Assessing cultural competency among Canadian chiropractors: a cross-sectional survey of Canadian Chiropractic Association members

Abstract

Background There is a paucity of research assessing cultural competency among Canadian chiropractors. Therefore, the aims of this study were to (1) measure cultural competency among Canadian chiropractors, (2) understand chiropractors’ perspectives of challenges and attitudes regarding the delivery of chiropractic services to equity-seeking communities, and (3) assess contextual factors associated with cultural competency. Methods We conducted a cross-sectional survey of members of the Canadian Chiropractic Association (CCA) (May–July 2021). The survey instrument consisted of 57 questions related to demographics, cultural competency, perceptions about health disparities, and challenges in delivery of rehabilitation. Cultural competency was measured using the Cultural Awareness and Sensitivity and Cultural Competence Behaviours subscales of the Cultural Competence Assessment Instrument. We conducted a multivariate linear regression to assess factors that may be associated with cultural competency. Results A total of 3143 CCA members responded (response rate of 41%). Mean scores for the Cultural Awareness and Sensitivity subscale were 5.8/7 (95% CI 5.7; 5.8) and 4.2/7 (95% CI 4.1; 4.2) for the Cultural Competence Behaviour subscale. Most chiropractors (72–78%) reported observing important cultural health disparities across various care-related outcomes. Cost of services and language were identified as barriers to providing care to equity-seeking communities. Cultural Awareness and Sensitivity scores were weakly associated with gender (men), years of clinical practice, cultural health disparities, the statement “I think some people have an agenda to look for discrimination even where it does not exist (DEI attitudes),” race (Caucasian), and prior DEI training, (R2 = 0.15, p < 0.0001). Cultural Competence Behaviour scores were weakly associated with race (Caucasian), cultural health disparities, prior DEI training, increased years of clinical experience, and higher Cultural Awareness and Sensitivity scores (R2 = 0.19, p < 0.0001). Conclusion This study provides the first description of cultural competency within the chiropractic profession in Canada. Findings suggest a gap between knowledge and behaviour and uncover several barriers and challenges that may inform the development of profession-specific training in cultural competence.

Overcoming barriers to equality, diversity, inclusivity, and sense of belonging in healthcare education: the Underrepresented Groups’ Experiences in Osteopathic Training (UrGEnT) mixed methods study.

“…This study focused on assessing levels of cultural humility in student osteopaths, but ndings indicated that experiences of discrimination were often associated with lack of awareness or negative attitudes among staff, suggesting that staff training is urgently required. Similar ndings were found in Bakaa et al (49) who surveyed cultural competence in a sample of 3,000 chiropractors and suggested that gaps between knowledge and self-reported behaviour required further research to clarify barriers and guide future training.…”

The top 100 highly cited articles on neck pain: A bibliometric analysis

“…Cassidy, J. David from the University of Toronto, researches the epidemiology and risk factors of NP [ 44 ]. Cote Pierre, from the University of Ontario Institute of Technology, investigates the prevalence of NP, the efficacy of manual interventions, and the relationship between NP, depression, and anxiety [ 34 , 45 , 46 ]. Disc degeneration's association with NP [ 47 ], as well as the prevalence of NP, whiplash injury, physical therapy, manual therapy, randomized controlled studies, and systematic reviews, are important keywords in this field.…”