Medical Student Research Forum Posters

Introduction: Experts recognize that organizational self-assessments are crucial for the planning, implementation, and evaluation of programmatic activities for improving culturally and linguistically appropriate services (CLAS); however, to-date, the attitudes of organization leaders towards such comprehensive audits, as well as their experiences with developing plans to better meet National CLAS Standards, are not well understood.

Objective: The study aimed to understand the value of the CLAS organizational assessment in planning and implementing CLAS and to also evaluate the mental health agency leaders’ attitudes towards the assessment. The study explored the actions that organizations are taking to operationalize the CLAS standards. Additionally, the impact of COVID-19 on organizational efforts to deliver CLAS was also investigated.

Methods: A total of 12 participants in leadership positions, one from Solano County Behavioral Health in California and 11 of their contracted mental health agencies and community-based organizations (CBOs), who completed the CLAS organizational assessment during Summer and Fall of 2018, were invited to the study. In-depth interviews were conducted over the phone following an interview guide that was reviewed by the assessment tool creator. Interview transcripts were analyzed, identifying major concepts and themes until reaching saturation (i.e., when no new themes emerged).

Results: A total of 7 in-depth interviews were conducted. Participants overall reported that the CLAS organizational assessment was a helpful tool for identifying which CLAS standards should be prioritized within their organization. Leaders shared the belief that the assessment served as an opportunity to review and learn more about the CLAS Standards in general. A common critique among leaders was that the assessment itself at times did not feel applicable to their agency as the assessment seemed to be tailored more towards large organizations centered in Solano County. Mental health agency and CBO leaders described that the COVID-19 pandemic limited their ability to provide in-person services and many noticed a significant decline with virtual services. CLAS initiatives were placed on hold by several agencies during the pandemic but many describe focusing on increasing cultural diversity in the workplace and incorporating language assistance programs, such as a language line, before the start of the pandemic. Recommendations on how the assessment could be improved were also collected from the interview which ranged from including sex and gender identity in the assessment to also including leaders in the development of the CLAS assessment tool.

Conclusion: Most mental health agency leaders valued several aspects of the CLAS organizational assessment especially its comprehensiveness. However, most participants also felt that the assessment had areas of weakness that should be addressed. The COVID-19 pandemic has prevented many of these leaders from planning and developing CLAS initiatives within their organization and limited the services they can provide to their consumers.