Background Cross-cultural educational initiatives for professionals are now commonplace across a variety of sectors including health care. A growing number of studies have attempted to explore the utility of such initiatives on workplace behaviors and client outcomes. Yet few studies have explored how professionals perceive cross-cultural educational models (e.g., cultural awareness, cultural competence) and the extent to which they (and their organizations) execute the principles in practice. In response, this study aimed to explore the general perspectives of health care professionals on culturally competent care, their experiences working with multi-cultural patients, their own levels of cultural competence and the extent to which they believe their workplaces address cross-cultural challenges. Methods The perspectives and experiences of a sample of 56 health care professionals across several health care systems from a Mid-Western state in the United States were sourced via a 19-item questionnaire. The questionnaire comprised both open-ended questions and multiple choice items. Percentages across participant responses were calculated for multiple choice items. A thematic analysis of open-ended responses was undertaken to identify dominant themes. Results Participants largely expressed confidence in their ability to meet the needs of multi-cultural clientele despite almost half the sample not having undergone formal cross-cultural training. The majority of the sample appeared to view cross-cultural education from a ‘cultural awareness’ perspective - effective cross-cultural care was often defined in terms of possessing useful cultural knowledge (e.g., norms and customs) and facilitating communication (the use of interpreters); in other words, from an immediate practical standpoint. The principles of systemic cross-cultural approaches (e.g., cultural competence, cultural safety) such as a recognition of racism, power imbalances, entrenched majority culture biases and the need for self-reflexivity (awareness of one’s own prejudices) were scarcely acknowledged by study participants. Conclusions Findings indicate a need for interventions that acknowledge the value of cultural awareness-based approaches, while also exploring the utility of more comprehensive cultural competence and safety approaches.

BackgroundDisparities across a number of health indicators between the general population and particular racial and cultural minority groups including African Americans, Native Americans and Latino/a Americans have been well documented. Some evidence suggests that particular groups may receive poorer standards of care due to biased beliefs or attitudes held by health professionals. Less research has been conducted in specifically non-urban areas with smaller minority populations.MethodsThis study explored the self-reported health care experiences for 117 racial and cultural minority Americans residing in a Mid-Western jurisdiction. Prior health care experiences (including perceived discrimination), attitudes towards cultural competence and satisfaction with health care interactions were ascertained and compared across for four sub-groups (African-American, Native American, Latino/a American, Asian American). A series of multiple regression models then explored relationships between a concert of independent variables (cultural strength, prior experiences of discrimination, education level) and health care service preferences and outcomes.ResultsOverall, racial/cultural minority groups (African Americans, Native Americans, Latino/a Americans, and Asian Americans) reported general satisfaction with current healthcare providers, low levels of both health care provider racism and poor treatment, high levels of cultural strength and good access to health care services. Native American participants however, reported more frequent episodes of poor treatment compared to other groups. Incidentally, poor treatment predicted lower levels of treatment satisfaction and racist experiences predicted being afraid of attending conventional health care services. Cultural strength predicted a preference for consulting a health care professional from the same cultural background.ConclusionsThis study provided a rare insight into minority health care expectations and experiences in a region with comparatively lower proportions of racial and cultural minorities. Additionally, the study explored the impact of cultural strength on health care interactions and outcomes. While the bulk of the sample reported satisfaction with treatment, the notable minority of participants reporting poor treatment is still of some concern. Cultural strength did not appear to impact health care behaviours although it predicted a desire for cultural matching. Implications for culturally competent health care provision are discussed within.

Violence risk instruments are widely employed with at-risk minority clients in correctional and forensic mental health settings. However, the construction and subsequent validation of such instruments rarely, if at all, incorporate the perceptions, worldviews, life experiences, and belief systems of non-white communities. This study utilized a culturally informed qualitative approach to address the cross-cultural disparities in the forensic risk literature. Cultural perspectives on violence risk assessment were elicited from a sample of 30 American Indian and First Nations professionals from health, legal, and pedagogical sectors following an inspection of the Structured Assessment of Violence Risk in Youth instrument. Generally, participants believed that the Structured Assessment of Violence Risk in Youth instrument was not culturally appropriate for use with American Indian and First Nations youth in its current form. Recurrent themes of concern included the instrument’s negative labeling capacity, lack of cultural contextualization, individualized focus, and absence of cultural norms and practices. Recommendations to improve the cross-cultural applicability of the Structured Assessment of Violence Risk in Youth are discussed within.

Racial bias in legal decision making has been given considerable attention over the past few decades, focusing mainly on African Americans to the exclusion of other minority groups. The purpose of this study was to address the dearth of research examining bias against Mexican American defendants. Two hundred forty-seven participants read through a trial transcript that varied defendant race/ethnicity (Mexican American or European American), defense attorney race/ethnicity (Mexican American or European American), and defendant socioeconomic status (SES; low or high [upper middle class]). Dependent measures included verdict, sentencing, culpability ratings, and trait assessments. Bias against Mexican American defendants occurred most when the Mexican American defendant was of low SES and represented by a Mexican American defense attorney. In addition, attorneys representing low-SES Mexican American defendants were perceived as less competent and rated lower on a number of trait measures. Limitations, applications, and future directions are discussed.

Patriotism and threat have been shown to predict immigration attitudes. We suggest that patriotism is influential in producing threat, and such threat drives anti-immigration attitudes, but this relationship is different for Whites and Latinos. All participants completed a patriotism scale (blind and constructive patriotism measures), a threat scale (realistic and symbolic threat), and anti-immigration attitude scale. Latinos showed lower blind patriotism, realistic threat, symbolic threat, and anti-immigration attitudes compared to Whites, with no differences in constructive patriotism. Threat partially mediated the relationship between blind patriotism and anti-immigration attitudes for Whites and fully mediated the relationship for Latinos. Threat partially mediated the relationship for cultural patriotism and anti-immigration attitude for Whites but not for Latinos. Implications for public policy and education concerning immigrant attitudes are discussed.