Building cultural competence: A systematic evaluation of the effectiveness of culturally sensitive interventions with ethnic minority youth

Growing diversity within the US population accentuates the need for the development and implementation of culturally competent services in the field of social work. Despite this few studies exist that examine the effectiveness of culturally sensitive interventions (CSI) with ethnic minority youth, who are considerably more at risk of developing psychosocial problems including substance and alcohol abuse, delinquency, low academic achievement, and poor self-esteem. With the demand for evidence-based practice it is imperative that we examine the effectiveness of CSI's designed to prevent and treat youth problems. The main goal of this study was to analyze the methodology of recent CSI research with populations of ethnic minority youth in order to evaluate each intervention's ability to adhere to existing standards of evidence-based practice. Ten CSI studies published between 1997 and 2007 were included in this systematic investigation. All of the interventions examined were preventatively focused and designed to enhance resiliency, reduce substance use and abuse, and/or increase self-esteem. This study used the California Evidence-Based Clearinghouse's (CEBC) Scientific Rating Scale for child welfare, and the National Resource Center's: Community-Based Child Abuse Prevention's (CBCAP) Levels of Evidence for Evidence-Based Practice, to devise a 5-level classification system to systematically review the methodology of CSI studies. This system (The Levels of Evidence-Based Intervention Effectiveness or LEBIE) included the following intervention classification categories: (1) Superior Intervention; (2) Effective Intervention; (3) Efficacious Intervention; (4) Emerging Intervention; and (5) Concerning Intervention. All of the investigated CSI studies fell within three categories of the LEBIE (2=Effective; 3=Efficacious; 4=Emerging). The largest number of intervention studies were classified as Efficacious (60%), falling within Level 3 of the LEBIE. These studies mainly utilized a quasi-experimental design and reported outcomes ranging from statistically significant to no change when matched up with a comparison or control group. Two major methodological themes emerged from this study's evaluation. The first illustrates the beginning progress CSI researchers are making to develop effective interventions based on sound theory and/or existing evidence-based interventions. All of the intervention studies described a solid theory or theoretical perspective relative to the major research questions under study. This contradicts previous criticisms of an overall absent theoretical framework in ethnic minority research (Hall, 2001; Phinney, 1990; Ponterotto, 1988; Ponterotto & Casas, 1991). The second methodological theme is the employment of more rigorous design and analysis methods to measure intervention effectiveness. For instance, 80% of the CSI studies employed a quasi or experimental pre-post test control group design. This empirical approach to studying the effectiveness of an intervention with an ethnic minority youth sample is evidence that some researchers are sorting through the murky waters surrounding the methodology complexities of research with ethnic minority populations. The CSI studies examined in this review illustrate progress in their attempt to adhere to the methodological rigor required of evidence-based practice. This study concludes with suggestions for how social work researchers can position themselves analogously with and embrace the movement toward designing and evaluating effective culturally sensitive interventions for ethnic minority youth.