“…The second consequence is adherence to treatment and advice when there is cultural competence (Harmsen et al, 2005;Horvat et al, 2014;Ishikawa et al, 2014;Majumdar et al, 2004;May & Potia, 2013;Owiti et al, 2014;Wade & Bernstein, 1991;Wall et al, 2013). The third consequence is satisfaction when clients perceive the health provider incorporates cultural perspectives (Dunagan, Kimble, Gunby, & Andrews, 2014;Foronda, 2008;Garneau & Pepin, 2015;Harmsen et al, 2005;Lucas et al, 2008;May & Potia, 2013;Owiti et al, 2014;Stanhope et al, 2008;Tayab & Narushima, 2015;Wall et al, 2013). The fourth consequence is effective interaction, which results from healthcare providers applying their cultural skills in communicating with clients (Carpenter & Garcia, 2012;Carpenter-Song et al, 2007;Foronda, 2008;Garneau & Pepin, 2015;Garran & Werkmeister Razas, 2013;Harmsen et al, 2005;Lucas et al, 2008;Majumdar et al, 2004;May & Potia, 2013;Stanhope et al, 2008).…”