2003
DOI: 10.1016/s0033-3549(04)50253-4
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Defining cultural competence: a practical framework for addressing racial/ethnic disparities in health and health care

Abstract: Demographic changes anticipated over the next decade magnify the importance of addressing racial/ethnic disparities in health and health care. A framework of organizational, structural, and clinical cultural competence interventions can facilitate the elimination of these disparities and improve care for all Americans.

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Cited by 1,266 publications
(867 citation statements)
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References 55 publications
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“…Formal teaching and training of patientcentered approaches to cross-cultural care, based on assessing core cross-cultural issues, exploring meaning of illness to patient, determining patient's lived social context, and negotiating adherence to recommendations and treatments, is being implemented in many countries [76,77,85]. To be effective, individual cultural competence must be accompanied by the establishment of culturally competent health care systems with the capacity to adapt their services to meet the culturally unique needs of their patients, also through the involvement of their different communities [85,86].…”
Section: The Cultural Dimension Of Supportive Care In Cancermentioning
confidence: 99%
“…Formal teaching and training of patientcentered approaches to cross-cultural care, based on assessing core cross-cultural issues, exploring meaning of illness to patient, determining patient's lived social context, and negotiating adherence to recommendations and treatments, is being implemented in many countries [76,77,85]. To be effective, individual cultural competence must be accompanied by the establishment of culturally competent health care systems with the capacity to adapt their services to meet the culturally unique needs of their patients, also through the involvement of their different communities [85,86].…”
Section: The Cultural Dimension Of Supportive Care In Cancermentioning
confidence: 99%
“…Cultural variations in patient's health beliefs, values, preferences, and behaviors affect the recognition of symptoms, the threshold for seeking care, the willingness and ability to communicate and explain symptoms, the understanding of standard information about diagnosis, prognosis and treatment options, the trust in different professionals, and the adherence to prescribed treatments [3,4,31]. Cultural competence is, therefore, especially needed in the practice of oncology.…”
Section: Culture and Cultural Competence In Oncologymentioning
confidence: 99%
“…A culturally competent health care system must also consider social, racial, and cultural factors in their separateness and yet in their reciprocal influences. Studies suggest that culturally competent health care leads to improved therapeutic outcome and may decrease disparities in medical care [4,34,63]. Teaching cultural competence to western medical student and young oncologists involves the provision of relevant information about different cultures with respect to different health issues, such as different cultural practices of truth telling or different decision-making styles throughout the world [59].…”
Section: Culture and Cultural Competence In Oncologymentioning
confidence: 99%
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“…The incorporation of culturally and linguistically competent values, policy, structures, and practices in health care systems remains a great challenge for many states and communities even though there is a growing body of evidence that validates cultural and linguistic competence as effective interventions in the goal to eliminate racial and ethnic health disparities and in the provision of quality care [16,[21][22][23]. As such, "translating this evidence" into policy and practice continues to be a significant barrier for organizations, programs, and personnel concerned with health care delivery, education, and advocacy [24][25][26][27][28].…”
Section: Policy and Program Responsesmentioning
confidence: 99%