Cultural competence: A systematic review of health care provider educational interventions

Mary Catherine Beach, Eboni G. Price, Tiffany L. Gary, Karen A. Robinson, Aysegul Gozu, Ana M Palacio, Carole Smarth, Mollie W. Jenckes, Carolyn Feuerstein, Eric B. Bass, Neil R. Powe, Lisa A. Cooper

Research output: Contribution to journalArticle

467 Citations (Scopus)

Abstract

Objective: We sought to synthesize the findings of studies evaluating interventions to improve the cultural competence of health professionals. Design: This was a systematic literature review and analysis. Methods: We performed electronic and hand searches from 1980 through June 2003 to identify studies that evaluated interventions designed to improve the cultural competence of health professionals. We abstracted and synthesized data from studies that had both a before- and an after-intervention evaluation or had a control group for comparison and graded the strength of the evidence as excellent, good, fair, or poor using predetermined criteria. Main Outcome Measures: We sought evidence of the effectiveness and costs of cultural competence training of health professionals. Results: Thirty-four studies were included in our review. There is excellent evidence that cultural competence training improves the knowledge of health professionals (17 of 19 studies demonstrated a beneficial effect), and good evidence that cultural competence training improves the attitudes and skills of health professionals (21 of 25 studies evaluating attitudes demonstrated a beneficial effect and 14 of 14 studies evaluating skills demonstrated a beneficial effect). There is good evidence that cultural competence training impacts patient satisfaction (3 of 3 studies demonstrated a beneficial effect), poor evidence that cultural competence training impacts patient adherence (although the one study designed to do this demonstrated a beneficial effect), and no studies that have evaluated patient health status outcomes. There is poor evidence to determine the costs of cultural competence training (5 studies included incomplete estimates of costs). Conclusions: Cultural competence training shows promise as a strategy for improving the knowledge, attitudes, and skills of health professionals. However, evidence that it improves patient adherence to therapy, health outcomes, and equity of services across racial and ethnic groups is lacking. Future research should focus on these outcomes and should determine which teaching methods and content are most effective.

Original languageEnglish
Pages (from-to)356-373
Number of pages18
JournalMedical Care
Volume43
Issue number4
DOIs
StatePublished - Apr 1 2005
Externally publishedYes

Fingerprint

Cultural Competency
Health Personnel
health care
health professionals
evidence
Attitude to Health
Health
Patient Compliance
costs
study attitude
Costs and Cost Analysis
teaching content
Patient Satisfaction
teaching method
Ethnic Groups
Health Status
health status
Cost-Benefit Analysis
Teaching
ethnic group

Keywords

  • Cultural competence
  • Health disparities
  • Race/ethnicity

ASJC Scopus subject areas

  • Nursing(all)
  • Public Health, Environmental and Occupational Health
  • Health(social science)
  • Health Professions(all)

Cite this

Beach, M. C., Price, E. G., Gary, T. L., Robinson, K. A., Gozu, A., Palacio, A. M., ... Cooper, L. A. (2005). Cultural competence: A systematic review of health care provider educational interventions. Medical Care, 43(4), 356-373. https://doi.org/10.1097/01.mlr.0000156861.58905.96

Cultural competence : A systematic review of health care provider educational interventions. / Beach, Mary Catherine; Price, Eboni G.; Gary, Tiffany L.; Robinson, Karen A.; Gozu, Aysegul; Palacio, Ana M; Smarth, Carole; Jenckes, Mollie W.; Feuerstein, Carolyn; Bass, Eric B.; Powe, Neil R.; Cooper, Lisa A.

In: Medical Care, Vol. 43, No. 4, 01.04.2005, p. 356-373.

Research output: Contribution to journalArticle

Beach, MC, Price, EG, Gary, TL, Robinson, KA, Gozu, A, Palacio, AM, Smarth, C, Jenckes, MW, Feuerstein, C, Bass, EB, Powe, NR & Cooper, LA 2005, 'Cultural competence: A systematic review of health care provider educational interventions', Medical Care, vol. 43, no. 4, pp. 356-373. https://doi.org/10.1097/01.mlr.0000156861.58905.96
Beach, Mary Catherine ; Price, Eboni G. ; Gary, Tiffany L. ; Robinson, Karen A. ; Gozu, Aysegul ; Palacio, Ana M ; Smarth, Carole ; Jenckes, Mollie W. ; Feuerstein, Carolyn ; Bass, Eric B. ; Powe, Neil R. ; Cooper, Lisa A. / Cultural competence : A systematic review of health care provider educational interventions. In: Medical Care. 2005 ; Vol. 43, No. 4. pp. 356-373.
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