Abstract
To improve cultural competency. Graduate students participating in nutrition counseling courses. The Campinha-Bacote Model of Cultural Competence in the Delivery of Health Care Services was used to design, implement, and evaluate two graduate nutrition counseling classes. Five interdependent constructs of this model include cultural awareness, cultural knowledge, cultural skill, cultural encounter, and cultural desire. Cultural competence is influenced by working on any of these areas and strengthens the impact of the others. Each assignment and activity addressed one or more of the constructs of the model. Examples included participation in a simulation to stimulate self-awareness, using respondent driven interview questions to develop skills, and conducting a nutrition and cultural assessment of an individual addressed encounter. A repeated measure ANOVA evaluated pre- and post-test cultural competence scores (n=34). Content analysis assessed impressions of course effectiveness. The overall cultural competence score significantly improved (p<0.001) from “culturally aware” (68.7 at pre-) to “culturally competent” (78.7 at post-). Students significantly improved (p<0.001) four constructs of the model including awareness, knowledge, skill, and encounter. Factor analysis indicated course activities accounted for 83.2% and course assignments accounted for 74.6% of the total variance of cultural competence. An activity-based counseling course encouraging self-evaluation and reflection and addressing awareness, knowledge, skill, and encounters significantly improved cultural competence. Because factor analysis showed that activities and assignments aligned with the model constructs, the findings of this study can help guide health educators to design effective cultural competence training programs.
Highlights
Health care professionals need to learn cultural competency skills in order to provide effective care due to changing demographics [1], health care inequalities [2], regulatory agency mandates [3], increased use of complementary and traditional therapies [4], and the need to decrease the cost of health care [5]
Factor analysis indicated that course activities accounted for 83.2% and course assignments accounted for 74.6% of the total variance of cultural competence
Services Action Plan to Reduce Racial and Ethnic Disparities: A Nation Free of Disparities in Health and Health Care [45], “The ability of the healthcare workforce to address disparities will depend on its future cultural competence and diversity.”
Summary
Health care professionals need to learn cultural competency skills in order to provide effective care due to changing demographics [1], health care inequalities [2], regulatory agency mandates [3], increased use of complementary and traditional therapies [4], and the need to decrease the cost of health care [5]. Considerable population shifts have been occurring and are expected to continue in the United. According to the U.S Census Bureau, the United States has been moving toward a cultural plurality since the 1970s, where no single racial or ethnic group is a majority. By 2044, non-Hispanic whites will become less than 50% of the total population of the United States [1]. This population shift creates an array of health care challenges because each group has unique linguistic patterns, cultural characteristics, and health profiles. As of 2011, 22.4% of Americans spoke English “not well”
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