Center on an Aging Society

WHAT IS CULTURAL COMPETENCE IN HEALTH CARE?Individual values, beliefs, and behaviors about health and well-being are shaped by various factors such as race, ethnicity, nationality, language, gender, socioeconomic status, physical and mental ability, sexual orientation, and occupation. Cultural competence in health care is broadly defined as the ability of providers and organizations to understand and integrate these factors into the delivery and structure of the health care system. The goal of culturally competent health care services is to provide the highest quality of care to every patient, regardless of race, ethnicity, cultural background, English proficiency or literacy. Some common strategies for improving the patient-provider interaction and institutionalizing changes in the healthcare system include:201. Provide interpreter services2. Recruit and retain minority staff3. Provide training to increase cultural awareness, knowledge, and skills4. Coordinate with traditional healers5. Use community health workers6. Incorporate culture-specific attitudes and values into health promotion tools7. Include family and community members in health care decision making8. Locate clinics in geographic areas that are easily accessible for certain populations9. Expand hours of operation10. Provide linguistic competency that extends beyond the clinical encounter to the appointment desk, advice lines, medical billing, and other written materials

AHRQ Setting the Agenda

Health care providers take many approaches to bridge barriers to communication that stem from racial, ethnic, cultural, and linguistic differences. "Cultural competence" encompasses both interpersonal and organizational interventions and strategies for overcoming those differences.
This document examines how cultural competence affects health care delivery and health outcomes, and it is sponsored by the Agency for Healthcare Research and Quality (AHRQ) and the Office of Minority Health (OMH). Part 1 of the report, which is presented here, comprises the introduction and key findings.

Executive Order 13166

The Rural Assistance Center gives information about cultural competence and laws designed to help those that do not speak english.
An Executive Order is an order given by the President to federal agencies. The “LEP” Executive Order 13166 "Improving Access to Services for Persons with Limited English Proficiency" states that people who are LEP should have meaningful access to federally conducted and federally funded programs and activities. Executive Order 13166 requires all agencies that provide federal financial assistance to issue guidance on how recipients of that assistance can take reasonable steps to provide meaningful access consistent with Title VI and the Title VI regulations. The Order also requires that federal agencies create plans for ensuring that their own activities also provide meaningful access for persons who are LEP.

Provider Training and California Endowment

Domains of Competency

Provider Training: Often left to medical schools or residency the clinicians need an orientation to the interaction between culture and medicine. Obvious examples have to do with examples of how expectations in clinical encounters vary by culture, how common illnesses are constructed linguistically and culturally, how dietary patterns impact illnesses like hyperlipidemia and diabetes that are determined by diet. How religious life impacts end of life discussions and certain illnesses.
The California Endowment has a program to achieve cultural competence.
Program Areas
Since we adopted our strategic plan in 2002, we have clarified our focus on how to achieve our mission. First, every Californian must have access to quality health services. Second, our health care system must be culturally competent to respond to the diversity and demographic changes in our state. Third, we must eliminate the disparities in health and strengthen communities to become healthy places to live.
Based on these convictions, we have organized our work around three goals:
Access to health;
Culturally competent health systems; and
Community health and the elimination of health disparities.
Read more

Cultural competency to improve quality healthcare

Researchers believe that cultural competency training is important. There was a study done among 43 healthcare professionals. This article confirms training is necessary.

In recent years, scholars and policy makers have paid
considerable attention to the topic of cultural competency,
especially as it relates to the delivery of health
care in the United States. Scholarly research has focused
on the potential role of cultural competency training for
health care providers in reducing health care disparities.1-3
Researchers suggest that appropriate cultural competency
training programs should be implemented to educate
care providers about the role of cultural factors, such as
ethnomedical beliefs and use of folk medicine, health
beliefs and worldview, culturally prescribed values and
norms, gender-specific status and roles, and religion, in
influencing the outcome of patient-provider encounters.4-6
Although some scholars continue to debate the benefits
and limitations of cultural competency training in health
care, there is general agreement among researchers that
it improves patient-provider communication and that, in
the long term, it increases patient satisfaction and compliance.
7-9 In this article, we report findings from a pilot
study designed to assess the outcomes of a training program
aimed at improving knowledge and skills related to
the provision of cultural competent care among providers
and administrators.
There is an increasing level of academic interest in
examining the interrelatedness of health and culture,
especially as it relates to the delivery of health care.1-6 In
light of growing ethnic diversity and associated health
disparities in the United States, health policy makers and
providers have realized the benefits of cultural competency
training. Key stakeholders in the health care arena—
for example, providers, administrators, insurers, and policy
makers—consider cultural competency training to be
germane to providing quality health care to a diverse population
of patients.

Assessing cultural competence

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Lilia

search goes on

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