Culturally Sensitive Interventions in Pediatric Primary Care Settings: A Systematic Review

Abstract

CONTEXT: Culturally sensitive interventions in the pediatric primary care setting may help reduce health disparities. Less is known on the development of these interventions, their target groups, and their feasibility, acceptability, and impact on health outcomes. OBJECTIVE: We conducted a systematic review to describe culturally sensitive interventions developed for the pediatric primary care setting. DATA SOURCES: PubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature, and PsycInfo (January 2000 to July 2020). STUDY SELECTION: Studies were eligible for inclusion if they were (1) original research on an intervention with an evaluation, (2) within a pediatric primary care setting, (3) not limited to education for providers, (4) not limited to interpreter use, and (5) based in the United States. DATA EXTRACTION: The following were extracted: study topic, study design, intervention, cultural sensitivity strategies and terminology, setting, target group, sample size, feasibility, acceptability, and health outcomes. RESULTS: Twenty-five studies described 23 interventions targeting a variety of health topics. Multiple cultural sensitivity strategies were used, most commonly sociocultural (83%). Most interventions (57%) were focused on Hispanic/Latino families. Interventions were generally reported as being feasible and acceptable; some also changed health outcomes. LIMITATIONS: Small samples and heterogenous methods subject to bias were used. Relevant articles may have been missed because of the variety of terms used to describe cultural sensitivity. CONCLUSIONS: The included articles provide preliminary evidence that culturally sensitive interventions can be feasible and effective and may help eliminate disparities for patients from communities with barriers to equitable care.

Impact of the Relational, Built, Community, and Policy/Political Environments on Immigrant Child Health: A Narrative Review

“…It is critical to remember that establishing a trusting therapeutic relationship over time and multiple visits is the cornerstone of effectively partnering with families of FGIC to help families adjust to their new environments. It is also imperative to continually incorporate cultural humility, cultural safety, and cultural sensitivity into clinical care to reduce healthcare disparities [88][89][90].…”

Cultural values and parental psychology: A multilevel analysis from the Joint Effort Toddler Temperament Consortium.

“…Because culture remains a relatively stable influence throughout the individuals’ daily lives (Harkness & Super, 2021), clinical approaches should aim to foster understanding about a child’s, parent’s, and the family unit’s cultural background. Appreciating the degree to which individual members within the family identify with the values emphasized by the cultural group(s) of which they are members of is likely to support the therapeutic alliance (Asnaani & Hofmann, 2012), potentially improving health outcomes and reducing health disparities (Okoniewski et al, 2022). For instance, differences between cultural groups with respect to stigmatization of mental health diagnoses and treatment would be important to consider when addressing parental psychology clinically (Abdullah & Brown, 2011; Misra et al, 2021).…”

Feeding, television, and sleep behaviors at one year of age in a diverse sample

“…Healthcare providers have implicit biases, and racial and ethnic minorities often experience inequities in the healthcare system [ 35 ]. It is important to strive for culturally sensitive care and communication with all families [ 36 ]. One area for potentially improved culturally effective messaging is around the transition to the sippy cup, as delayed transition is one risk factor for early childhood obesity [ 8 ].…”