The Development and Validation of a Scale Measuring Multicultural Competence Towards Arab-Americans

The majority of research on mental health service use and access focuses on the four major racial/ethnic groups in the U.S.  There is significantly less attention and research afforded to Arab-Americans. There is evidence of mental health service use disparities among Arab-Americans, with little known about potential avenues for more comprehensively understanding and addressing these disparities.  One of the identified barriers related to the decision to seek mental health services among racial and ethnic minorities, including Arab Americans, is a lack of availability of culturally competent or compatible mental health services.  To facilitate an understanding of this barrier, a measure of cultural competency towards Arab Americans was developed and validated through a focus group and pilot testing. 

The scale used a five point Likert scale, wherein lower numbers indicated higher levels of cultural competence. This measure was subsequently presented to a focus group of Arab Americans, feedback from which was the basis of modifications to the measure. The modified measure was subsequently piloted among mental health practitioners in five agencies in the Richmond, VA community.

The focus group consisted of five women and one man, with an age range of 26-56.  All participants were Coptic Christians from Egypt.  Focus group participants were concerned about the social desirability of specific items, particularly around a reluctance to admit to holding stereotypes or biases of Arab Americans. 

Demographics of the 19 pilot study participants consisted of 84% females and 68% White.  42% of participants had less than five years of clinical experience, and 32% were below the age of 35.

Given the small sample size (N=19), exploratory analyses were run in order to identify characteristics of subscales, including alpha, means, and standard deviations.

Three subscales were identified.  The first subscale, Awareness, consisted of 6 items with an alpha of .745.  The mean and standard deviation for was 1.53 and .52, respectively.  The second subscale, Knowledge, consisted of 4 items, with an alpha of .569.  The mean and standard deviation was 3.03 and .83, respectively.  The third subscale, Skills, consisted of 5 items, with an alpha of .721.  The mean and standard deviation was 2.07 and .80, respectively.  The overall scale consisted of 15 items, with an alpha of .753, mean and standard deviation of 2.12 and .46, respectively.

Convergent Validity with the MCKAS, or Multicultural Counseling Knowledge and Awareness Scale was found with a correlation of .612 (p=.007).

This is the first measure to look at levels of cultural competence among mental health practitioners specifically towards Arab Americans.  The development and initial validation of this measure adds to the literature on the operationalization and measurement of cultural competence.  This measure will increase our understanding of the process through which Arab Americans and other diverse groups go when making a decision to see mental health services or remain in mental health services.  This will ultimately allow us to further elucidate and subsequently address the mechanisms that contribute to, and reproduce, racial/ethnic disparities in mental health service use and access.