In recent years, there have been increasing national calls for patient-centered, culturally sensitive health care (PC-CSHC). The impetus for these calls include (a) the reality that health care providers are increasingly having to provide health care to a more culturally diverse patient population without the necessary training to do so effectively, (b) the growing evidence that culturally insensitive health care is a major contributor to the costly health disparities that plague our nation, and (c) the fact that racial/ ethnic minorities and individuals with low household incomes are more likely than their non-Hispanic white and higher-income counterparts to experience culturally insensitive health care and dissatisfaction with health care-health care experiences that have been linked to poorer health outcomes. This article (a) presents literature on the definition of PC-CSHC and the need for this care, (b) presents research on assessing and promoting this care, and (c) offers research-informed strategies and future directions for customizing and institutionalizing this care.

Research suggests that patient-centered culturally sensitive health care may be an important precursor to patient satisfaction and treatment adherence. Data from this study are a subset from the data collected for the Patient-Centered Culturally Sensitive Health Care and Health Promotion Research Project. The present study was designed to (a) explore the relationship between patients’ perceived patient-centered cultural sensitivity of their health care sites (ie, the physical and social environment and clinic policies) and their self-reported adherence to treatment and (b) investigate whether this relationship is mediated by satisfaction with health care experienced. Participants consisted of a low-income, culturally diverse sample of 1581 patients from 67 health care sites across the United States. A significant positive relationship between patients’ perceived patient-centered cultural sensitivity of their health care sites and their self-reported treatment adherence to a prescribed regimen was observed. Patient satisfaction with care partially mediated the relationship between these 2 variables. Assessing the level of patient-centered cultural sensitivity patients perceive in their health care sites might provide guidance to health care administrators as to how to make their sites more culturally sensitive from the perspective of patients. This, in turn, might increase patients’ treatment adherence, leading to improved health outcomes.

IntroductionDisparities in treatment adherence based on race and ethnicity are well documented but poorly understood. Specifically, the causes of treatment nonadherence among Latino patients living in the USA are complex and include cultural and language barriers.PurposeThe purpose of this study was to examine whether patients’ perceptions in patient-provider interactions (i.e., trust in provider, patient satisfaction, and patient sense of interpersonal control in patient-provider interactions) mediate any found association between patient-perceived provider cultural sensitivity (PCS) and treatment adherence among English-preferred Latino (EPL) and Spanish-preferred Latino (SPL) patients.MethodsData from 194 EPL patients and 361 SPL patients were obtained using questionnaires. A series of language-specific structural equation models were conducted to test the relationship between patient-perceived PCS and patient treatment adherence and the examined mediators of this relationship among the Latino patients.ResultsNo significant direct effects of patient-perceived PCS on general treatment adherence were found. However, as hypothesized, several significant indirect effects emerged. Preferred language appeared to have moderating effects on the relationships between patient-perceived PCS and general treatment adherence.ConclusionThese results suggest that interventions to promote treatment adherence among Latino patients should likely include provider training to foster patient-defined PCS, trust in provider, and patient satisfaction with care. Furthermore, this training needs to be customized to be suitable for providing care to Latino patients who prefer speaking Spanish and Latino patients who prefer speaking English.

Research suggests that patients' interactions with their front desk office staff and patient-centered culturally sensitive health care are important factors in diverse patients' overall health care satisfaction. Yet, patient-centered culturally sensitive health care research has focused almost exclusively on provider care. This study tested the hypothesis that patient-perceived cultural sensitivity of front desk office staff has a significant positive association with patient treatment adherence and that this relationship is mediated by patient health care satisfaction. Study participants were a culturally diverse sample of 1,191 patients from health care sites across the U.S. Results of a meditational analysis supported the tested hypothesis. Patient health care satisfaction fully mediated the relationship between patient-perceived cultural sensitivity of front desk office staff and patient treatment adherence. The patient satisfaction and cultural sensitivity variables explained 10% of the variance in patient treatment adherence. Training front desk office staff in patient-centered culturally sensitive health care may improve patients' health care satisfaction and treatment adherence.

Aim/Background Research suggests that patient-perceived culturally sensitive healthcare encompasses multiple components of the healthcare delivery system including the cultural sensitivity of front desk office staff. Despite this, research on culturally sensitive health care focuses almost exclusively on provider behaviors, attitudes, and knowledge. This is due in part to the paucity of instruments available to assess the cultural sensitivity of front desk office staff. Thus, the objective of the present study is to determine the psychometric properties of the pilot Tucker-Culturally Sensitive Health Care Office Staff Inventory-Patient Form (T-CSHCOSI-PF), which is an instrument designed to enable patients to evaluate the patient-defined cultural sensitivity of their front desk office staff. Methods A sample of 1,648 adult patients was recruited by staff at 67 health care sites across the United States. These patients anonymously completed the T-CSHCOSI-PF, a demographic data questionnaire, and a patient satisfaction questionnaire. Findings Confirmatory factor analyses of the TCSHCOSI-PF revealed that this inventory has two factors with high internal consistency reliability and validity (Cronbach's alphas = .97 and .95). Conclusions It is concluded that the T-CSHCOSI-PF is a psychometrically strong and useful inventory for assessing the cultural sensitivity of front desk office staff. This inventory can be used to support culturally sensitive health care research, evaluate the job performance of front desk office staff, and aid in the development of trainings designed to improve the cultural sensitivity of these office staff.