Developing cultural competence across communities: a coronary heart disease training programme for health advocates and trainers

The health disadvantages faced by ethnic minority communities have prompted a range of local and national initiatives aimed at improving health outcomes. Community-based health promotion and advocacy is one such initiative, which has been further developed in the UK by employing health trainers in voluntary and community organisations as part of a nationally sponsored government programme. These trainers complement the work of health advocates, interpreters and community health workers, bridging the gap between statutory provision and local communities by encouraging healthy lifestyles across different ethnic groups.

Between 2006 and 2008, the British Heart Foundation (BHF) delivered a series of training courses to improve the knowledge of these workers, while at the same time ensuring that this knowledge had meaning within the context of a multi-cultural society. Evaluation of these courses, using a mixed methods approach, from the perspectives of different stakeholders demonstrated the value of planning proactive engagement with local voluntary and community organisations, ensuring diverse representation among participants, the importance of locating learning in concrete, everyday settings that are relevant to the way in which delegates worked, and relating training to local circumstances.

The long-term impact of such initiatives is difficult to gauge, but successful interventions can be viewed as building blocks towards facilitating community engagement and building capacity. They are also a potential stepping stone in developing a culturally competent workforce. A proactive third-sector organisation that is willing to develop these ideas is equally important for ensuring that the value of such initiatives assumes relevance long after funding has formally ended.