Interventions to improve cultural competency in health care for Indigenous peoples of Australia, New Zealand, Canada and the USA: a systematic review

Abstract

There is a lack of evidence from rigorous evaluations on the effectiveness of interventions for improving cultural competency in health care for Indigenous peoples. Future evaluations should employ more rigorous study designs and extend their measurement of outcomes beyond those relating to health professionals, to those relating to the health of Indigenous peoples.

Cultural Competency Training and Education in the University-based Professional Training of Health Professionals: Characteristics, Quality and Outcomes of Evaluations

“…Consistent with previous reviews, a small number of published evaluations of cultural competency interventions were identified in the peer review literature and their methodological quality was less than optimal [6,7]. No evaluation studies from Canada or New Zealand were identified, despite these countries having accredited cultural competence training programs [27,28].…”

“…Although these requirements ensure that cultural competency is included in health and medical curricula, there is variation between health and medical schools in the content and delivery of this training [2,5]. Several reviews have examined the effects of cultural competence interventions on trained health professionals [6][7][8].…”

“…The findings of these reviews demonstrate that cultural competence training can be effective for improving health professionals' knowledge, attitudes and skills and patient satisfaction [6][7][8][9]. Despite the promise of cultural competency training, there has been little systematic evaluation of its potential impact when included in the university-based professional training of health professionals.…”

Eating in the City: A Review of the Literature on Food Insecurity and Indigenous People Living in Urban Spaces

“…as natural comparators in terms of Indigenous well-being..." because "these countries consistently place near the top of the United Nations Development Programme's Human Development Index (HDI) rankings, yet all have minority Indigenous populations with much poorer health and social conditions than their non-Indigenous compatriots". Various studies have compared some or all of these nations when examining Indigenous issues, including: social determinants of health [23]; rural food security [24]; culturally-competent health care practices [25]; lack of Indigenous participation in health research [26]; and disproportionate rates of urban homelessness for Indigenous peoples [27], yet there has not been a review of urban Indigenous food security that compares Indigenous experiences in Canada, the United States, and Australia. The Indigenous populations living in these three settler states face many of the same structural social, economic, and political inequalities that make them disproportionately vulnerable to food insecurity.…”

Practical Suggestions for Preventing Conflicts through a Better Understanding of Culture and Differences: Tips, Anecdotes, and the Impact of Public Events

“…The main purpose of the present article is to offer a pragmatic approach, based on personal experiences in cross-cultural research, [7][8][9][10] by sharing some tips, anecdotes, and the eventual impact on public events. Hopefully some of these personal hints might serve professionals and other readers interested in promoting a better dialogue between different cultures thus going a little way towards solving conflicts, preventing violence, and achieving peace through tolerance.…”