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Center for Substance Abuse Treatment (US). Improving Cultural Competence. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2014. (Treatment Improvement Protocol (TIP) Series, No. 59.)

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Improving Cultural Competence.

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Appendix BInstruments To Measure Identity and Acculturation

Some researchers have tested the usefulness of acculturation and identity models with people who abuse substances. For example, Peña and colleagues' racial identity attitude scale was found, in a study of African American men in treatment for cocaine dependence, to help counselors better understand the roles that ethnic and cultural identity play in clients' substance abuse issues (Peña et al. 2000). In 1980, Cuellar and colleagues published their acculturation rating scale for Mexican Americans, which conceptualized acculturation as progressing across a 5-point continuum ranging from Mexican or low acculturated (level 1) to American or high acculturated (level 5). The mid-level designation of bicultural (level 3) was set as the midpoint between the two extremes, although various investigators have questioned this assumption (Oetting and Beauvais 1990; Sayegh and Lasry 1993). Since then, scholars have developed new ways to conceptualize identity and acculturation, ranging from simple scales to complex multidimensional models (Skinner 2001). The table that begins on the next page summarizes the instruments available to measure acculturation and ethnic identity. (See also the Center of Excellence for Cultural Competence for additional resources at http://nyculturalcompetence.org).

Other scales have been developed to examine specific culture-related variables, including machismo (Cuellar et al. 1995; Fragoso and Kashubeck 2000), simpatía (Griffith et al. 1998), familismo (Sabogal et al. 1987), traditionalism–modernism (Ramirez 1999), and family traditionalism and rural preferences (Castro and Gutierres 1997). Counselors can use acculturation scales to help match patients to providers, to make treatment plans, and to identify the role of identity in substance abuse. Although these instruments can be helpful, the counselor must not rely solely on them to determine the client's identity or level of acculturation.

Acculturation and Ethnic Identity Measures

InstrumentDescriptionCultural Group
African American Acculturation Scale-Revised (Klonoff and Landrine 2000)This scale measures eight dimensions of African American culture: (1) traditional beliefs and practices, (2) traditional family structure and practices, (3) traditional socialization, (4) preparation and consumption of traditional foods, (5) preference for African American things, (6) interracial attitudes, (7) superstitions, and (8) traditional health beliefs and practices.African Americans
Black Racial Identity Attitude Scale—Form B (Helms 1990)This scale measures beliefs or attitudes of Blacks toward both Blacks and Whites using 5-point scales. It is available in short and long forms.African Americans
Cross Racial Identity Scale (Worrell et al. 2001)This scale measures six identity clusters associated with four stages of racial identity development.African Americans
Multidimensional Inventory of Black Identity (MIBI; Sellers et al. 1997)The MIBI measures centrality of Black identity, ideology, and regard for a Black identity. It is available online at http://sitemaker​.umich​.edu/aaril/files/mibiscaleand scoring.pdf.African Americans
Scale To Assess African American Acculturation (Snowden and Hines 1999)This is a 10-item scale that assesses media preferences, racial bias in relationships, race-related attitudes, and comfort in interacting with other races.African Americans
African Self-Consciousness Scale (Baldwin and Bell 1985)This scale measures within-group variability in the level of acculturation/cultural identity continuum (Baldwin and Bell 1985) based on degree of Afrocentricity or Nigrescence (White and Parham 1996). It indicates a client's level of involvement in traditional African American culture or the core African-oriented culture.African Americans/African Immigrants
Native American Acculturation Scale (Garrett and Pichette 2000)The Native American Acculturation scale asks 20 questions to ascertain a client's level of involvement with Native American culture.Native Americans
Rosebud Personal Opinion Survey (Hoffmann et al. 1985)This assessment evaluates components of acculturation, including language use, values, social behaviors, social networks, religious affiliation and practice, home community, education, ancestry, and cultural identification.Native Americans
Asian American Multidimensional Acculturation Scale (AAMAS; Gim Chung et al. 2004)The AAMAS was developed to be easy to use with a variety of Asian American ethnic groups. It includes questions relating to cultural identity, language use, cultural knowledge, and food preferences.Asian Americans
Cultural Adjustment Difficulties Checklist (CADC; Sodowsky and Lai 1997)The CADC helps avoid potential problems relating to acculturation by asking about language use, social customs, family interactions, perceptions of prejudice, friendship networks, and cultural adjustment.Asian Americans (East Asians)
East Asian Acculturation Measure (Barry 2001)This instrument includes 29 items that assess assimilation, level of separation from other Asians, integration, and marginalization.Asian Americans (East Asians)
General Ethnicity Questionnaire (GEQ; Tsai et al. 2000)The GEQ is an instrument designed to be used with minor modifications for assessing cultural orientation with different cultural groups. There are original and abridged versions. The original includes 75 items asking about language use, social affiliations, cultural practices, and cultural identification.Asian Americans (although designed to be multicultural in orientation)
Suinn-Lew Asian Self-Identity Acculturation Scale (Suinn et al. 1992)This instrument was modeled after the Acculturation Rating Scale for Mexican Americans, and research indicates it has high reliability.Asian Americans
Ethnocultural Identity Behavioral Index (Yamada et al. 1998)This is a 19-item self-report assessment with high validity.Asian Americans and Pacific Islanders
Internal-External Ethnic Identity Measure (Kwan 1997)The instrument evaluates ethnic friendships and affiliation, ethnocommunal expression, ethnic food orientation, and family collectivism, in order to differentiate three Chinese American identity groups: (1) internal, (2) external, and (3) internal-external undifferentiated.Chinese Americans
Marín and Marín Acculturation Scale (Marín et al. 1987)This scale is a 12-item instrument that assesses three domains: (1) language use, (2) media preferences, and (3) ethnic diversity of social relations. It is available online at http://www​.columbia.edu​/cu/ssw/projects/pmap​/docs/gupta_acculturation.pdfChinese Americans
Behavioral Acculturation Scale and Value Acculturation Scale (Szapocznik et al. 1978)These two scales, used in conjunction with one another, ask individuals about behaviors and values in order to determine acculturation. If used singly, the behavioral scale is the superior measure for acculturation.Cuban Americans
Na Mea Hawai'i (Hawaiian Ways), A Hawaiian Acculturation Scale (Rezentes 1993)This is a 34-item scale. An adolescent version is available (Hishinuma et al. 2000).Native Hawaiians
Abbreviated Multidimensional Acculturation Scale (AMAS-ZABB; Zea et al. 2003)The AMAS-ZABB is a multidimensional, bilinear, 42-item scale that evaluates identity, language competence, and cultural competence.Latinos
Acculturation Scale (Marin et al. 1987)This 12-item acculturation scale, available in English and Spanish, evaluates language use, media preferences, and social activities. It is available online at http://casaa​.unm.edu​/inst/MARIN%20Short%20Scale.pdfLatinos
Bicultural Involvement Questionnaire (BIQ; Szapocznik et al. 1980)The BIQ assesses language use and involvement in both Latino and mainstream American activities. It relates two sets of scores to derive a measure of bicultural involvement, with individuals who are highly involved in both cultures scoring highest on the scale.Latinos
The Bidimensional Acculturation Scale for Hispanics (Marin and Gamba 1996)This 24-item scale asks questions about language use, language proficiency, and media preferences.Latinos
Brief Acculturation Scale for Hispanics (Norris et al. 1996)This scale has only four items, but scores on the scale have been correlated highly with generation, nativity, length of time in the United States, language preferences, and subjective perceptions of acculturation.Latinos
Multidimensional Measure of Cultural Identity for Latinos (Felix-Ortiz et al. 1994)This measure places adolescents in one of four categories based on language, behavior/familiarity, and values/attitudes: (1) bicultural, (2) Latino-identified, (3) American-identified, and (4) low-level bicultural.Latinos
Acculturation Rating Scale for Mexican Americans-I (ARSMA-I; Cuellar et al. 1980)The ARSMA-I differentiates between 5 levels of acculturation: (1) Very Mexican, (2) Mexican-Oriented Bicultural, (3) True Bicultural, (4) Anglo-Oriented Bicultural, and (5) Very Anglicized. Established validity.Mexican Americans
Acculturation Rating Scale for Mexican Americans-II (Cuellar et al. 1995)This scale is like the ARSMA-I, except that it includes separate subscales to measure multidimensional aspects of cultural orientation toward Mexican and Anglo cultures independently.Mexican Americans
Cultural Life Style Inventory (Mendoza 1989)This self-report instrument, available in Spanish and English, evaluates five dimensions of acculturation: intrafamily language use, extrafamily language use, social activities and affiliations, cultural knowledge and activities, and cultural identification and pride.Mexican Americans
Cultural Life Style Inventory (Mendoza 1989)This self-report instrument, available in Spanish and English, evaluates acculturation on five dimensions: intrafamily language use, extrafamily language use, social activities and affiliations, cultural knowledge and activities, and cultural identification and pride.Mexican Americans
Mexican American Acculturation Scale (Montgomery 1992)This 28-item scale evaluates cultural orientation and comfort with ethnic identity. Items ask about language use, media preferences, cultural activities/traditions, and self-perceived ethnic identity.Mexican Americans
Padilla's Acculturation Scale (Padilla 1980)Padilla's Acculturation Scale is a 155-item questionnaire that assesses cultural knowledge and ethnic loyalties.Mexican Americans
Bidimensional Acculturation Scale for Hispanics (Marín and Gamba 1996)This scale measures evaluates two major dimensions of acculturation (Hispanic and non-Hispanic) using 12 items measuring 3 language-related areas. It has been found to have high consistency and validity.Mexican Americans and Central Americans
Stephenson Multigroup Acculturation Scale (Stephenson 2000)This is a 32-item instrument that evaluates immersion in both culture of origin and the dominant culture of the society.Multicultural
Vancouver Index of Acculturation (Ryder et al. 2000)This instrument includes 20 questions that assess interest/participation in one's “heritage culture” and “typical American culture” (available online at http://www2​.psych.ubc​.ca/˜dpaulhus​/Paulhus_measures/VIA.American.doc).Multicultural
Bicultural Acculturation Scale (Cortés and Rogler 1994)Developed for use with first- and second-generation Puerto Rican adults, this scale measures involvement in American culture and Puerto Rican culture, but it has limited evidence of validity and reliability.Puerto Rican Americans
Psychological Acculturation Scale (Tropp et al. 1999)The items on this scale pertain to the client's sense of psychological attachment to and belonging within Anglo American and Hispanic/Latino cultures.Puerto Ricans on the U.S. mainland
Acculturation Scale for Southeast Asians (Anderson et al. 1993)This 13-item scale evaluates languages proficiency and preferences regarding social interactions, cultural activities, and food. It includes two subscales for proficiency in languages, as well as language, social, and food preferences.Cambodian, Laotian, and Vietnamese Americans
White Racial Identity Attitude Scale (Helms and Carter 1990)This 50-item instrument rates items on a 5-point scale to measure attitudes associated with Helms's stages of racial identity development for Caucasians.White Americans

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