Psychometric Evaluation of the Cultural Competence Assessment Instrument Among Healthcare Providers

Abstract

b Background: The relevance of healthcare provider cultural competency to the achievement of goals for reduction in extant health disparities has been demonstrated; however, there are deficits with regard to cultural competency measurement. b Objectives: To examine the testYretest reliability of the cultural competence assessment instrument (CCA) among hospice providers, and to examine the reliability and validity of the CCA among healthcare providers in nonhospice settings. b Method: TestYretest reliability of the CCA was assessed using a sample of 51 hospice respondents who completed the CCA at two time points. The internal consistency reliability and construct validity of the CCA for healthcare providers in nonhospice settings were evaluated using a convenience sample of 405 healthcare providers.b Results: The CCA demonstrated adequate testYretest reliability (r = .85, p = .002) in hospice providers over 4 months. Among healthcare providers in nonhospice settings, the CCA had an internal consistency reliability of .89 overall (.91 and .75 for the two subscales). Construct validity was supported by principal axis factor analysis, which showed two factors with item loadings above .40, explaining 56% of the variance. Mean scores of the CCA were significantly higher for providers who reported previous diversity training compared to those who had not. b Discussion: Findings for the psychometric properties of the CCA supported its potential as an instrument for measuring provider cultural competence. Knowledge gained will be useful for developing future research studies and specific cultural competence intervention approaches for healthcare providers that may decrease health disparities. b

Cultural Competence and Psychological Empowerment Among Acute Care Nurses

“…Nurses with high perceptions of meaning in their work may be more motivated to become culturally aware and sensitive and develop the knowledge and behaviors required to meet patients' cultural-specific care needs. Having a passion for work that is personally meaningful may enhance the nurse's capacity for what Doorenbos, Schim, Benkert, and Borse (2005) describe as culturally attuned nursing, They describe this as the "complex interplay of sensitivity, knowledge, behaviors, and awareness" (Doorenbos et al, 2005, p. 325) that results in culturally congruent care. A sense of meaning in their work may facilitate the nurse's commitment to the ongoing process of becoming culturally competent.…”

Provider and clinic cultural competence in a primary care setting

“…Two strengths of the CCA are that it assesses self-report of actual behavior rather than self-efficacy for performing a behavior and it has been demonstrated to be reliable and valid (Doorenbos, Schim, Benkert, & Borse, 2005;Schim et al, 2005;Schim, Doorenbos, Miller, & Benkert, 2003). Items were selected from the CCA that had eigenvalue scores greater than .600 and that measured the adaptation of care to meet the needs and expectations of diverse patients.…”

Factor Structure of Almutairi’s Critical Cultural Competence Scale

“…First, the items are written at an advanced reading level that can pose difficulties for a multidisciplinary healthcare team where members have varying levels of fluency in the language of the questionnaire and varying levels of education, such as with the items that ask about "ethnic pharmacology" and "anatomical and physiological variations." The second limitation pertains to the multiple response formats used for the 20-item instrument, which can pose difficulties when transitioning from one response format to another [13]. The CCCS was developed to overcome these aforementioned limitations.…”