The study and evaluation of culture-centered practice effectiveness can pose unique challenges. Often, researchers will discover that they cannot conduct randomized controlled trials (RCTs) or rigorous quasi-experimental designs (QEDs) for these types of services for pragmatic, cultural, and ethical reasons. In addition, the type of evidence required by registries of evidence-based practices may not be compatible with culture-centered practice.
A few specific challenges in building evidence for culture-based practices include small sample sizes, a difficulty in identifying appropriate comparison groups, the ethics of randomly assigning individuals for care in communities with high need and limited resources, and methodology that is incompatible with cultural values, beliefs, mores, and the traditions of local communities.
It is important to remember that while RCTs and QEDs play important roles in establishing evidence, they represent only a sliver of the available information about practice effectiveness. Other approaches to evidence building are needed to fully explore the breadth of practices available to the widest range of populations.
Practitioners, community leaders, and researchers have been able to demonstrate the effectiveness of culture-centered practices by using different research methods and metrics.
A practice-based evidence approach uses research methods that quantify existing community practice outcomes and demonstrates the effectiveness of culture-centered practices using culturally syntonic research methods and metrics. In addition, a practice-based evidence approach can more clearly document the characteristics and treatment significance of cultural practices designed for underserved populations.
The case studies featured in this section provide examples of the broader range of research methods and types of evidence that can be used to improve practices for underserved communities.
Read about Emerging Evidence Case Studies.