Cultural Competence

Beach, Mary Catherine; Price, Eboni G.; Gary, Tiffany L.; Robinson, Karen A.; Gozu, Aysegul; Palacio, Ana; Smarth, Carole; Jenckes, Mollie W.; Feuerstein, Carolyn J; Bass, Eric B.; Powe, Neil R.; Cooper, Lisa A.

doi:10.1097/01.mlr.0000156861.58905.96

Cited by 759 publications

(271 citation statements)

References 33 publications

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“…Currently, many cultural competency efforts revolve around discussions of cultural values and practices rather than training and interventions that actually improve clinical practice (Dogra et al 2007). The literature on promoting cultural competence is heavily weighted towards providing conceptual models and guidelines rather than on rigorous evaluation of the outcomes of cultural competency practices (Chipps et al 2008), and studies that empirically examine the impact of such practices on clients are virtually non-existent (Bhui et al 2007;Beach et al 2005).…”

Section: Discussionmentioning

confidence: 99%

Psychoeducation to Address Stigma in Black Adults Referred for Mental Health Treatment: A Randomized Pilot Study

Alvidrez

Snowden

Rao

et al. 2008

Community Ment Health J

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Forty-two Black clients referred for outpatient treatment were randomly assigned to receive existing brochures about services or a psychoeducational booklet about stigma based on experiences of Black mental health consumers. At 3-month follow-up, clients reported that both types of information were helpful; there were no significant differences between the types of information on treatment attendance. However, individuals who reported higher perceived treatment need or greater uncertainty about treatment showed greater stigma reduction from the psychoeducation. Findings indicate the need to move beyond "customer satisfaction" to evaluate educational interventions, as well as for greater understanding of differential impact of stigma reduction interventions.

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Section: Discussionmentioning

confidence: 99%

Psychoeducation to Address Stigma in Black Adults Referred for Mental Health Treatment: A Randomized Pilot Study

Alvidrez

Snowden

Rao

et al. 2008

Community Ment Health J

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“…Of training sessions that have undergone evaluation, results that show effectiveness have been mixed. However, in spite of these limitations, evaluation data have suggested significant improvements in skills, knowledge, behavior, and attitudes after training (Beach et al, 2005;Kardong-Edgren et al, 2005). Notably, a recent study of a lesbian, gay, bisexual, transgender (LGBT) health curriculum showed a significant change in knowledge and beliefs about LGBT individuals among second-year medical students at the University of California at San Francisco, including an increase in awareness that sexual orientation and gender identity are clinically relevant (Kelley, Chou, Dibble, & Robertson, 2008).…”

mentioning

confidence: 91%

A Community-Based Program Evaluation of Community Competency Trainings

Hanssmann¹,

Morrison²,

Russian³

et al. 2010

Journal of the Association of Nurses in AIDS Care

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Transgender and gender-nonconforming individuals encounter a multitude of barriers to accessing clinically and culturally competent health care. One strategy to increase the quality and competence of care delivery is workplace trainings. This study describes a community-based program for the evaluation of this type of training. Using a mixed-methods approach, the research team assessed the effectiveness of three competency trainings administered by a local nonprofit organization in the Northwest United States. Quantitative data indicated a significant shift in self-assessed knowledge associated with completion of the training. Qualitative data confirmed this result and revealed a number of important themes about the effect of the trainings on providers and their ability to implement knowledge and skills in practice. Clinical considerations are proposed for providers who seek similar trainings and who aim to increase clinical and cultural competency in delivering care to transgender and gender-nonconforming patients and clients.

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“…115 This contrasts with the more traditional concept of the provision of 'culturally fitting care' that involves matching a person's needs based on an understanding of the clients' culture in terms of caring actions, health-care information and knowledge particular to each culture. 116 Such a 'fact file' approach to assumed cultural characteristics of ethnic groups fails to capture the diverse and fluid nature of culture and ethnicity and may lead to reifying existing racial categories rather than achieving the intention of deconstructing barriers to health care.…”

mentioning

confidence: 99%

Increasing the acceptability and rates of organ donation among minority ethnic groups: a programme of observational and evaluative research on Donation, Transplantation and Ethnicity (DonaTE)

Morgan

Kenten

Deedat

et al. 2016

Programme Grants Appl Res

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BackgroundBlack, Asian and minority ethnic (BAME) groups have a high need for organ transplantation but deceased donation is low. This restricts the availability of well-matched organs and results in relatively long waiting times for transplantation, with increased mortality risks.ObjectiveTo identify barriers to organ donor registration and family consent among the BAME population, and to develop and evaluate a training intervention to enhance communication with ethnic minority families and identify impacts on family consent.MethodsThree-phase programme comprising (1) community-based research involving two systematic reviews examining attitudes and barriers to organ donation and effective interventions followed by 22 focus groups with minority ethnic groups; (2) hospital-based research examining staff practices and influences on family consent through ethics discussion groups (EDGs) with staff, a study on intensive care units (ICUs) and interviews with bereaved ethnic minority families; and (3) development and evaluation of a training package to enhance cultural competence among ICU staff.SettingCommunity focus group study in eight London boroughs with high prevalence of ethnic minority populations. Hospital studies at five NHS hospital trusts (three in London and two in Midlands).Participants(1) Community studies: 228 focus group participants; (2) hospital studies: 35 nurses, 28 clinicians, 19 hospital chaplains, 25 members of local Organ Donation Committees, 17 bereaved family members; and (3) evaluation: 66 health professionals.Data sourcesFocus groups with community residents, systematic reviews, qualitative interviews and observation in ICUs, EDGs with ICU staff, bereaved family interviews and questionnaires for trial evaluation.Review methodsSystematic review and narrative synthesis.Results(1) Community studies: Organ Donor Register – different ethnic/faith and age groups were at varying points on the ‘pathway’ to organ donor registration, with large numbers lacking knowledge and remaining at a pre-contemplation stage. Key attitudinal barriers were uncertainties regarding religious permissibility, bodily concerns, lack of trust in health professionals and little priority given to registration, with the varying significance of these factors varying by ethnicity/faith and age. National campaigns focusing on ethnic minorities have had limited impact, whereas characteristics of effective educational interventions are being conducted in a familiar environment; addressing the groups’ particular concerns; delivery by trained members of the lay community; and providing immediate access to registration. Interventions are also required to target those at specific stages of the donation pathway. (2) Hospital studies: family consent to donation – many ICU staff, especially junior nurses, described a lack of confidence in communication and supporting ethnic minority families, often reflecting differences in emotional expression, faith and cultural beliefs, and language difficulties. The continuing high proportion of family donation discussions that take place without the collaboration of a specialist nurse for organ donation (SNOD) reflected consultants’ views of their own role in family consent to donation, a lack of trust in SNODs and uncertainties surrounding controlled donations after circulatory (or cardiac) death. Hospital chaplains differed in their involvement in ICUs, reflecting their availability/employment status, personal interests and the practices of ICU staff. (3) Evaluation: professional development package – a digital versatile disc-based training package was developed to promote confidence and skills in cross-cultural communication (available at:www.youtube.com/watch?v=ueaR6XYkeVM&feature=youtu.be). Initial evaluation produced positive feedback and significant affirmative attitudinal change but no significant difference in consent rate over the short follow-up period with requirements for longer-term evaluation.LimitationsParticipants in the focus group study were mainly first-generation migrants of manual socioeconomic groups. It was not permitted to identify non-consenting families for interview with data regarding the consent process were therefore limited to consenting families.ConclusionsThe research presents guidance for the effective targeting of donation campaigns focusing on minority ethnic groups and provides the first training package in cultural competence in the NHS.Future workGreater evaluation is required of community interventions in the UK to enhance knowledge of effective practice and analysis of the experiences of non-consenting ethnic minority families.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.

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Cultural Competence

Cited by 759 publications

References 33 publications

Psychoeducation to Address Stigma in Black Adults Referred for Mental Health Treatment: A Randomized Pilot Study

Psychoeducation to Address Stigma in Black Adults Referred for Mental Health Treatment: A Randomized Pilot Study

A Community-Based Program Evaluation of Community Competency Trainings

Increasing the acceptability and rates of organ donation among minority ethnic groups: a programme of observational and evaluative research on Donation, Transplantation and Ethnicity (DonaTE)

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