Public Health Administrators' Perceptions of Community Diversity as Predictors to implement CLAS Standards (Culturally and Linguistically Appropriate Services) in Kentucky's Local Health Departments

Objectives: (1)To assess the implementation of public health practices based on the national standards for Culturally and Linguistically Appropriate Services (CLAS Standards) in local health departments in Kentucky; (2) Provide policy recommendations for program development to address the needs of diverse communities.

Methodology: Cross-sectional survey to public health administrators across 56 counties in Kentucky. Instrument: Self-Assessment Tool for CLAS Services in Local Public Health Agencies. Association of implementation of CLAS practices and perceptions of the community diversity were examined. Variables of interest were 1) cultural competency training to staff; 2) practices related to non-English Speaking clients; and 3) practices related to patients with low literacy skills and patients with disabilities.

Logistic regression statistical technique was performed.

Results: A total of 159 Kentucky public health administrators received the survey, and 123 (77%) were returned.  Cultural competency online training to staff was statistically significant associated with the Hispanic population as perceived by the Nurse Leaders (p=.026). Practices related to serve the non-English speaking population were statistically significant associated with the Hispanic population such as: contracting bilingual/bicultural staff (p=.024 public health directors, p=.017 nurse leaders); provide translations services (p=.030 nurse leaders); hire interpreters (p=.009 public health directors, p=.007 nurses); and ethnic media advertisements (p=.041 nurse leaders).

Conclusion: Local health departments across Kentucky have initiated and have implemented policies that comply with the CLAS Standards and address the need of the growing population diversity in KY. The role of the Nurse Leader in local health departments is more likely to impact and influence decision making regarding CLAS practices.