Development of a Cultural Competence Assessment Instrument

2003 ◽  
Vol 11 (1) ◽  
pp. 29-40 ◽  
Author(s):  
Stephanie Myers Schim ◽  
Ardith Z. Doorenbos ◽  
June Miller ◽  
Ramona Benkert

This article describes initial testing of an instrument designed to provide evidence of cultural competence among health care providers and staff. The Cultural Competence Assessment (CCA) instrument was based on a model describing cultural competence components (fact, knowledge, attitude, and behavior). Content and face validity were confirmed through expert panel review, subject feedback, and field-testing. The CCA was administered to an interdisciplinary health care team in a community hospice setting. Preliminary findings suggest that the CCA performed well. Internal consistency reliability for the scale was 0.92. Construct validity by factor analysis demonstrated that 25 items had loadings above 0.42. Construct validity was supported with a significant correlation to the widely used Inventory for Assessing the Process of Cultural Competence among Health care Professionals (IAPCC). Validity also was supported by significant differences between individuals with different educational levels and prior diversity training. The CCA is a promising tool to measure cultural competence in populations with a wide range of educational levels and backgrounds.

2016 ◽  
Vol 39 (6) ◽  
pp. 784-802 ◽  
Author(s):  
Adel F. Almutairi ◽  
V. Susan Dahinten

Cultural diversity in health care settings can threaten the well-being of patients, their families, and health care providers. This psychometric study evaluated the construct validity of the recently developed four-factor, 43-item Critical Cultural Competence Scale (CCCS) which was designed to overcome the conceptual limitations of previously developed scales. The study was conducted in Canada with a random sample of 170 registered nurses. Comparisons with the Cultural Competence Assessment instrument, Scale of Ethnocultural Empathy, and Cultural Intelligence Scale provided mixed evidence of convergent validity. Modest correlations were found between the total scale scores suggesting that the CCCS is measuring a more comprehensive and conceptually distinct construct. Stronger correlations were found between the more conceptually similar subscales. Evidence for discriminant validity was also mixed. Results support use of the CCCS to measure health care providers’ perceptions of their critical cultural competence though ongoing evaluation is warranted.


2007 ◽  
Vol 68 (2) ◽  
pp. 81-85 ◽  
Author(s):  
Wendy Gamblen ◽  
Sherri Schamehorn ◽  
Anne Marie Crustolo ◽  
Tracy Hussey ◽  
Nick Kates ◽  
...  

The Hamilton Health Service Organization Nutrition Program integrates nine registered dietitians (RDs) into the offices of 80 family physicians (FPs) at 50 sites in Hamilton, Ontario. The program is based on a shared care model, in which FPs and RDs work collaboratively to provide nutrition services aimed at prevention, treatment, and management of nutrition-related problems. In addition to their clinical role, dietitians in the program are involved in health promotion, disease prevention and early intervention strategies, interdisciplinary collaboration, building links with community services, and research. The RDs’ specialized knowledge, skills, and experience allow them to provide a wide range of services that complement and augment those of the FP. This model is consistent with Canadian health care reform recommendations and offers significant benefits for both health care providers and consumers.


1998 ◽  
Vol 3 (1) ◽  
pp. 50-57 ◽  
Author(s):  
Sandra Nutley ◽  
Peter C. Smith

Objectives: Increasingly health care performance data are being disseminated in the form of ‘league tables' of health care providers, with the implication that such publication helps purchasers select the better providers, and spurs providers into improvements. This paper examines progress to date. Methods: Three stages of the league table process are considered: measurement, analysis and action. Results: A wide range of measurement schemes are now in place, although the emphasis has been on process variables and mortality as a measure of outcome. Several analytical techniques have been deployed to help users make sense of league tables, and to help determine the causes of variations in reported performance. The weakest aspect of current methods relates to the use to which such analysis is put. Conclusions: A haphazard approach to using league table data exists, with few reports on the impact of publication. A variety of directions for future research into the use of performance data are needed.


2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Jane Holstein ◽  
Gunilla M. Liedberg ◽  
Yolanda Suarez-Balcazar ◽  
Anette Kjellberg

Based on the increasing diversity of Swedish society, health professionals, like occupational therapists, find it challenging to provide culturally competent services to international clients. Consequently, cultural competence among professionals needs to be measured and improved using psychometrically tested instruments. This study examines the clinical relevance, construct validity, and reliability of the Swedish version of the Cultural Competence Assessment Instrument among Swedish occupational therapists. Material and Methods. A randomised sample of 312 Swedish occupational therapists answered a survey based on the Swedish version of the Cultural Competence Assessment Instrument with supplementary questions on the clinical relevance of the instrument. Descriptive statistics were used to examine the clinical relevance of the Swedish version of the Cultural Competence Assessment Instrument. Factor analyses, both exploratory and confirmatory, were run to examine the factor structure. Cronbach’s alpha was performed to assess the internal consistency of the instrument. Results. The participants reported that the 24 items had high clinical relevance. The validation yielded a three-factor model: openness and awareness, workplace support, and interaction skills. All three of these factors showed high loadings. Conclusions. The study results indicated positive clinical relevance and psychometric properties for the Swedish version of the Cultural Competence Assessment Instrument and strong support to be utilised in Sweden. The implications of this study are important given the rapid growth in migration over the last few decades. A self-rating instrument measuring cultural competence could support occupational therapists’ professional knowledge and development when they interact with international clients. As the tool was originally developed in English in the United States, the feedback from the Swedish version could potentially be useful for the instrument in modified form and for use by occupational therapists in English-speaking countries.


2019 ◽  
Author(s):  
Jing Liu ◽  
Shengchao Hou ◽  
Richard Evans ◽  
Chenxi Xia ◽  
Weidong Xia ◽  
...  

BACKGROUND Complaints made online by patients about their health care experiences are becoming prevalent because of widespread worldwide internet connectivity. An a priori framework, based on patient centeredness, may be useful in identifying the types of issues patients complain about online across multiple settings. It may also assist in examining whether the determinants of patient-centered care (PCC) mirror the determinants of patient experiences. OBJECTIVE The objective of our study was to develop a taxonomy framework for patient complaints online based on patient centeredness and to examine whether the determinants of PCC mirror the determinants of patient experiences. METHODS First, the best fit framework synthesis technique was applied to develop the proposed a priori framework. Second, electronic databases, including Web of Science, Scopus, and PubMed, were searched for articles published between 2000 and June 2018. Studies were only included if they collected primary quantitative data on patients’ online complaints. Third, a deductive and inductive thematic analysis approach was adopted to code the themes of recognized complaints into the framework. RESULTS In total, 17 studies from 5 countries were included in this study. Patient complaint online taxonomies and theme terms varied. According to our framework, patients expressed most dissatisfaction with patient-centered processes (101,586/204,363, 49.71%), followed by prerequisites (appropriate skills and knowledge of physicians; 50,563, 24.74%) and the care environment (48,563/204,363, 23.76%). The least dissatisfied theme was expected outcomes (3651/204,363, 1.79%). People expressed little dissatisfaction with expanded PCC dimensions, such as involvement of family and friends (591/204,363, 0.29%). Variation in the concerns across different countries’ patients were also observed. CONCLUSIONS Online complaints made by patients are of major value to health care providers, regulatory bodies, and patients themselves. Our PCC framework can be applied to analyze them under a wide range of conditions, treatments, and countries. This review has shown significant heterogeneity of patients’ online complaints across different countries.


2019 ◽  
Vol 29 (Supp2) ◽  
pp. 359-364 ◽  
Author(s):  
Brian McGregor ◽  
Allyson Belton ◽  
Tracey L. Henry ◽  
Glenda Wrenn ◽  
Kisha B. Holden

 Racial/ethnic disparities have long persisted in the United States despite concerted health system efforts to improve access and quality of care among African Americans and Latinos. Cultural competence in the health care setting has been recognized as an important feature of high-quality health care delivery for decades and will continue to be paramount as the society in which we live becomes increasingly culturally diverse. Unfortunately, there is limited empirical evidence of patient health benefits of a culturally competent health care workforce in integrated care, its feasibility of imple­mentation, and sustainability strategies. This article reviews the status of cultural competence education in health care, the merits of continued commitment to training health care providers in integrated care settings, and policy and practice strategies to ensure emerging health care professionals and those already in the field are prepared to meet the health care needs of racially and ethnically diverse populations. Ethn Dis. 2019;29(Supp 2):359-364. doi:10.18865/ed.29.S2.359


2018 ◽  
Vol 27 (3) ◽  
pp. 284-288 ◽  
Author(s):  
Miranda Brunett ◽  
René Revis Shingles

Clinical Scenario: The level of cultural competence of health care providers has been studied. However, limited scholarship has examined whether the cultural competence of the health care provider affects patient satisfaction. Focused Clinical Question: Does cultural competence of health care providers influence patient satisfaction with their experience with their provider? Summary of Key Findings: Having a culturally competent health care provider, or one who a patient perceives as culturally competent, does increase patient satisfaction. Clinical Bottom Line: Cultural competence in health care plays an important role in patients being satisfied with their providers, as well as patients willingly and actively participating in their treatment. Strength of Recommendation: Questions 1 to 5 and 9 of the critical appraisal skills program were answered “yes” for all studies in the critically appraised topic. Thus, the authors strongly support the findings.


2015 ◽  
Author(s):  
Giancarlo Cicolini ◽  
Carlo Della Pelle ◽  
Dania Comparcini ◽  
Marco Tomietto ◽  
Francesca Cerratti ◽  
...  

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Katherine Jefferson ◽  
Amber Armstrong-Izzard ◽  
JoAnne Arcand

Abstract Objectives To test the construct validity of the Sodium Advice Score (SAS). The SAS is a tool developed to measure the quality of brief advice provided by health care providers (HCP) about dietary sodium reduction. The validation of this tool will support its implementation in a behavioural intervention trial. Methods Thirty English speaking patients with a diagnosis of hypertension and no memory impairments were recruited from a primary care clinic in Ontario, Canada. Patients were randomized to a high quality dietary sodium advice group or to a low quality dietary sodium advice group. Each intervention was delivered by a registered dietitian and took no longer than 5–7 minutes for high quality advice and 1–2 minutes for low quality advice. After the dietary sodium advice was provided the patient completed the SAS tool (< 5 minutes). Frequency, type and duration of advice was assessed by the SAS tool, which had a maximum score of 16. Therefore, the high quality advice had an expected SAS score of 16. The low quality advice had an expected SAS score of 5. Results Patients included were 71.3 ± 7.9 years old and 53% were male. Overall, 43% and 47% of patients had received previous counseling from a dietitian and family doctor, respectively. Mean daily sodium intakes of 2593 ± 1403 mg/day and 3040 ± 2283 mg/day were similar between high and low quality advice groups. The mean SAS score was 6.9 ± 3.6 (range: 2 to 14) in the low quality advice group and 14.5 ± 1.5 (range: 10 to 16) in the high quality advice group. The high quality advice scores observed were statistically similar to the expected scores (P = 0.001), however the low advice scores were not. Overall, the low quality advice score was significantly lower than the high quality advice score (P < 0.000). Conclusions The SAS tool showed evidence of construct validity as it can differentiate between high and low quality sodium reduction advice provided by HCPs. It can be used as a valid tool for measuring quality of brief sodium reduction advice by HCPs in future research. Funding Sources Heart and Stroke Foundation of Canada.


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