Interventions to improve cultural competency in healthcare: a systematic review of reviews

Abstract

BackgroundCultural competency is a recognized and popular approach to improving the provision of health care to racial/ethnic minority groups in the community with the aim of reducing racial/ethnic health disparities. The aim of this systematic review of reviews is to gather and synthesize existing reviews of studies in the field to form a comprehensive understanding of the current evidence base that can guide future interventions and research in the area.MethodsA systematic review of review articles published between January 2000 and June 2012 was conducted. Electronic databases (including Medline, Cinahl and PsycINFO), reference lists of articles, and key websites were searched. Reviews of cultural competency in health settings only were included. Each review was critically appraised by two authors using a study appraisal tool and were given a quality assessment rating of weak, moderate or strong.ResultsNineteen published reviews were identified. Reviews consisted of between 5 and 38 studies, included a variety of health care settings/contexts and a range of study types. There were three main categories of study outcomes: patient-related outcomes, provider-related outcomes, and health service access and utilization outcomes. The majority of reviews found moderate evidence of improvement in provider outcomes and health care access and utilization outcomes but weaker evidence for improvements in patient/client outcomes.ConclusionThis review of reviews indicates that there is some evidence that interventions to improve cultural competency can improve patient/client health outcomes. However, a lack of methodological rigor is common amongst the studies included in reviews and many of the studies rely on self-report, which is subject to a range of biases, while objective evidence of intervention effectiveness was rare. Future research should measure both healthcare provider and patient/client health outcomes, consider organizational factors, and utilize more rigorous study designs.

Cultural competence of pre-licensure nursing faculty

“…4.2 Differences in cultural competency scores based on demographic variables CC was not found to be related to demographic differences, which is consistent with Campinha-Bacote's (2006) model and theory (Liu, 2013;Truong, Paradies, & Priest, 2014). [16,27,28] Campinha-Bacote's theory is based on the idea that CC is a journey and an ongoing process rather than something that can be obtained through certain criteria or meeting specific requirements on a checklist.…”

“…[16,27,28] Campinha-Bacote's theory is based on the idea that CC is a journey and an ongoing process rather than something that can be obtained through certain criteria or meeting specific requirements on a checklist. [29,30] Part of the journey and ongoing process to CC is through education.…”

Changing the ward culture in a clinic during the implementation of person-centred care

“…[29] The inner diversity of cultures is considered to contribute to conflicts that are important in the development of change processes. [30] A diversity of organizational cultures has been identified in health-care settings and has been shown to improve communication, collaboration and co-ordination of activities. [31,32] Xiao et al [33,34] described, for example, how integrative cultural components have supported rapid and dynamic collaboration in hospital teams.…”

Incorporando a Competência Cultural para Atenção à Saúde Materna em População Quilombola na Educação das Profissões da Saúde

“…As revisões de literatura explicitam a falta de uniformidade nas definições e matrizes de competências culturais nas diferentes áreas de atenção à saúde 23 . Essa falta de consenso na definição e avaliação da competência cultural pode contribuir para a heterogeneidade das intervenções e a falta de detalhamento sobre os componentes da competência cultural, especialmente para as intervenções de desenvolvimento da competência, embora as limitações de contagem de palavras também possam restringir o relato de adaptação cultural em detalhes.…”