Part 7: Cultural Change

CTCs will be expected to be leaders and drivers of change, both within the CTC and with service partners, toward a service culture that is,

• strengths-based and solution-focused
• child- and family-centred
• trauma-informed

and that promotes,

• equity,
• anti-oppression,
• anti-ableism and
• anti-racism^{footnote 11[11]}

Environmental, social and attitudinal barriers can result in challenges accessing supports for many people, particularly for those from marginalized groups, including people with disabilities; racialized people; women; LGBTQ+ people; people from non-Western/non-Christian religions/cultures; low-income people.

For many families, traditional models of service delivery, including some professional behaviours, can be experienced as patronizing and invalidating of their lived experience, expertise, and priorities, and can feel unwelcoming or unsafe.

These experiences are even more common for families who are racialized or from equity-deserving (marginalized) groups, and can be compounded by inherent bias, sexism, racism, xenophobia, Islamophobia, anti-Semitism, or anti-Blackness, and other modes of systemic oppression.^{footnote 12[12]}

When families have negative experiences interacting with the service system or with service providers, these may result in a lack of trust and engagement in the service system, and may negatively impact families’ ability to access and participate in services, which can impact the effectiveness of those services.

Examples from families of bias/discrimination/patronizing interactions with care providers from the health and social sectors include:

• Using technical ‘jargon’ without explaining in plain language
• Feeling “rushed” through appointments or visits with clinicians
• Feeling that families with more privilege get access to more services more quickly than others
• Culturally insensitive questions that exhibit bias
• Feeling judged or blamed and worrying about being reported to child welfare services or more likely to have certain diagnoses suspected (e.g. Fetal Alcohol Spectrum Disorder)

CTCs will ensure that SmartStart Hubs services are culturally safe for families of all races and cultures, and to ensure that all people feel safe when receiving services and supports. Cultural safety is an outcome based on respectful engagement that recognizes and strives to address power imbalances inherent in systems.^{footnote 13[13]} There is an inherent power imbalance between a service provider, clinician and/or professional working with a child and their family, and this power imbalance can be compounded by the intersection of additional factors such as race, religion, disability, sexual orientation, gender, etc.

It is important for service providers to adopt a curious and humble perspective when working with families. Just as family-centred service asserts that families are the authority on their children, cultural humility acknowledges oneself as a learner when it comes to understanding another’s experience. Cultural humility is a process of self-reflection to understand personal and systemic biases and to develop and maintain respectful processes and relationships based on mutual trust.^{footnote 14[14]}

SmartStart Hubs will provide services that are trauma-informed, meaning that service providers will be continuously aware of the impact of trauma and endeavour to make people feel safe in their interactions with the Hub.

SmartStart Hubs will work to address concerns related to discrimination and bias, and will evolve over time to earn the trust of those they serve.

Requirements for CTCs^{footnote 15[15]}

Lasting cultural change will require a multi-pronged approach that is supported through formal and informal levers, including policies, processes, tools, training, performance measures/metrics, change agents, and communities of practice.

CTCs are required to put in place the following elements, to support the cultural safety of SmartStart Hubs services:

1. Training

CTCs will provide training for SmartStart Hubs staff on:

• Anti-racism and/or bias awareness training
  • All SmartStart Hubs workers will engage in anti-racism and/or bias awareness training that includes examination of race-based discrimination/biases.
  • Training can be general, as well as specific to the workplace setting to ensure that racialized families and families from diverse backgrounds, cultures and lived experience have interactions with the service system that are free from racism, prejudice and discrimination.
    • Training can highlight topics such as recognizing racial micro aggressions (either intended or unintended), that may have a negative impact on racialized children, youth and families.
• Indigenous cultural competency
  • CTCs will partner with local Indigenous communities and partners tooffer training/learning experiences about cultural safety for the specific communities they serve.
  • While general learning about Indigenous cultures and experiences (including experiences that are common to many Indigenous communities, such as residential schools) can be valuable, CTCs should also ensure that Hubs workers are provided with training or other learning opportunities to deepen their knowledge of the specific First Nations, Métis and Inuit communities they serve.
• Strengths-based and family-centred service
  • All SmartStart Hubs workers will be trained on the F-words for Child Development.^{footnote 16[16]}
  • Training on family-centred service delivery is also encouraged.
• Solution-focused coaching
  • All SmartStart Hubs workers will be trained on solution-focused coaching.
• Trauma-informed service delivery
  • All SmartStart Hubs workers will be trained on trauma-informed service delivery approaches.

2. Work with Indigenous Partners

CTCs will work with Indigenous partners to deliver culturally-safe and responsive services to First Nations, Métis and Inuit children and youth (for the requirements for building respectful and meaningful relationships with Indigenous partners, see page 45).

3. Engagement with a diverse range of families

It is important for CTCs to engage with families to understand their service experiences and obtain advice and input on service delivery approaches related to the SmartStart Hub.

CTCs will ensure child and family engagement mechanism(s) are in place at the organizational level to enable children and families to provide ongoing guidance and advice in service planning and delivery. CTCs may leverage existing mechanisms to embed the voices of children and families with lived experience into all aspects of the Hub functions.

It is important that efforts are made to ensure that family engagement mechanisms reflect the diversity of the community. For many racialized and other equity deserving groups, formal tables and committees have, historically, not always been welcoming, safe or inclusive for everyone. CTCs will work to seek input from the diverse communities they serve, using creative and flexible approaches that reduce barriers for people, such as opportunities to provide anonymous feedback, scheduling meetings on evenings/weekends, hosting virtual meetings, or focus groups without clinical staff involvement (for example, led by members of these communities) to increase safety. Families should be compensated for their time wherever possible. Consideration could also be given to paid positions, such as family engagement workers, if possible (see Family-Based Supports on page 36 for more information about family engagement workers).

4. Incorporate diversity, equity and anti-racism into organizational policies

CTCs will formally incorporate the principles of diversity, equity, anti-oppression and anti-racism into their organizational policies, including adopting diverse hiring practices and embedding approaches to equity and anti-racism in their service delivery, encouraging engagement and working with cultural service organizations.