Inventory For Assessing The Process Of Cultural Competence
Among Healthcare Professionals- Student Version (IAPCC-SV)
*ABOUT THE IAPCC-SV©
The IAPCC-SV is designed to measure the level of cultural competence among undergraduate students in the health professions.
The IAPCC-SV is a pencil/paper self-assessment tool that measures the level of cultural competence among undergraduate students. It consists of 20 items that measure the five cultural constructs of desire, awareness, knowledge, skill and encounters. The IAPCC-SV uses a 4-point likert scale reflecting the response categories of strongly agree, agree, disagree, strongly disagree. Completion time is approximately 10 -15 minutes. Scores range from 20-80 and indicate whether a student is operating at a level of cultural proficiency, cultural competence, cultural awareness or cultural incompetence. Higher scores depict a higher level of cultural competence. The IAPCC-SV has been translated into Thai and Korean.
Development Of The Instrument:
The IAPCC-SV© was developed in 2007 by Dr. Campinha-Bacote. It is based on the Inventory for Assessing the Process of Cultural Competence Among Healthcare Professionals-Revised (IAPCC-R©) (link). Researchers using the IAPCC-R© noted that the reliability of this tool was slightly lower when used with students. Vito, Roszkowski, & Wieland (2005) noted in a study of 695 undergraduate student nurses that the IAPCC-R© could be further revised resulting in a higher reliability of this tool. The IAPCC-SV© is a result of modifying the response format of the IAPCC-R© to reflect only responses of strongly agree, agree, disagree, strongly disagree and modifying and deleting selected questions on the IAPCC-R©.
Obtaining A Copy Of The IAPCC-SV For Review Purposes Only:
The IAPCC-SV© is available for review and personal use only by purchasing the book, “The Process of Cultural Competence in the Delivery of Healthcare Services: The Journey Continues, 5th Edition (2007), authored by Campinha-Bacote (order form link). There are additional requirements and a fee associated with use of the IAPCC-SV beyond personal self-assessment (see Permission To Use IAPCC-SV and Cost of Using IAPCC-SV).
Permission To Use IAPCC-SV In A Study/Project:
The IAPCC-SV© is copyrighted and formal permission and a fee is required before the tool can be used. To obtain permission to use the IAPCC-SV©, please mail (no fax/email) your request to Dr. Josepha Campinha-Bacote at 11108 Huntwicke Place, Cincinnati; Ohio 45241. In your request, please include the title of your project, purpose, target population, specific time frame of use (specific dates), method of administration (personally hand-administered or non-hand-administered), study design (i.e. one-time testing or pre/post test design) and a money order (US Dollars only) or check (US Dollars and drawn from a US Bank) for fees associated with your method of administration (see Cost of Using IAPCC-SV). Dr. Campinha-Bacote will return a letter granting permission to use the tool, articulate specific terms regarding use of the tool and include the number of tools if being used in a hand-administered pencil/paper format or internal/external mailings. Only one copy of the tool will be provided if the request is for online/electronic administration or to be translated. You can utilize this copy for conversion into an electronic format or to translate, if granted permission, into another language for the designated time granted.
Permission To Submit IAPCC-SV For A Proposal (I.E., Institutional Review Board (IRB), Research Committee, Academic Proposal):
The IAPCC-SV is copyrighted and formal permission and a fee is required before the tool can be submitted in a proposal. To obtain permission to use the IAPCC- SV, please mail (no fax/email) your request to Dr. Josepha Campinha-Bacote at 11108 Huntwicke Place, Cincinnati; Ohio 45241. In your request, please include the title of your project, specific time frame you plan to submit the tool in the proposal, method of administration (personally hand-delivered to the committee or non-hand-delivered, which includes all other formats; such as electronic submission, internal/external mailings, etc.), and a money order (US Dollars only) or check (US Dollars and drawn from a US Bank) for fees associated with your method of your submission (see Cost of Using IAPCC-SV). Dr. Campinha-Bacote will return a letter granting permission to use the tool, articulate specific terms regarding use of the tool and include the number of tools requested. Only one copy of the tool will be provided if the request is for online/electronic administration.
Permission To Translate IAPCC-SV:
A formal letter of request is required to translate the IAPCC-SV into another language, with the understanding that: 1) there will only be one copy of the IAPCC-SV that will be sent for translation when permission is granted and the researcher must pay, in advance, for the number of translated copies that will be used in the study; 2) there must be psychometric rigor in translating each of the items on the IAPCC-SV to its original meaning; 3) the translated copy must be sent to Dr. Campinha-Bacote; 4) the name of the tool and Dr. Campinha-Bacote’s name as the author of the tool is to be put on all translated versions exactly as it appears on the English version; 5) Dr. Campinha-Bacote will retain the copyright ownership of all translated versions of the IAPCC- SV; and 6) the translated version of the IAPCC-SV is for a one-time use and any further/future use of the translated version in any studies, publications, presentations or any other use, cannot be done without first seeking and obtaining written permission from Dr. Campinha-Bacote.
Cost Of Using IAPCC-SV:
There is a fee of $8.00 per tool when personally hand-administered in a pencil/paper format for research studies, grants, projects or in any onsite pencil/paper distribution to a group of subjects/participants. In this personally hand-administered format the IAPCC-SV is to be personally (face-to-face) hand-distributed to each subject/participant and then personally collected immediately following the subjects’/participants’ completion of the IAPCC-SV. For example, if you are assessing 20 subjects/participants in a hand-administered format the cost would be $160 plus shipping and handling. Please note that the fee is for the number of tools distributed to complete the study; not necessarily the number of subjects/ participants in the study. Therefore, if you are conducting a pre/post test design with 20 subjects and testing the subjects/participants before and after an intervention, such as an educational program, you will need to double the amount of tools (40 tools) as the number of participants and the cost would be $320 plus shipping and handling. There is a fee of $20 fee per subject access when non-personally hand-administered in all other formats (e.g., electronically; internal or external mailing; online secure format for a training program, in-service educational program, academic course or continuing education offering; an external postal mailing offsite) or internal mailing distribution or any form of administration that is not personally hand-administered to each subject/participant and then personally collected immediately following the subjects’/participants’ completion of the IAPCC-SV©. Fees associated with this tool are for a one-time use per aggregate distribution in one study and not for unlimited use. Permission is required for further use of the IAPCC-SV in any additional projects related or unrelated to its initial use. Please use an order form when purchasing the IAPCC-SV (order form).
PSYCHOMETRIC PROPERTIES OF THE IAPCC-SV & STUDIES USING THE IAPCC-SV
Fike, D., Denton, J., and Esparza, S. (2015). Calculation of Minimal Detectable Change of Individual Constructs of a Cultural Competence Measurement Instrument. 8th Annual UIW Research Week Proceedings – Poster Presentation Abstracts, pg. 71. (link)
Seventy-nine doctor of physical therapy (DPT) and undergraduate Athletic Training and Rehabilitation Science (ATHP) students completed the IAPCC-SV and 52 students completed a retest 1 week later to allow calculation of the MDC of the IAPCC-SV. Test-retest reliability and MDC were calculated. For the combined DPT and ATHP group, the MDC95 for the entire instrument is 4.10. The MDC95 of the individual constructs are as follows: Cultural Awareness = 1.34, Knowledge = 2.02, Skill = 1.52, Encounters = 1.61, and Desire = 1.17. The MDC patterns were consistent between the two student groups (DPT and ATHP) for the cumulative assessment tool and across the individual constructs. The results provide educators in physical therapy educational programs and other allied health educational programs with the ability to assess individual domains of learning during the process of achieving cultural competence. Specifically, educators can assess for meaningful changes in Cultural Knowledge, Skills, and Awareness, which are the primary goals of classroom and curricular activities designed to facilitate improvements in cultural competence.
Daugherty-Wood, H. (2015). Measuring the Impact of Cultural Competence Training for Dental Hygiene Students. The purpose of this study was to measure the level of cultural competence of senior level dental hygiene students. The students were given a pretest, the Inventory for Assessing the Process of Cultural Competence- Student Version (IAPCC-SV). The students then completed the US Department of Health and Human Services (HHS) Office of Minority Health (OMH) Cultural Competency Program for Oral Health Professionals, a three module online training program. Three weeks after the pre-test the students re-took the IAPCC-SV. The results indicated that there was a significant increase from the pre-test mean (55.14) to the post-test mean (61.37). https://etd.ohiolink.edu/!etd.send_file?ccession=osu1429889900&disposition=inline
Institute Sirindhorn College of Public Health, Yala.
This quasi-experimental research, a one group pre-post test design, was aimed to evaluate the effectiveness of community based learning on cultural competence among first year Thai Traditional Medicine students of Sirindhorn College of Public Health, Yala. Sample was 25 first year Thai Traditional Medicine students. The research instrument was Inventory for Assessing the Process of Cultural Competence among Healthcare Professionals-Student Version, which was translated into Thai. Psychometric findings revealed: Alpha Coefficient of Cronbach = 0.78; Internal consistency pre-test and post-test with paired sample t-test =.86, p = 0.001
Wilson, A., Bennett, D., Dorman, G., Holtz, C. and Bairan, A. (2012). Cultural Competence and Perceptions of the Mexican Culture Among Undergraduate and Graduate Nursing Students. Contact: email@example.com
The purpose of this mixed method study was to measure cultural competence and elicit perceptions of Mexican culture among undergraduate and graduate nursing students enrolled in two study abroad courses in Mexico. The Culturally Competent Model of Care (Campinha-Bacote, 2007) provided the framework for the study. Two groups of undergraduate (n=13) and two groups of graduate (n=17) nursing students participated in the study. Before and after the courses, undergraduate students were administered the Inventory for Assessing the Process of Cultural Competence Among Health Care Professionals-Student Version (IAPCC-SV) and graduate students were administered the (IAPCC-R) for health care providers. The instruments measure four categories of cultural competence (proficient, competent, aware, and incompetent). A paired t-test was used to determine statistical significance in the pre and post tests in each group. The results in part showed an increase in all group mean scores on the post tests with a statistical difference (p= .021) in one undergraduate group and (p=.024) in one graduate group. The level of cultural competence of undergraduate groups (competent) was higher than the graduates (aware).
Jones, M., Michael, R., Della, P., Stoddart, C., and Mella, P. (2012). Striving for cultural Competence: The Impact of International Clinical Placements in Tanzania on Nursing Students.
This research project was aimed to evaluate cultural competence amongst twenty pre-registration nursing students from Schools of Nursing and Midwifery at the five Universities of Western Australia (WA). The universities form the foundation partners of the Global Health Alliance in the Department of Health WA, which through a successful partnership with Hubert Kairuki Memorial University in Tanzania, Africa, provides students opportunity to be involved in clinical practice programs within the Tanzanian culture. The aspects of the experience examined include the students’ perceptions of culture and nursing in Tanzania, including their reflections on personal and professional growth. A mixed research methodology was used to address the aim of the project. This included the Campinha-Bacote (2007) Inventory for Assessing the Process of Cultural Competency-SV (IAPCC-SV).
Palombaro, K. and Lattanzi, J. (2012). Calculating the Minimal Detective Change for a Cultural Competency Tool.
Contact: firstname.lastname@example.org or email@example.com
The purpose of this study was to determine the minimal detectable change (MDC) of the Inventory for Assessing the Process of Cultural Competence Among Healthcare Professionals-Student Version (IAPCC-SV) in order to gain a greater understanding of the tool’s psychometric properties. Th is study used a cohort design involving four classes of doctor of physical therapy (DPT) students. Calculation of internal consistency was 0.856. This study provides the additional psychometric property of MDC for the IAPCC-SV which allows for a judgment to be made as to whether any pre-post change is beyond error.
Wilson, S. (2011). A Comparison of Nursing Student’s Levels of Knowledge: Cultural Competence in Providing Care Public versus Private Colleges.
The purpose of this quantitative study was to compare nursing students’ knowledge in providing culturally competent care in public versus private colleges. Data were collected from a convenience sample of 60 nursing students in the last quarter/semester of two associate degree nursing programs located in a Midwestern state. Cronbach alpha for the total item scale was .793.
Okere, S., Gleeson, P., Melzer, B., Olson, S. and Mitchell, K. (2011). Psychometric Testing and the Effects of a Cultural Competence Education Module on the Cultural Competence of Student Physical Therapists: A Pilot Study.
Contact: firstname.lastname@example.org; Pgleeson@twu.edu
The purpose of this study was to document the internal consistency and test re-test reliability of the IAPCC-SV for student physical therapists. In addition, the effect of a cultural competence education module on the cultural competence of student physical therapists as measured by the IAPCC-SV was conducted. Thirty-nine (39) student physical therapists in their first semester of their physical therapist education participated in this study. Participants completed the IAPCC-SV, Time 1 (test), and again the following week, Time 2 (re-test/pre-test) prior to any cultural competence education. Subjects then participated in a cultural competence education module and completed the IAPCC-SV, Time 3 (post-test). Results revealed that the IAPCC-SV demonstrated good internal consistency with a Cronbach’s Alpha of .75 and good test-re-test reliability (ICC(2,) of .870. This study provides support for the use of the IAPCC-SV to measure cultural competence of student physical therapists.
Clevenger, K. (2011) Effects of a Formal Service-Learning Program on Baccalaureate Nursing Student’s Perception of Their Level of Cultural Competence.
The purpose of this quasi-experimental study was to test Kolb’s theory of experiential learning, related to the effect of a formal service learning program on students’ perceived level of cultural competence. The research question examined the impact of a formal service learning program in a baccalaureate nursing program on developing culturally competent individuals, compared to traditional community service. The nonequivalent control group pre/post design used the Inventory for Assessing the Process of Cultural Competence Among Healthcare Professionals Student Version (IAPCC-SV). The treatment group of 37 entry-level baccalaureate nursing program (BNP) students received a formalized service learning program, while the control group of 37 upper-level BNP students took part in traditional community service. Both groups were administered the IAPCC-SV before and after participating in a service project. A t test was conducted and data analysis revealed no significant differences on the pretest, and significant differences on the posttest. The post intervention results indicated a greater level of cultural competence among traditional service-learning program students; however, students within both groups perceived themselves to be operating within a level of cultural competence, and levels increased for both groups, following the service experiences. The results suggest any type of service experience can reinforce the importance of caring for diverse populations, increase cultural competence, and thus contributing to positive social change.
Marie, J. (2010). Influence of an Overseas Clinical Placement on the Acquisition of Cultural Competence in Chiropractic Students. Murdoch University, Australia. Available at (link).
The purpose of this study was to assess the level of cultural competence in twenty-two students in their 5th year of a chiropractic course in Perth Australia participated in a voluntary clinical placement in Siliguri India using the IAPCC-SV immediately prior to their placement. Nineteen students from the same cohort who did not participate in the placement served as controls. A post-test survey was administered to both groups within two weeks of their return to Australia. There was no significant difference in the Level of Cultural Competence score, nor any of the subscale scores between experimental and control groups before the intervention. After the overseas placement, the overall level of Cultural Competence increased by 14% (P < 0.05) in the experimental group, while the control group showed no change. Of note, the Overseas born participants scored significantly higher on the Overall Level of Competence than did the Australian-born participants (5%) although it is questionable whether this is an important difference. Both groups (overseas-born and Australian-born) increased their level of competence by the same degree following the intervention.
Hsiu-Chin, C. (2010). Through Service Learning to Develop Cultural Competence Among Nursing Students. Utah Valley University. Orem, UT.
The purpose of this study was to understand cultural competence of nursing students and to enhance their cultural competence through service learning in a community. The IAPCC-SV was used in a pre/post test quasi-experimental study design with 26 nursing students in their last semester of an Associate Degree in Nursing program. Results indicated that the reliability for pretest data for the total score was an alpha of .66 and the alpha of the posttest data for the total score was .76. Alpha reliabilities for each subscale of the IAPCC-SV in the pre/ post testing demonstrated a wide range of variability.
Young, S. (2009). Assessment of Cultural Diversity Training: An Experiment for Hawaii Nursing Students. Medical University of South Carolina.
This experimental study examined the effectiveness of an experimental educational intervention consisting of a presentation on cultural diversity and competence. The IAPCC-SV was given to 46 nursing students in a Hawaii-based nursing program. In analyzing the data, the IAPCC-SV revealed a Reliability Coefficient Cronbach’s alpha of .84.
Goebel, C., Henderson, C., and Sperstad, R. (2008). Nursing Students’ Cultural Competence: Pre and Post a Short-Term Diverse Clinical Immersion Experience. (2008).
The purpose of this educational research study was to describe the influence of participating in a short-term cultural diverse nursing clinical immersion experience on students’ level of cultural competence. Both quantitative and qualitative methods were used in this study. Campinha-Bacote’s (2007) Inventory for Assessing the Process of Cultural Competence Among Healthcare Professionals-Student Version (IAPCC-SV) was completed before and again after the clinical immersion experience.
Fitzgerald, E., Cronin, S., and Campinha-Bacote. (2008). Psychometric Testing of a Proposed Student Version of the Tool, “Inventory for Assessing the Process of Cultural Competence Among Healthcare Professionals-Revised
The purpose of this study was to provide nurse educators with a reliable and valid tool for assessing the level of cultural competence among student nurses. The IAPCC-SV was administered to 91 undergraduate nursing students in a BSN program at a private university in the mid western part of the USA. Reliability testing revealed a Cronbach’s alpha of .783. Construct validity was addressed, in that the IAPCC-SV is based on the five constructs of Campinha-Bacote’s theoretical model of cultural competence in healthcare delivery. Content validity was established, in that the items on the IAPCC-SV clearly reflect the review of the literature of cultural competence in healthcare delivery that identifies awareness/attitudes, skill and knowledge as domains of cultural competence. Face and content validity was established by reviews of national experts in the field of transcultural healthcare.
Young, S. and Lu, K. (2018). Educational Interventions to Increase Cultural Competence for Nursing Students. International Journal of Organization Theory & Behavior, 21(2), 85-97.
Chen, H., Jensen, J., Measom, G., Bennett, S., Nichols, N., Wiggins, L. and Anderton, A. (2018). Factors Influencing the Development of Cultural Competence in Undergraduate Nursing Students. Journal of Nursing Education. 57(1), 40-43.
Chen, H., Jensen, F., Measom, G., Bennett, S. and Nichols, N. (2018). Evaluating Student Cultural Competence in an Associate in Science in Nursing Program. Teaching and Learning in Nursing, 13(3), 161-167.
Mauro, M., Tracey, D., LoGrippo, M., Anderson, S. Bravo, A., Byrne, C, Geisser, B., and Escallier, L. (2017). Simulation Innovation to Redesign the Baccalaureate Curriculum to Address Population Health. Nurse Educator.
Jensen, F., Nichols, N., Chen, H., Bennett, S., Measom, G., Anderton, A. and Wiggins, L. (2017). Evaluating cultural competence in undergraduate nursing students. J Nurs Care, 6:2 (Suppl).
Chen, A., Cailor, S. (2017). Longitudinal Assessment of Changes in Cultural Competence and Health Literacy Knowledge in Pharmacy Students. American Journal of Pharmaceutical Education, 81 (5) Article S5, p.113.
Daugherty, H., and Kearney, R. (2017). Measuring the Impact of Cultural Competence Training for Dental Hygiene Students. Journal of Dental Hygiene, 91:48-54.
Eche, I., and Aronowitz, T. (2017). Evaluating Cultural Competence of Pediatric Oncology Nurses at a Teaching Hospital: A Pilot Study. Journal of Pediatric Oncology Nursing, 1043454217713452.
Smith, L., Perry, M. and Yorke, A. (2017). Does Interprofessional Education Influence Self-Efficacy and Cultural Competence in Pre-Clinical Doctor of Physical Therapy Students . AMEE MedEdPublish. https://www.mededpublish.org/manuscripts/951/v1.aspx
Keane, E. and Provident, I. (2017). Combining Online Education with International Service Learning to Increase Cultural Competence. The Internet Journal of Allied Health Sciences and Practice. 15(3), Article 6. http://nsuworks.nova.edu/cgi/viewcontent.cgi?article=1636&context=ijahsp
Denton, J., Shandra, E., Gonzalez, D., and Denton, M. (2017). Improvements in Cultural Competence Through Classroom and Local Cross-Cultural Service-Learning Activities
Journal of Physical Therapy Education, 30(2), 6-13.
Fike, D., Denton, J., Esparza, S. and Palombaro, K. (2016). Calculation of Minimal Detectable Change of Individual Constructs of a Cultural Competence Measurement Instrument. Journal of Physical Therapy Education, 30(1), 25+. https://www.questia.com/library/journal/1P3-4008788421/calculation-of-minimal-detectable-change-of-construct
Peer, N. (2016). Meeting Cultural Competency Standards for Accreditation in an Associate Degree Nursing Program. Journal of Nursing and Women’s Health : J104. https://www.gavinpublishers.com/admin/assets/articles_pdf/1511169506article_pdf342633273.pdf
Jones, M. and Salman, K. (2016). Incorporating Online Education Modules with Community Clinical Experiences to Enhance Cultural Competency Among Student Nurses. 27th International Nursing Research Congress. http://hdl.handle.net/10755/616050
Kohlbry, P. (2016). The Impact of International Service-Learning on Nursing Students’ Cultural Competency. Journal of Nursing Scholarship,48(3):303-11.
Sander, A., Francis, N., Edmonds, C., Van Der Laan, K. and Salzman. A. (2015). Development of International Clinical Education Experiences for Doctor of Physical Therapy Students in the United States. Physiotherapy, Volume 101, Supplement 1, pages eS1332-eS1333. http://www.physiotherapyjournal.com/article/S0031-9406(15)01291-2/pdf
Cailor, S., Chen, A. and Frame, T. (2015). Assessment of Changes in Cultural Competence and Health Literacy Knowledge in First-year Student Pharmacists. Currents in Pharmacy Teaching and Learning, 7(3), 292-301.
Palombaro, K., Dole, R. and Black, J. (2015). Curricular Integration and Measurement of Cultural Competence Development in a Group of Physical Therapy Students. Journal of the Scholarship of Teaching and Learning, 15(5), 82-96.
Hayward, L. (2014). Promoting and Assessing Cultural Competence, Professional Identity, and Advocacy in Doctor of Physical Therapy (DPT) Degree Students Within a Community of Practice. Journal of Physical Therapy Education, 28(1), 23-36.
Isaacson, M. (2014). Clarifying concepts: Cultural Humility or Competency. Journal of Professional Nursing, 30:251–258.
Clevenger, K. (2013). Effects of a Formal Service-Learning Program on Baccalaureate Nursing Student’s Perception of Their Level of Cultural Competence. Kentucky Nurse, 61(2), 14.
Miller, M. and Schellhase, E. (2013). An Interdisciplinary Active Learning Intercultural Training Course. https://www.pharmacademy.itomicpowered.com/sites/default/files/launch/posters/TIP62%20Mil ler%20Intercultural%20Learning%20Poster%202017.pdf
Cailor, S., Chen, A. and Frame, T. (2013). Assessment of Changes in Cultural Competence and Health Literacy Knowledge in First-year Student Pharmacists. American Journal of Pharmaceutical Education, 77(5) Article 109.
Werremeyer, A., and Skoy, E. (2012). Instructional Design and Assessment: A Medical Mission to Guatemala as an Advanced Pharmacy Practice Experience. American Journal of Pharmaceutical Education, 76 (8) Article 156.
Ruangdej, K., Chaosuansreecharoen, P., Rodkhem, R. and Ochaompawon, K. (2012). Effectiveness of Community Based Learning on Cultural Competence among First Year Thai Traditional Medicine Students. Nursing Journal of the Ministry of Public Health, 13-25.
Shawala-Druy, S, and Hill, M. (2012). Interdisciplinary: Cultural Competency and Cultural Congruent Education for Millennians in Health Professions. Nurse Education Today, 32(7), 772-8.
Palombaro, K. and Lattanzi, J. (2012). Calculating the Minimal Detective Change for a Cultural Competency Tool. HPA PTJ-PAL Resource,(12(2), 1-7. http://www.aptahpa.org/associations/9956/files/Vol12_N2.pdf
Durand, C., Abel, C., Silva, M., and Desilets, A. (2012). An Elective Course in Cultural Competence. Currents in Pharmacy Teaching & Learning. (February 2012).
Escallier, L., Fullerton, J. and Messina, B. (2011). Cultural Competence Outcomes Assessment: A Strategy and Model. International Journal of Nurse Midwifery, 3(3), 35-42.
Abel, C., Silva, M., Desilets, A. and Durand, C. (2010). Integration of Cultural Competence Training into an Accelerated Doctor of Pharmacy Curriculum. Journal of the American Pharmacists Association, 50(2), 282.
Fitzgerald, E., Cronin, S. and Campinha-Bacote, J. (2009). Psychometric Testing of the Inventory for Assessing the Process of Cultural Competence Among Healthcare Professionals-Student Version (IAPCC-SV). Journal of Theory Construction & Testing, 13(2), 64-68.
*Duplication/Copying of IAPCC-SV: The IAPCC-SV is copyrighted and therefore cannot be duplicated/copied without written permission from the author, Dr. Josepha Campinha-Bacote, or her designee. Transcultural C.A.R.E. Associates has a policy regarding the unauthorized use of this copyrighted tool.