The Cultural Awareness, Respect, and Engagement (C.A.R.E.) Toolkit Helps Home Visitors work with Refugee Families


Talking to families about the details of their lives is always an exercise in both empathy and tact. Now imagine that the family whose home you entered moments before not only speaks a different language but hails from a distant part of the world — a place they may have escaped under traumatic circumstances — and follows cultural practices you’ve never heard of, much less encountered first-hand.

That was the challenge facing home visitors working with refugee families in Kansas. Social workers are trained to deal with a variety of circumstances and experiences, but it’s hard for them to employ those skills when even the most basic interaction is fraught with potential misunderstandings. From etiquette to eye contact to working with interpreters, home visitors found themselves in uncharted territory — trying to teach people from other cultures to navigate new lives in Kansas without access to any of the familiar landmarks.

The Cultural Awareness, Respect, and Engagement (C.A.R.E.) Toolkit, introduced in the fall of 2015, was designed as a resource for home visitors in these situations. Created through a partnership between the Kansas Department of Health and Environment’s MIECHV (Maternal, Infant and Early Childhood Home Visiting) and Project LAUNCH programs, and KU’s Center for Public Partnerships and Research (CPPR), the C.A.R.E. toolkit offers introductory webinars on issues that come into play when communicating across cultures, as well as background information on the specific groups home visitors are likely to encounter in Kansas.

“Home visitors were running into a lot of new experiences,” said Adam Brazil, a CPPR researcher who oversaw the development of the toolkit. “Their jobs are very difficult, and any time you can weave in development or support … that’s going to help them, whether directly or indirectly.”

Topics covered by the C.A.R.E. toolkit range from explaining the concept of ‘culture’ to illuminating the diversity among cultures in areas such as world view (for example, how time is measured and understood, and whether more emphasis is placed on individual or collective needs) and behavioral factors (e.g. hand gestures and facial expressions, which can have radically different meanings from one culture to the next).

According to Brazil, the toolkit is about “equipping home visitors with some strategies to think critically about what they’re seeing and to reflect on themselves.”

Learning to recognize their own cultural paradigms helps home visitors understand that not all values are universal. People from other countries may have entirely different expectations regarding education, health care, politics, money, religion and family. Even among refugees from Burma — one of the primary refugee populations in Kansas — there are multiple ethnic subgroups, each with distinct traditions and beliefs. Working with an interpreter can bridge the language gap, but also presents its own set of challenges for a home visitor unaccustomed to working through an intermediary.

Both the toolkit and related training sessions have begun to address these and similar issues likely to confront those assisting refugee families with the assimilation process. Working in cooperation with Catholic Charities of Northeast Kansas and the Bethel Neighborhood Center in Kansas City, Kansas, the C.A.R.E. initiative offers support and advice for those who spend their days helping others.

To learn more about the C.A.R.E. toolkit, or test your own cultural competence, visit