The effectiveness of culturally appropriate interventions to manage or prevent chronic disease in culturally and linguistically diverse communities: a systematic literature review

Abstract

Culturally and linguistically diverse (CALD) communities in Australia experience both significant health disparities and a lack of access to services. Consequently, there have been calls for culturally appropriate services for people with chronic disease in CALD populations. This paper presents a systematic review of the literature on the effectiveness of culturally appropriate interventions to manage or prevent chronic disease in CALD communities. Evidence was sought from randomized controlled trials and controlled studies that examined strategies for promoting cultural competence in health service delivery to CALD communities. The outcomes examined included changes in consumer health behaviours, utilisation/satisfaction with the service, and the cultural competence of health‐care providers. Of the 202 studies that were identified only 24 met the inclusion criteria. The five categories of intervention that were identified included: (1) the use of community‐based bi‐lingual health workers; (2) providing cultural competency training for health workers; (3) using interpreter service for CALD people; (4) using multimedia and culturally sensitive videos to promote health for CALD people and (5) establishing community point‐of‐care services for CALD people with chronic disease. The review supported the use of trained bi‐lingual health workers, who are culturally competent, as a major consideration in the development of an appropriate health service model for CALD communities.

The predictors of cultural competence among new baccalaureate degree nursing graduates: Implications for nursing education

“…[14] These notable disparities in health and health care suggest the need for increased attention to specific cultural differences and how these differences relate to health outcomes. [3][4][5][6] Regardless of the method of implementation (integration of specific theory or model, integrated concepts throughout several courses, stand-alone course on culture), graduates are only achieving cultural awareness.…”

“…[1] In addition to the influence of ethnic diversity, other cultural variables such as varying attitudes, beliefs, and life circumstances affect a person's health status, perspective on health care and their ability to access it. [2][3][4][5][6] The increase in minority populations, as well as the varying beliefs and practices of a highly diverse population, have attributed to the problem of disparities in health and health care. [2] Health disparities refer to the differences in the state of health of a person as it relates to a person's race/ethnicity, socioeconomic status, age, location, gender, disability status, and sexual orientation.…”

“I Am Getting Healthier”. Perceptions of Urban Aboriginal and Torres Strait Islander People in a Chronic Disease Self-Management and Rehabilitation Program

“…Several features have been identified as critical in development of culturally safe chronic disease management and rehabilitation programs for Aboriginal and Torres Strait Islander people and for culturally and linguistically diverse populations more generally [7] [8]. These include information that is accessible and culturally relevant, adequate aboriginal community engagement, utilising local knowledge, strong leadership, shared responsibilities, sustainable resources and integrated data and systems, and the involvement of Aboriginal and Torres Strait Islander staff in service delivery and the integration of care across conditions and sectors [7]- [9].…”

“…These include information that is accessible and culturally relevant, adequate aboriginal community engagement, utilising local knowledge, strong leadership, shared responsibilities, sustainable resources and integrated data and systems, and the involvement of Aboriginal and Torres Strait Islander staff in service delivery and the integration of care across conditions and sectors [7]- [9]. Brach & Fraser [10], also suggest that culturally safe and competent services will translate into better health via the impact they have on improved communication, increased trust in the health system, greater knowledge about health and services in the local community and expanded cultural understanding within the health system.…”

Culturally and linguistically diverse patient participation in glioma research

“…54 Studies targeting different groups of health professionals have indicated that training in cultural competency has been beneficial for the health care of CALD communities. 55 Systematic rollout of education around CALD-specific issues has been limited. 56 Cultural knowledge/sensitivity and communication skills require ongoing training of research investigators through interactive courses, whether residential or online, with practical tips on making the best use of individual and institutional resources, enhancing cultural humility, and enabling culturally versed "global physicians."…”