Cultural sensitivity

{{Short description|Knowledge, awareness, and acceptance of other cultures}}

File:Maxwell hosts first Cultural Awareness Day 140620-F-ZI558-005.jpg

Cultural sensitivity, also referred to as cross-cultural sensitivity or cultural awareness, is the knowledge, awareness, and acceptance of other cultures and others' cultural identities. It is related to cultural competence (the skills needed for effective communication with people of other cultures, which includes cross-cultural competence), and is sometimes regarded as the precursor to the achievement of cultural competence, but is a more commonly used term. On the individual level, cultural sensitivity is a state of mind regarding interactions with those different from oneself. Cultural sensitivity enables travelers, workers, and others to successfully navigate interactions with a culture other than their own.

Cultural diversity includes demographic factors (such as race, gender, and age) as well as values and cultural norms. Cultural sensitivity counters ethnocentrism, and involves intercultural communication, among relative skills. Most countries' populations include minority groups comprising indigenous peoples, subcultures, and immigrants who approach life from a different perspective and mindset than that of the dominant culture. Workplaces, educational institutions, media, and organizations of all types are becoming more mindful of being culturally sensitive to all stakeholders and the population at large. Increasingly, training of cultural sensitivity is being incorporated into workplaces and students' curricula at all levels. The training is usually aimed at the dominant culture, but in multicultural societies may also be taught to migrants to teach them about other minority groups. The concept is also taught to expatriates working in other countries to ingratiate them into other customs and traditions.

Definitions and aims

There are a variety of definitions surrounding cultural sensitivity. All of these definitions revolve around the idea that it is the knowledge, awareness, and acceptance of other cultures.{{Cite journal|last=Kubokawa|first=Amanda|date=2009|title=Positive Psychology and Cultural Sensitivity: A Review of the Literature|url=https://epublications.marquette.edu/cgi/viewcontent.cgi?article=1029&context=gjcp|journal=Graduate Journal of Counseling Psychology|volume=1|pages=2|access-date=20 June 2018|archive-date=20 June 2018|archive-url=https://web.archive.org/web/20180620074208/https://epublications.marquette.edu/cgi/viewcontent.cgi?article=1029&context=gjcp|url-status=live}} It includes "the willingness, ability and sensitivity required to understand people with different backgrounds", and the acceptance of diversity.{{cite web | title=Migration and cultural diversity: Cultural competence and cultural sensitivity | website=Finnish Institute for Health and Welfare | url=https://thl.fi/en/web/migration-and-cultural-diversity/good-practices/cultural-competence-and-cultural-sensitivity | date=20 July 2020 | access-date=7 September 2020 | archive-date=7 September 2020 | archive-url=https://web.archive.org/web/20200907015712/https://thl.fi/en/web/migration-and-cultural-diversity/good-practices/cultural-competence-and-cultural-sensitivity | url-status=live }} Crucially, it "refers to being aware that cultural differences and similarities between people exist without assigning them a value."{{cite web | title=Practicing Cultural Sensitivity | website=Southeastern University Online | date=16 October 2017 | url=https://online.seu.edu/articles/practicing-cultural-sensitivity/ | access-date=7 September 2020 | archive-date=6 August 2020 | archive-url=https://web.archive.org/web/20200806013817/https://online.seu.edu/articles/practicing-cultural-sensitivity/ | url-status=dead }}{{cite web | last=Dabbah | first=Mariela | title=What is Cultural Sensitivity? Discover Definition & Theory | website=Red Shoe Movement | date=31 October 2014 | url=https://redshoemovement.com/what-is-cultural-sensitivity/ | access-date=7 September 2020 | archive-date=7 September 2020 | archive-url=https://web.archive.org/web/20200907025443/https://redshoemovement.com/what-is-cultural-sensitivity/ | url-status=dead }} Definitions also include the skill set acquired by this learning.{{cite web|url=https://study.com/academy/lesson/what-is-cultural-sensitivity-definition-examples-importance.html|title=What is Cultural Sensitivity? - Definition, Examples & Importance|website=study.com|first1=Yolanda|last1=Williams|first2=Jennifer|last2=Levitas|access-date=7 September 2020|archive-date=7 September 2020|archive-url=https://web.archive.org/web/20200907023943/https://study.com/academy/lesson/what-is-cultural-sensitivity-definition-examples-importance.html|url-status=live}} Cultural awareness is having the knowledge of the existence of multiple different cultures with different attitudes and worldviews, while cultural sensitivity means the acceptance of those differences and accepting that one's own culture is not superior.

In 2008, cultural sensitivity was found to be a widely used term in a literature search of global databases, both popular and scholarly. Based on this literature, cultural sensitivity is defined as "employing one's knowledge, consideration, understanding, [and] respect, and tailoring [it] after realizing awareness of self and others, and encountering a diverse group or individual".

There are many different types of cultural diversity in any society, including factors such as marginalized or socially excluded groups; ethnicity; sexual orientation; disability; values and cultural norms. Cultural sensitivity is relevant to all of these.{{cite journal|first1 = G.|last1 = Ferris|first2 = D.|last2 = Frink|first3 = M.C.|last3 = Galang|title = Diversity in the Workplace: The Human Resources Management Challenges|journal = Human Resource Planning|volume = 16|number = 1|date = 1993|page = 42|url = http://web.b.ebscohost.com/abstract?site=ehost&scope=site&jrnl=01998986&AN=9503103275&h=KCRbWtQSG7Xch8mcwk9hpFO%2f3rgZq%2f%2fc60WSPso2EORHnlDW5YSiFC3h52LgJsN%2bTqyjui7iugjPyTmw4Op%2fuw%3d%3d&crl=f&resultLocal=ErrCrlNoResults&resultNs=Ehost&crlhashurl=login.aspx%3fdirect%3dtrue%26profile%3dehost%26scope%3dsite%26authtype%3dcrawler%26jrnl%3d01998986%26AN%3d9503103275|url-access = subscription|access-date = 7 September 2020|archive-date = 12 October 2021|archive-url = https://web.archive.org/web/20211012011537/http://web.b.ebscohost.com/abstract?site=ehost&scope=site&jrnl=01998986&AN=9503103275&h=KCRbWtQSG7Xch8mcwk9hpFO%2F3rgZq%2F%2Fc60WSPso2EORHnlDW5YSiFC3h52LgJsN+Tqyjui7iugjPyTmw4Op%2Fuw%3D%3D&crl=f&resultLocal=ErrCrlNoResults&resultNs=Ehost&crlhashurl=login.aspx%3Fdirect%3Dtrue&profile=ehost&scope=site&authtype=crawler&jrnl=01998986&AN=9503103275|url-status = live}}

Support of cultural sensitivity is based on ideological or practical considerations. Former Secretary-General of the United Nations, Kofi Annan, advocated cultural sensitivity as an essential value in the modern world:{{cite web|url=https://www.un.org/News/Press/docs/2004/sgsm9195.doc.htm.|archive-url=https://web.archive.org/web/20140321215137/http://www.un.org:80/News/Press/docs/2004/sgsm9195.doc.htm|title=Tolerance, Inter-Cultural Dialogue, Respect for Diversity More Essential Than Ever, Secretary-General Says in Message for Day to Eliminate Racial Discrimination|first=Kofi|last=Annan|author-link=Kofi Annan|date=12 March 2004|archive-date=21 March 2014|website=United Nations|series=Press Release SG/SM/9195, OBV/410, RD/982}}{{Blockquote|Tolerance, inter-cultural dialogue and respect for diversity are more essential than ever in a world where people are becoming more and more closely interconnected.}}

Factors for cultural awareness

Certain factors that affect cultural sensitivity include religion, ethnicity, race, national origin, language, or gender. Others areas to look at include age, education, socio-economic status, sexual orientation, and mental/physical challenges.

= Cultural competence =

Awareness and understanding of other cultures is a key factor of cultural sensitivity. Cultural Competence relies on the ability of both parties involved to have a pleasant and successful interaction. The term "cultural competence" is often used to describe those skills acquired to embody cultural sensitivity, particularly in the workplace. Cultural sensitivity requires flexibility.{{cite web |last=Sherman |first=Fraser |date=11 March 2019 |title=Cultural Sensitivity Skills in the Workplace |url=https://smallbusiness.chron.com/cultural-sensitivity-skills-workplace-20375.html |access-date=7 September 2020 |website=Small Business - Chron.com |archive-date=7 September 2020 |archive-url=https://web.archive.org/web/20200907084931/https://smallbusiness.chron.com/cultural-sensitivity-skills-workplace-20375.html |url-status=live }} Louise Rasmussen and Winston Sieck{{Cite journal |last1=Rasmussen |first1=Louise J. |last2=Sieck |first2=Winston R. |date=2015-09-01 |title=Culture-general competence: Evidence from a cognitive field study of professionals who work in many cultures |url=https://www.sciencedirect.com/science/article/pii/S0147176715000371 |journal=International Journal of Intercultural Relations |series=Intercultural Competence |language=en |volume=48 |pages=75–90 |doi=10.1016/j.ijintrel.2015.03.014 |issn=0147-1767|url-access=subscription }} led studies consisting of members of the U.S. Military that identified 12 Core Aspects (consisting of four subgroups) of successful cross-cultural interactions.{{Cite web |last=Rasmussen |first=Louise |date=2013-10-05 |title=Cross-Cultural Competence: Engage People from any Culture |url=https://www.globalcognition.org/cross-cultural-competence/ |access-date=2022-10-22 |website=Global Cognition |language=en-US |archive-date=22 October 2022 |archive-url=https://web.archive.org/web/20221022043437/https://www.globalcognition.org/cross-cultural-competence/ |url-status=live }} These aspects rely on the subjects of the study being able to remain diplomatic and learn from intercultural interactions.

The 12 Core Aspects Include:

A diplomatic stance
Maintaining a Mission Orientation
Understanding Self in Social Context
Managing Attitude Towards Culture
Cultural Learning
Self-Directed Learning of Cultures
Developing Reliable Information Sources
Learning New Cultures Efficiently
Cultural Reasoning
Coping with Cultural Surprises
Developing Cultural Explanations of Behavior
Cultural Perspective Taking
Intercultural Interaction
Intercultural Communication Planning
Disciplined Self Presentation
Reflection and Feedback

In the dominant culture

Cultural awareness and sensitivity help to overcome inherent ethnocentrism by learning about other cultures and how various modes and expectations may differ between those cultures. These differences range from ethical, religious, and social attitudes to body language and other nonverbal communication.{{cite web | title=How to Overcome Ethnocentrism | website=UKEssays.com | date=3 July 2018 | url=https://www.ukessays.com/essays/cultural-studies/overcoming-ethnocentrism-through-communication-cultural-studies-essay.php | access-date=7 September 2020 | archive-date=7 September 2020 | archive-url=https://web.archive.org/web/20200907020816/https://www.ukessays.com/essays/cultural-studies/overcoming-ethnocentrism-through-communication-cultural-studies-essay.php | url-status=live }} Cultural sensitivity is just one dimension of cultural competence, and has an impact on ethnocentrism and other factors related to culture.{{cite journal | last=Chen | first=Guo-ming | title=The Impact of Intercultural Sensitivity on Ethnocentrism and Intercultural Communication Apprehension | date=8 August 2017 | s2cid=3259100 }} The results of developing cultural sensitivity are considered positive: communication is improved, leading to more effective interaction between the people concerned, and improved outcome or interventions for the client or customer.{{cite journal | last=Foronda | first=Cynthia L. | title=A Concept Analysis of Cultural Sensitivity | journal=Journal of Transcultural Nursing | publisher=SAGE Publications | volume=19 | issue=3 | date=10 April 2008 | issn=1043-6596 | doi=10.1177/1043659608317093| pages=207–212| pmid=18411414 | citeseerx=10.1.1.821.6802 | s2cid=40826823 }}

The concept is taught in many workplaces, as it is an essential skill for managing and building teams in a multicultural society. Intercultural communication has been cited as one of the two biggest challenges within the workplace, along with internal communications (mission statement, meetings, etc.).{{cite web | title=Cultural Sensitivity in the Workplace | website=Penn State Extension | url=https://extension.psu.edu/cultural-sensitivity-in-the-workplace | first=Montserrat Fonseca | last=Estrada | date=6 May 2015 | access-date=7 September 2020 | archive-date=25 September 2020 | archive-url=https://web.archive.org/web/20200925073101/https://extension.psu.edu/cultural-sensitivity-in-the-workplace | url-status=live }}

=In healthcare=

{{further|Cultural competence in healthcare|Antisemitism in health care}}

Cultural sensitivity training in health care providers can improve the satisfaction and health outcomes of patients from different minority groups.{{Cite web| url=http://www.culturalcandor.com/blogs/the-importance-of-cultural-competence-in-healthcare/| title=The Importance of Cultural Competence in Healthcare| access-date=25 November 2015| publisher=Cultural Candor Inc.| date=25 November 2015| archive-date=26 March 2016| archive-url=https://web.archive.org/web/20160326062537/http://www.culturalcandor.com/blogs/the-importance-of-cultural-competence-in-healthcare/| url-status=live}} Because standard measures for diagnosis and prognosis relate to established norms, cultural sensitivity is essential. A person's norms are defined by their culture, and these may differ significantly from the treating medical professional. Language barriers, beliefs, and trust are just a few of the factors to consider when treating patients of other cultural groups.{{cite journal | last1=Seibert | first1=P S | last2=Stridh-Igo | first2=P | last3=Zimmerman | first3=C G | title=A checklist to facilitate cultural awareness and sensitivity | journal=Journal of Medical Ethics | volume=28 | issue=3 | date=1 June 2002 | issn=0306-6800 | pmid=12042396 | doi=10.1136/jme.28.3.143 | pages=143–146 | pmc=1733575 }} [https://jme.bmj.com/content/medethics/28/3/143.full.pdf PDF] {{Webarchive|url=https://web.archive.org/web/20200929012518/https://jme.bmj.com/content/medethics/28/3/143.full.pdf |date=29 September 2020 }} Understanding cultural beliefs regarding health and care can give healthcare professionals a better idea of how to proceed with providing care.{{Cite journal |last1=Kaihlanen |first1=Anu-Marja |last2=Hietapakka |first2=Laura |last3=Heponiemi |first3=Tarja |date=2019-08-22 |title=Increasing cultural awareness: qualitative study of nurses' perceptions about cultural competence training |journal=BMC Nursing |volume=18 |issue=1 |pages=38 |doi=10.1186/s12912-019-0363-x |issn=1472-6955 |pmc=6704569 |pmid=31440116 |doi-access=free }}

It is important to understand the concept behind the buzzword in the healthcare setting, as cultural sensitivity can increase nurses' appreciation of and communication with other professionals as well as patients. Part of providing culturally sensitive care is to develop cultural competence as an ongoing process. Nurses and employers should be committed to educating themselves about different patients' beliefs, values, and perspectives.{{Cite web |date=2020-03-12 |title=Guide to Cultural Sensitivity in Nursing |url=https://online.ahu.edu/blog/infographic/guide-to-cultural-sensitivity-in-nursing/ |access-date=2022-03-15 |website=AHU Online |language=en-US |archive-date=28 January 2022 |archive-url=https://web.archive.org/web/20220128205322/https://online.ahu.edu/blog/infographic/guide-to-cultural-sensitivity-in-nursing/ |url-status=live }}

= In therapy =

In a study on narrative theory in therapy, Cynthia C. Morris concluded that culture in made up of the collected stories of a group of people.{{Cite web |title=Narrative Theory: A Culturally Sensitive Counseling and Research Framework |url=https://www.counseling.org/resources/library/Selected%20Topics/Multiculturalism/Narrative_Theory.htm |access-date=2022-10-22 |website=www.counseling.org |archive-date=22 October 2022 |archive-url=https://web.archive.org/web/20221022051040/https://www.counseling.org/resources/library/Selected%20Topics/Multiculturalism/Narrative_Theory.htm |url-status=live }} In the practice of therapy, understanding a patient's point of view is vital to the clinician. Cultural Sensitivity allows for a clinician to get a more well-rounded understanding of where the client is coming from, why they may think about things in a certain way, or their approach to thought in general. Culturally Sensitive Therapy approaches psychotherapy by emphasizing how the clinician understands the client's race, ethnicity, sexual orientation, gender, religion and any other aspects that relate to culture and identity.{{Cite web |title=Culturally Sensitive Therapy {{!}} Psychology Today |url=https://www.psychologytoday.com/us/therapy-types/culturally-sensitive-therapy |access-date=2022-11-12 |website=www.psychologytoday.com |language=en-US |archive-date=10 February 2023 |archive-url=https://web.archive.org/web/20230210102756/https://www.psychologytoday.com/us/therapy-types/culturally-sensitive-therapy |url-status=live }} Culturally sensitive therapists will help their patients feel more seen and understood, while those without cultural sensitivity may turn away patients from the practice of therapy altogether.

Working and travelling abroad

On the individual level, cultural sensitivity allows travelers and expatriate workers to successfully navigate a different culture with which they are interacting.{{cite book | last1=Maheshkar | first1=C. | last2=Sharma | first2=V. | title=Handbook of Research on Cross-Cultural Business Education | publisher=IGI Global | series=Advances in Logistics, Operations, and Management Science (2327-350X) | year=2018 | isbn=978-1-5225-3777-9 | url=https://books.google.com/books?id=hipbDwAAQBAJ&pg=PA1 | access-date=7 September 2020 | page=7 | archive-date=10 February 2023 | archive-url=https://web.archive.org/web/20230210102740/https://books.google.com/books?id=hipbDwAAQBAJ&pg=PA1 | url-status=live }} It can increase the security of travelers because it helps them understand interactions from the perspective of the native culture.{{Cite book|title=Managing Cross-Cultural Communication: Principles and Practice|last=Maude|first=Barry|publisher=Macmillan Education| year=2016| isbn=9781137507464| location=London|pages=249}} One individual's understanding of another's culture can increase respect for the other individual, allowing for more effective communication and interactions. For managers as well as employees, cultural sensitivity is increasingly more vital in business or government jobs.{{cite web | title=What is Cultural Sensitivity and How Does it Develop? | website=Global Cognition | date=12 September 2019 | url=https://www.globalcognition.org/what-is-cultural-sensitivity/ | access-date=7 September 2020 | archive-date=24 September 2020 | archive-url=https://web.archive.org/web/20200924235940/https://www.globalcognition.org/what-is-cultural-sensitivity/ | url-status=live }}

This cross-cultural sensitivity can lead to both competitiveness and success when working with or within organizations located in a different country.{{cite book | last1=Adler | first1=L.L. | last2=Gielen | first2=U.P. | title=Cross-cultural Topics in Psychology | publisher=Praeger | year=2001 | isbn=978-0-275-96973-8 | url=https://books.google.com/books?id=TbPKIWow4soC | access-date=7 September 2020 | page=211 | archive-date=10 February 2023 | archive-url=https://web.archive.org/web/20230210102742/https://books.google.com/books?id=TbPKIWow4soC | url-status=live }} These benefits highlight the consideration of how two societies and cultures operate, particularly with respect to how they are similar and different from each other. Being able to determine these in terms of thoughts, behavior beliefs, and expressions among others makes it possible to solve problems meaningfully and act in a manner that is acceptable to all stakeholders.

Lacking awareness of foreign cultures can also have adverse consequences. These can be as severe as reaching the point of legal action.{{cite web | title=Rape victim sentenced to jail | website=Daily Telegraph | date=21 July 2013 | url=https://www.dailytelegraph.com.au/news/nsw/woman-raped-on-business-trip-in-dubai-jailed-for-having-extramarital-sex/news-story/e272d8fda2bd341d0d40ae23ad664999 | access-date=7 September 2020}} Similarly, certain etiquettes in one country can be considered violations of business codes in another.

= Tourism =

Tourism is a major opportunity to experience and interact with other cultures. It is therefore one of the most vital times to be culturally sensitive. There are major faux pas to be aware of regarding the locals. Ensuring awareness of table manners, common phrases, local dress, etiquette at holy sites, and other immersions into the culture are great ways to be sensitive to the destination and engage with it.{{Cite web |date=2020-09-15 |title=What It Means to Be a Culturally Sensitive Traveler {{!}} Go Overseas |url=https://www.gooverseas.com/blog/culturally-sensitive-traveler |access-date=2022-11-12 |website=www.gooverseas.com |language=en |archive-date=12 November 2022 |archive-url=https://web.archive.org/web/20221112165624/https://www.gooverseas.com/blog/culturally-sensitive-traveler |url-status=live }}

Tourism to areas with Indigenous people requires more awareness and cultural sensitivity. Many of these areas have been colonized and turned into tourist attractions that put on display the culture that is being erased. These kinds of attractions lead to stereotyping that negatively impacts the culture rather than exposing others to it. These displays can often turn the culture into an exotic aesthetic that leads to inauthentic portrayals of the culture and furthers stereotypes. This cultural insensitivity happens when cultural practices and products are sold by another cultural group without consent.{{Cite journal |last1=Viken |first1=Arvid |last2=Höckert |first2=Emily |last3=Grimwood |first3=Bryan S. R. |date=2021-07-01 |title=Cultural sensitivity: Engaging difference in tourism |journal=Annals of Tourism Research |language=en |volume=89 |pages=103223 |doi=10.1016/j.annals.2021.103223 |s2cid=236340344 |issn=0160-7383|doi-access=free |hdl=10037/24277 |hdl-access=free }} Due to this, culturally sensitive tourism is an up and coming industry that aims to engage with a culture rather than exoticized.

Models

=Bennett scale=

Milton Bennett was the first to create a model or framework designed to help comprehension of various stages of intercultural sensitivity. This became known as the Developmental Model of Intercultural Sensitivity (DMIS),{{citation | last=Bennett | first=Milton J. | title=The International Encyclopedia of Intercultural Communication | chapter=Developmental Model of Intercultural Sensitivity | publisher=Wiley | date=27 June 2017 | isbn=978-1-118-78394-8 | doi=10.1002/9781118783665.ieicc0182 | pages=1–10| s2cid=151315097 }} otherwise referred to as the Bennett scale. This scale has been adapting and developing since 1986{{cite web| title=The Developmental Model of Intercultural Sensitivity: Summary| first=Milton J.| last=Bennett| edition=Revised| date=2014| website=IDR Institute| url=https://www.idrinstitute.org/dmis/| access-date=7 September 2020| archive-date=7 September 2020| archive-url=https://web.archive.org/web/20200907064250/https://www.idrinstitute.org/dmis/| url-status=live}} and is included in The International Encyclopedia of Intercultural Communication (2017).{{cite book | last=Kim | first=Y.Y. | title=The International Encyclopedia of Intercultural Communication | publisher=Wiley-Blackwell | series=Icaz - Wiley Blackwell-Ica International Encyclopedias of Co | issue=v. 1 | year=2017 | isbn=978-1-118-78366-5 | url=https://books.google.com/books?id=iB0lyAEACAAJ | access-date=7 September 2020 | archive-date=10 February 2023 | archive-url=https://web.archive.org/web/20230210102744/https://books.google.com/books?id=iB0lyAEACAAJ | url-status=live }}

Bennett developed the framework of the model to show the intercultural sensitivity a person may experience. Intercultural sensitivity is defined as an individual's ability to develop emotion towards understanding and appreciating cultural differences that promotes appropriate and effective behavior in intercultural communication"{{Cite journal |date=2021-03-02 |title=Impact of Intercultural Sensitivity and Intercultural Communication Apprehension on Ethnocentrism: A Select Study of HEI of India |url=http://dx.doi.org/10.47750/cibg.2021.27.02.156 |journal=Journal of Contemporary Issues in Business and Government |volume=27 |issue=2 |doi=10.47750/cibg.2021.27.02.156 |s2cid=236750897 |issn=2204-1990|url-access=subscription }}

According to Bennett, “As one’s perceptual organization of cultural difference becomes more complex, one’s experience of culture becomes more sophisticated and the potential for exercising competence in intercultural relations increases." By recognizing how cultural difference is being experienced, predictions about the effectiveness of intercultural communication can be made.{{Cite web |date=2019-11-01 |title=Developmental Model of Intercultural Sensitivity |url=https://organizingengagement.org/models/developmental-model-of-intercultural-sensitivity/ |access-date=2022-03-21 |website=Organizing Engagement |language=en-US |archive-date=4 February 2022 |archive-url=https://web.archive.org/web/20220204104224/https://organizingengagement.org/models/developmental-model-of-intercultural-sensitivity/ |url-status=live }}

Bennett describes a continuum, which moves from ethnocentrism to "ethnorelativism". The model includes six stages of experiencing difference.

The six stages explained in the model include:{{Cite journal |last1=Kim |first1=Ryung S. |last2=Shankar |first2=Viswanathan |date=2020-04-06 |title=Prevalence estimation by joint use of big data and health survey: a demonstration study using electronic health records in New York city |journal=BMC Medical Research Methodology |volume=20 |issue=1 |page=77 |doi=10.1186/s12874-020-00956-6 |pmid=32252642 |pmc=7137316 |issn=1471-2288 |doi-access=free }}

Denial - when people fail to recognize distinctions among cultures or consider them to be irrelevant
Defense - people perceive other cultures in a competitive way, or in an us-against-them way
Minimization - people assume that their distinct cultural worldview is shared by others, or when they perceive their culture's values as fundamental or universal human values that apply to everyone.
Acceptance - recognize that different beliefs and values are shaped by culture,
Adaptation - when people are able to adopt the perspective of another culture,
Integration - someone's identity or sense of self evolves to incorporate the values, beliefs, perspectives, and behaviors of other cultures.

=Community Tool Box=

The Community Tool Box was developed by the University of Kansas' Center for Community Health and Development, a designated World Health Organization Collaborating Centre for Community Health and Development.{{cite web | title=Who We Are | website=Community Tool Box | url=https://ctb.ku.edu/en/who-we-are | access-date=7 September 2020 | archive-date=14 August 2020 | archive-url=https://web.archive.org/web/20200814032008/https://ctb.ku.edu/en/who-we-are | url-status=live }} The Centre's idea of "Building Culturally Competent Organizations," is a guide for diversity and inclusion training in the workplace. The Tool Box refers to three levels leading up to the fourth, the end goal:

cultural knowledge
cultural awareness
cultural sensitivity
cultural competence

Each step builds on the previous one, with the final one, cultural competence, being the stage where the organization has effectively enabled better outcomes in a multicultural workforce.{{cite web | title=Chapter 27. Working Together for Racial Justice and Inclusion - Section 7. Building Culturally Competent Organizations - Main Section | website=Community Tool Box | url=https://ctb.ku.edu/en/table-of-contents/culture/cultural-competence/culturally-competent-organizations/main | access-date=7 September 2020 | archive-date=6 September 2020 | archive-url=https://web.archive.org/web/20200906233219/https://ctb.ku.edu/en/table-of-contents/culture/cultural-competence/culturally-competent-organizations/main | url-status=live }} (Licensed under a Creative Commons Attribution-Noncommercial-Share Alike 3.0 United States License.){{cite web | last=Guyton | first=Glen | title=Understanding Cultural Competence vs Cultural Awareness for Diversity & Inclusion Training | website=Glen Guyton | date=11 September 2019 | url=https://www.glenguyton.com/2019/09/11/promoting-cultural-competence-in-the-workplace-understanding-the-difference-between-cultural-competence-and-awareness/ | access-date=7 September 2020 | archive-date=1 November 2020 | archive-url=https://web.archive.org/web/20201101010202/https://www.glenguyton.com/2019/09/11/promoting-cultural-competence-in-the-workplace-understanding-the-difference-between-cultural-competence-and-awareness/ | url-status=live }}

Competence training

Training to achieve cultural competence or cultural sensitivity is undertaken in schools,{{Cite news|url=http://www.nea.org/tools/30402.htm|title=Diversity Toolkit: Cultural Competence for Educators|work=NEA|access-date=2017-05-01|language=en|archive-date=13 August 2020|archive-url=https://web.archive.org/web/20200813103330/http://www.nea.org/tools/30402.htm|url-status=live}} workplaces, in healthcare settings