McLean Leow Tackles Cross-Cultural Challenges

Deborah McLean Leow is a woman with a mission. Her newest challenge is to help substance-abuse prevention workers in 11 states work more effectively with racial and ethnic minorities and new immigrants.

McLean Leow is associate director of the Center for Substance Abuse Prevention's Northeast Center for the Application of Prevention Technologies, or Northeast CAPT. In October, she was one of 10 fellows named in the Developing Leadership in Reducing Substance Abuse Program, sponsored by The Robert Wood Johnson Foundation.

The fellowship is designed to support emerging leaders in the field of substance abuse prevention and treatment. Each fellow receives $75,000 over a three-year period to develop and implement a community project in a specific area of substance abuse. Fellows select mentors and participate in educational programs and networking opportunities.

In her project, McLean Leow will design and disseminate training and professional development curriculum and systems to help draw attention to minorities and new immigrant populations who have historically had limited access to preventive and early intervention services.

Her work will intersect some of the cross-cultural challenges that Northeast CAPT has already started to identify through its annual needs assessment. McLean Leow's findings and models could be replicated nationally so that eventually all substance abuse professionals might have the training and professional development they need to relate to families from different ethnic and racial backgrounds.

Q: How did the idea for this cross-cultural project originate?

A: This project combines my personal experiences with my professional interests.

I relocated from Guyana South America to New York with my family in 1986, moved to Brooklyn and attended high school. For me, a memorable part of my transition was the extent to which accessing essential services was very challenging for my family.

Here at the NECAPT, we undertook a comprehensive review of our existing materials to determine how well these materials and products speak to cultural issues. From the review, we were able to identify ways in which those materials could be enhanced. One of the byproducts of that process was the development of a series of case examples that could be used in our training workshop to address cross-cultural challenges.

Q: Why does substance abuse in cross-cultural settings deserve special attention?

A: The US is becoming much more racially diverse. As a result, public health systems will definitely need to find a way to respond to communities and individuals who have different beliefs, different experiences and different attitudes about health. The failure to understand these cultural differences can result in negative health outcomes for populations, especially those that have been historically unable to get easy access to basic healthcare –- including substance abuse prevention and treatment services.

There is an emerging focus on the field of cultural competence – the extent to which people can relate and communicate with each other across cultural differences -- and these concerns are not limited to public health. They pertain to the educational system, to business and to the workforce. The growing diversity in our country is a trend that all systems need to address.

Q: What are some examples of specific challenges for immigrant populations?

A: Culture and immigrant status has a lot to do with whether people seek help in first place and what kind of help they seek and the stigma that they attach to helping services. A key challenge is in serving families who have different beliefs about health and illness and who may have beliefs about substance abuse and addiction such as --these are private issues that we deal with in our families. And for those who are willing to seek help, consider the difficulty that a new comer unfamiliar with the system will have in accessing information about prevention or early intervention services.

If you are delivering a preventive intervention across cultural groups, how do you begin to do that with youth and families who speak different languages? How do you as a professional deal with such diversity and cultural differences in your community or in your school? These are some of the questions that my project will examine.

Another challenge that emerging populations and communities may face is that funding is increasingly tied to the use of proven practices based on research. If there’s no program that is designed for instance, for the Somali population that has moved into Lewiston, Maine, how do you adapt a best practice to work with that population? Inability to locate or adapt appropriate practices can limit access to funding for these communities. Through this project, I hope to increase understanding in the field about what some of these challenges are, and how they can be addressed by tapping into the strengths that exist within racial and ethnic minority and new immigrant communities.

Q: What is the three-year plan for your community project?

A: In the first year, my goal is to better understand the needs and resources that exist to prevent substance abuse and addiction among emerging ethnic and racial populations. In October, we conducted surveys and interviews with state agency representatives, and site visits to each of the states. Another step will be to conduct interviews with experts who are doing work in cross-cultural competence and capacity building in the substance abuse field. By the end of first year, I’ll draft a report of what I’ve found about cross-cultural challenges in prevention.

The second year will involve either developing or adapting a capacity-building model for professional and organizational development and community involvement in prevention efforts that target emerging ethnic and racial populations. I don’t necessarily want to reinvent the wheel, but rather to enhance what’s already there. The goal is to determine what models currently exist, and how effective they are, and how appropriate they will be in the context of the targeted communities.

The goal of year three is to implement this model in selected communities to get culturally appropriate prevention tools into the hands of parents, teachers and professionals who touch the lives of children. Another aspect of implementation may involve mobilizing these communities to reduce the threats that alcohol and other drugs can pose to all families and children living in these communities.

A: I see this project outlasting the three-year fellowship. The Robert Wood Johnson Foundation fellowship provides me with seed money and a network of fellows and experts in the field to enable me to do this work now and in the future.

My hope for this project’s long-term impact is that, through access to this model, professionals in the field will become more culturally competent and will have a greater ability to communicate with and serve individuals from diverse backgrounds. And hopefully the application of this model will also lead to greater diversity among the leadership and service providers in the field.

November, 2003