A skillset and a stance: Program planning for cultural competence and cultural humility in home visitation.

Cultural competence has long been valued in home visitation, with a special focus on adapting home visiting programs to maximize their effects on specific cultures and populations. Critics advocate that traditional cultural competence training focusing on individual, professional skills-building should be replaced by cultural humility approaches that focus on humble engagement of participants. Little is known about how home visiting programs serving broadly diverse populations experience cultural competence and/or cultural humility efforts and initiatives on the ground. Interviews approximately 90-120 min in length were conducted with 34 home visiting program administrators in a large Midwestern state. Interviews were audio-recorded, transcribed, coded thematically, and subjected to content analysis. Two themes were identified from interviews. Respondents emphasized that: 1) cultural competency training was required by home visiting program models, so cultural competency questions were always addressed in home visitation, especially in training for new home visitors; and 2) cultural competence also included many aspects of cultural humility, commitment to continuous self-evaluation and self-reflection on cultural encounters that identified cultural knowledge gaps and sought more information. Respondents did not see cultural competency and cultural humility as oppositional and saw both concepts as important for engaging participants in home visitation.