, supervisionsupervision

Hartford is first city to “go to scale” in Hartford is first city to “go to scale” in 20052005

Focus Group Study: Nov/Dec 2007Focus Group Study: Nov/Dec 2007

Purpose: Understand the decision-making Purpose: Understand the decision-making process in identifying family needs and process in identifying family needs and linking families to community resourceslinking families to community resources

4 focus groups: home visitors & 4 focus groups: home visitors & supervisorssupervisors

8-10 participants/group, mix from 8-10 participants/group, mix from different sitesdifferent sites

Focus Group DiscussionsFocus Group Discussions

Families with multiple problemsFamilies with multiple problems

The “big three” risk factorsThe “big three” risk factors

Creating changeCreating change

The cultural broker modelThe cultural broker model

Bridging Two CulturesBridging Two Cultures

……like I came from where a lot of these girls like I came from where a lot of these girls came from. Life was hard for me growing up…came from. Life was hard for me growing up…And I don’t get personal with them but I let And I don’t get personal with them but I let them know ‘I’ve been there.’ [Another home them know ‘I’ve been there.’ [Another home visitor: Exactly.]...visitor: Exactly.]... And I need to come off my And I need to come off my professional pedestal, so to speak, and come professional pedestal, so to speak, and come down a couple of notches on her level and be down a couple of notches on her level and be like ‘Look.’ Get with the slang terms and like ‘Look.’ Get with the slang terms and everything for her to understand, where everything for her to understand, where normally I don’t talk like that. I used to, but I normally I don’t talk like that. I used to, but I am here now and it’s like just to show her ‘You am here now and it’s like just to show her ‘You can do it.’ Not to gloat to her. I don’t gloat to can do it.’ Not to gloat to her. I don’t gloat to her, but I am like ‘Look. I been there. And she her, but I am like ‘Look. I been there. And she respects me...It works. It really does.respects me...It works. It really does.

Generalist v. SpecialistGeneralist v. Specialist

““That’s why so many families that come into That’s why so many families that come into the program new when we first start the program new when we first start working with them there is no time to do working with them there is no time to do any curriculum...That’s the last thing that any curriculum...That’s the last thing that they want to hear or see or read. They they want to hear or see or read. They have so many other issues… They need to have so many other issues… They need to know where their next meal is coming know where their next meal is coming from, like you said where they are going to from, like you said where they are going to lay their head. All that type thing. How are lay their head. All that type thing. How are they going to take the baby to the doctor they going to take the baby to the doctor with no medical insurance, and all this with no medical insurance, and all this type thing.”type thing.”

Curriculum & ParentingCurriculum & ParentingOf Central ImportanceOf Central Importance

They are not ready for it. But then you get They are not ready for it. But then you get overwhelmed when they are going on and overwhelmed when they are going on and on about ‘This is how I feel. This is what’s on about ‘This is how I feel. This is what’s going on’. And you still have to try to find a going on’. And you still have to try to find a way to bring it back to the child so that you way to bring it back to the child so that you are still being effective.are still being effective.

So then I take the book out. Parents as So then I take the book out. Parents as Teachers. The best thing…I like it a lot…Teachers. The best thing…I like it a lot…That’s our Bible. [laughter from everyone]…That’s our Bible. [laughter from everyone]…And then I give them the handoutsAnd then I give them the handouts … …

When and how is clinical When and how is clinical supervision involved in the supervision involved in the

process?process?

What is the supervisor’s What is the supervisor’s role??role??

To Listen, Ask QuestionsTo Listen, Ask Questions

“ “ [[Clinical supervisors] have to know the Clinical supervisors] have to know the family and they have to listen to what you family and they have to listen to what you say. Because [we] see themsay. Because [we] see them every week. every week. So it’s a person that’s really involved and So it’s a person that’s really involved and really caring...Caring. That’s the key word. really caring...Caring. That’s the key word. They have to be caring...And They have to be caring...And understanding, too.understanding, too. [Clinical supervisors] [Clinical supervisors] understand where the families are coming understand where the families are coming from. Not trying to put them where [they] from. Not trying to put them where [they] think they should be,...”think they should be,...”

And Provide FeedbackAnd Provide Feedback ““With all the problems that [NFN families] With all the problems that [NFN families]

have sometimes you don’t know whether you have sometimes you don’t know whether you are coming or going. So you need someone are coming or going. So you need someone that has their head on their shoulders and……that has their head on their shoulders and……says, ‘Why don’t we try this?’says, ‘Why don’t we try this?’ “ “

““we always keep her informed and we are in we always keep her informed and we are in her office a lot, too, to try to get ideas or ask her office a lot, too, to try to get ideas or ask questionsquestions

Or by you telling [supervisor] what’s been Or by you telling [supervisor] what’s been going on to develop that plan, how can we be going on to develop that plan, how can we be creative? How can we address the curriculum creative? How can we address the curriculum in a different way? How can we get the baby in a different way? How can we get the baby out of the parents’ room?out of the parents’ room?

And SupportAnd Support

““Sometimes I feel really overwhelmed and Sometimes I feel really overwhelmed and drained and I sit with her and she can be drained and I sit with her and she can be very positive and help us a lot with our very positive and help us a lot with our clients. [others agree]…And we do clients. [others agree]…And we do supervision every week. [laughs]…Oh, supervision every week. [laughs]…Oh, yeah. Because sometimes she has to tell yeah. Because sometimes she has to tell us, ‘Okay, don’t take it personal’ about us, ‘Okay, don’t take it personal’ about certain things... Let’s think about how we certain things... Let’s think about how we can work around it, how we can make it can work around it, how we can make it better.’ Yeah, supervision is crucial”better.’ Yeah, supervision is crucial”

Do you see change? Yes!Do you see change? Yes!

RelationshipsRelationships

Identifying problems with support Identifying problems with support and supervisionand supervision

Figuring out effective strategiesFiguring out effective strategies

Time and turning pointsTime and turning points

Cultural Broker Model as the Cultural Broker Model as the mechanism for creating changemechanism for creating change

Improve support by focusing on the frontlines Improve support by focusing on the frontlines where staff and families come togetherwhere staff and families come together

Professional CultureProfessional Culture↕↕↕↕↕↕↕↕

Community/Family CultureCommunity/Family Culture

Experiences and knowledge that home Experiences and knowledge that home visitors have of families and communities are visitors have of families and communities are a powerful resource for informing practice a powerful resource for informing practice and policyand policy

How can we improve the How can we improve the program model?program model?

What are the most challenging What are the most challenging issues right now and is the issues right now and is the program model effective in program model effective in addressing them?addressing them?

Questions for DiscussionQuestions for Discussion