Patient Perspectives on the Cultural Competence of US Health Care Professionals

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Abstract

This survey study uses data from the 2017 National Health Interview Survey to examine patients’ perspectives on the cultural competence of US health care professionals.

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Structural Racism and Supporting Black Lives - The Role of Health Professionals.

Rachel R Hardeman, Eduardo M Medina, Katy Kozhimannil (2016)

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Does Cultural Competency Training of Health Professionals Improve Patient Outcomes? A Systematic Review and Proposed Algorithm for Future Research

Desiree A. Lie, Elizabeth Lee-Rey, Art Gomez … (2010)

Background Cultural competency training has been proposed as a way to improve patient outcomes. There is a need for evidence showing that these interventions reduce health disparities. Objective The objective was to conduct a systematic review addressing the effects of cultural competency training on patient-centered outcomes; assess quality of studies and strength of effect; and propose a framework for future research. Design The authors performed electronic searches in the MEDLINE/PubMed, ERIC, PsycINFO, CINAHL and Web of Science databases for original articles published in English between 1990 and 2010, and a bibliographic hand search. Studies that reported cultural competence educational interventions for health professionals and measured impact on patients and/or health care utilization as primary or secondary outcomes were included. Measurements Four authors independently rated studies for quality using validated criteria and assessed the training effect on patient outcomes. Due to study heterogeneity, data were not pooled; instead, qualitative synthesis and analysis were conducted. Results Seven studies met inclusion criteria. Three involved physicians, two involved mental health professionals and two involved multiple health professionals and students. Two were quasi-randomized, two were cluster randomized, and three were pre/post field studies. Study quality was low to moderate with none of high quality; most studies did not adequately control for potentially confounding variables. Effect size ranged from no effect to moderately beneficial (unable to assess in two studies). Three studies reported positive (beneficial) effects; none demonstrated a negative (harmful) effect. Conclusion There is limited research showing a positive relationship between cultural competency training and improved patient outcomes, but there remains a paucity of high quality research. Future work should address challenges limiting quality. We propose an algorithm to guide educators in designing and evaluating curricula, to rigorously demonstrate the impact on patient outcomes and health disparities. Electronic supplementary material The online version of this article (doi:10.1007/s11606-010-1529-0) contains supplementary material, which is available to authorized users.

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Author and article information

Journal

Journal ID (nlm-ta): JAMA Netw Open

Journal ID (iso-abbrev): JAMA Netw Open

Journal ID (pmc): JAMA Netw Open

Title: JAMA Network Open

Publisher: American Medical Association

ISSN (Electronic): 2574-3805

Publication date (Electronic): 27 November 2019

Publication date Collection: November 2019

Publication date PMC-release: 27 November 2019

Volume: 2

Issue: 11

Electronic Location Identifier: e1916105

Affiliations

[1 ]Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis

[2 ]State Health Access Data Assistance Center, Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis

[3 ]Hennepin Healthcare Research Institute, Minneapolis, Minnesota

[4 ]Division of General Internal Medicine, Department of Medicine, Hennepin Healthcare, Minneapolis, Minnesota

Author notes

Article Information

Accepted for Publication: October 4, 2019.

Published: November 27, 2019. doi:10.1001/jamanetworkopen.2019.16105

Corresponding Author: Lynn A. Blewett, PhD, MA, Division of Health Policy and Management, University of Minnesota School of Public Health, 2221 University Ave, Ste 345, Minneapolis, MN 55414 ( blewe001@ 123456umn.edu ).

Author Contributions: Dr Blewett had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Blewett, Hardeman, Winkelman.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Blewett, Hardeman.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Blewett, Hest.

Obtained funding: Blewett.

Administrative, technical, or material support: Blewett, Winkelman.

Supervision: Blewett.

Conflict of Interest Disclosures: Dr Blewett reported receiving a grant from the National Institutes of Child Health and Human Development during the conduct of the study. No other disclosures were reported.

Article

Publisher ID: zld190031

DOI: 10.1001/jamanetworkopen.2019.16105

PMC ID: 6902827

PubMed ID: 31774517

SO-VID: 8bb8c518-1993-4495-8256-82542da1fb8d

License:

This is an open access article distributed under the terms of the CC-BY License.

History

Date received : 21 August 2019

Date accepted : 4 October 2019

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