Cultural Assessment Tool Research Articles

Development and validation of cultural competence assessment tool for healthcare professionals, India.

Culture influences an individual's perception of “health” and “sickness”. Therefore, cultural competence assessment of healthcare professionals is very important. Existing assessment scales have limited application in India due to the nation's rich cultural diversity and heterogeneous healthcare streams. This study was undertaken to develop and validate a cultural competence assessment tool for healthcare professionals in India. A cross-sectional study using convenience sampling was conducted following all standard steps among 290 healthcare professionals in India. Item reduction was followed by estimation of validity and reliability. Responses were recorded on a five-point Likert scale, ranging from strongly disagree to strongly agree. The resultant tool, named Cultural Competence Assessment Tool–India (CCT-I) showed an acceptable internal consistency (Cronbach's alpha =0.734). Inter-rater agreement was 81.43%. Face, content, and construct validity were demonstrated. There was no statistically significant difference in cultural competence between the healthcare streams based on years of clinical experience. There was statistically significant difference between streams of healthcare (p-value =0.009) and also between dentistry and Ayurveda groups (p-value = 0.003). This comprehensive tool can be used as the first step toward designing cultural competence training of healthcare manpower and the establishment of culturally sensitive healthcare organizations.

Spanish adaptation and validation of the Cultural Competence Assessment Tool (CCATool) for undergraduate nursing students.

To analyse and validate a contextually adapted version of the Papadopoulos' Cultural Competence Assessment Tool (CCATool) for Spanish undergraduate nursing students. Globalization has driven and intensified international migration. Thus, nurses must treat patients of many different cultural origins. Accordingly, both cultural competence and an appropriate tool with which to evaluate it are required. The CCATool questionnaire was adapted for use in a Spanish context and was evaluated through a questionnaire completed by 262 undergraduate nursing students. Seven days later, the same students completed the questionnaire, without any intervention, and a subgroup of 144 students completed the questionnaire for a third time after taking a course in Transcultural Care. The reliability, sensitivity and stability of the questionnaire were assessed. The reliability of the questionnaire obtained an adequate Cronbach's alpha of 0.81. Stability was assessed at seven days, using the intraclass correlation coefficient, which showed good/excellent results. Moreover, the questionnaire was able to detect the changes related to the nursing educative programme, thus highlighting a good sensitivity of the tool. Cultural competence is an essential element of nurses' education, and instruction in this area should begin as soon as possible. In addition, an appropriate evaluation system is required. For this purpose, the present study describes and analyses a valid, reliable tool for use with undergraduate nursing students in Spain. Health and education policies must be sensitive to the ethnic and cultural differences of the patients who are cared for, and address the situations that cause difficulties in care. Hospitals and health centres must offer good care to patients from diverse cultures, so one of the necessary situations is the training and evaluation of the cultural competence of health professionals.

Validity And Reliability of the Turkish Version of the Cultural Competence Assessment Tool in Nursing Students

Objective: Increased cultural diversity in society like Turkey is becoming increasingly important to give a holistic nursing care to meet cultural requirements. It is important to assess cultural competence in order to provide appropriate care for cultural needs. The purpose is to adapt the Cultural Competence Assessment Tool (CCATool) for nursing students into the Turkish language and to determine its validity and reliability. Methods: A total of 400 nursing students were included in the methodological study in Ankara, Turkey. In the validity study of the CCATool were performed language validity, content validity, construct validity, tool response bias and in the reliability study were performed test-retest reliability and internal consistency analysis. Results: In the content validity analysis the Item Content Validity Index was .91 and the Scale Content Validity Index was .90. The tool Cronbach's α value is .876 and the Cronbach's α values of the sections vary between .706-.821. The scale was determined there is a statistically positive relationship between test-repeat test score averages of the scale. Conclusions: The results showed that CCATool adapted to Turkish is a valid and reliable scale in determining the cultural competence level of nursing students.

Nursing Student and Faculty Perceptions of Just Culture

Just culture is essential for quality improvement and patient safety. This descriptive study measured perceptions of just culture among nursing students and faculty using the Just Culture Assessment Tool for Nursing Education (JCAT-NE). There were no significant differences in JCAT-NE scores for students (M = 133.43, SD = 19.12) and faculty (M = 136.34, SD = 22.73) (t[159] = 0.82, p = .42); however, there were significant differences in JCAT-NE scores based on level of experience. For students, JCAT-NE scores were significantly higher for sophomores than for seniors (F[2, 114] = 4.9, p = .01). For faculty, advanced beginner and competent faculty had significantly higher scores compared with proficient and expert faculty (t[42] = 2.36, p = .02). More needs to be done to establish a fair and just culture in schools of nursing. [J Nurs Educ. 2022;61(5):257-260.].

Interprofessional Simulation as an Educational Tool to Assess Cultural Competence Among Health Professions Students.

The concept of collaborative practice within health professions is viewed as "best practice." Poor collaboration can adversely affect patient safety. Interprofessional (IP) teamwork skills can be developed and nurtured through the health professionals' education; however, many barriers exist, which deter this from occurring. A lack of cultural diversity exposure within the healthcare setting can result in treatment disparities and place the patient at risk. One healthcare area that has gained considerable interest is the practitioners' understanding of multiculturalism and how cultural competence subsequently influences health disparities. This study examined the application of culturally complex clinical simulation scenarios that intentionally integrated IP teamwork and hypothesized that participants' understanding of cultural competence would improve. Participants were junior-level nursing, bachelor-level social work, graduate-level occupational therapy, and PharmD students (N = 180) who participated in an IP simulation exercise composed of culturally complex clinical scenarios performed by trained standardized patients designed to demonstrate underrepresented populations with diverse religious/spiritual, sexual orientation, racial/ethnic, socioeconomic, psychosocial, and geographic characteristics. Survey tools included an adapted Multicultural Awareness, Knowledge, and Skills Survey (MAKSS) and the Cultural Awareness Assessment Tool (CAAT). Descriptive statistical analyses were conducted to describe the sample population with the use of inferential statistics to analyze the MAKSS and CAAT scores using a statistical significance level of 0.05. Data were analyzed using SPSS v25 using paired t tests to compare pretest-posttest results. Results showed that there was a statistically significant increase in MAKSS and CAAT scores from presimulation to postsimulation. The findings also suggest that participation in this type of exercise may have increased self-assessment of cultural awareness and multicultural awareness, knowledge, and skills among health professions students. This study described the planning and execution of a large multiple scenario simulation event that involved 180 students spanning 5 healthcare disciplines. Findings demonstrated that the IP simulation event improved the students' self-assessment of multicultural awareness, knowledge, and skills as well as their own cultural awareness. The exploration of cultural competence and humility should be a priority for simulation-based learning.

A Systematic Review of Assessment Tools Measuring Cultural Competence Outcomes Relevant to Pharmacy Education

Objective. To identify and describe validated assessment tools that measure cultural competence and are relevant to pharmacy education.Methods. A systematic approach was used to identify quantitative cultural competence assessment tools relevant to pharmacy education. A systematic search of the literature was conducted using the OVID and EBSCO databases and a manual search of journals deemed likely to include tools relevant to pharmacy education. To be eligible for the review, the tools had to be developed using a study sample from the United States, have at least one peer-reviewed validated publication, be applicable to the pharmacy profession, and be published since 2010.Results. The systematic literature and manual search identified 27 tools. Twelve assessment tools met the criteria to be included in the summary and their relevancy to pharmacy education is discussed.Conclusion. A review of literature demonstrates that assessment tools vary widely and there is no one tool that can effectively assess all aspects of cultural competence in pharmacy students or the Doctor of Pharmacy curriculum. As cultural competence is a priority within the accreditation standards for pharmacy education, PharmD programs are encouraged to develop additional tools that measure observed performance.

The forest is clothing for the ancestors: A rapid cultural assessment tool for forest landscape restoration policy processes

Restoration of degraded lands and ecosystems is one of the largest challenges of our times. Many countries are making pledges to restore their lands and use the Restoration Opportunities and Assessment Methodology (ROAM) to prioritise restoration as part of their work on Forest Landscape Restoration (FLR). In FLR, the integration of cultural knowledge is acknowledged. However, despite some excellent examples, and calls for more integration, practical guidance on how to achieve this has been lacking. In order to address this gap in the context of ROAM, a rapid cultural assessment tool of 10 questions was developed for ROAM practitioners to bring cultural perspectives into participatory restoration planning and policy processes. In this paper, we (1) provide the 10 questions tool that was developed and tested during ROAM assessments in Malawi and Mozambique, and (2) discuss the impact of the tool in ROAM processes in each country and regionally, including through interviews with practitioners and with an expansion to coastal and marine ecosystems. The questions have since become part of ROAM training modules and been taken up in other ROAM processes. The application of the 10 questions highlighted different ways in which the questions could bring culture into FLR practice: sensitizing participants in policy processes to the cultural dimension of land and ecosystem restoration, opening space for cultural inputs and raising cultural voices seldom heard in technical policy dialogues, providing specific information on culture and cultural institutions to enhance the policy processes, and generating information of relevance to landscape level ‘on the ground’ restoration actions. The article ends with suggestions for improving the method and for conceiving of new cultures of restoration, bringing experiences from the past and present together.

POSSIBILITIES FOR ADAPTING SECURITY CULTURE MODEL AND ASSESSMENT TOOL FOR THE CORPORATE SECTOR

Each organization forms a unique organizational culture in accordance with the intentions and behavior of management, social and business environment in which it operates, the characteristics of employees, the presence of subcultures, etc. The characteristics of the organizational culture that are relevant to security form the security culture in that organization. It is important to implement security culture model and assessment tools for proper management of the human factors involved in security. This article explores the possibilities to adapt the existing models of security culture and the tools for its assessment for the needs of corporate sector.

Aboriginal and Torres Strait Islander Subjects in a Graduate Diploma of Midwifery: A pilot study

Background: Australian Nursing and Midwifery Accreditation Council prescribes midwifery accreditation standards that support students’ development in Aboriginal and Torres Strait Islander Health and cultural safety to be deemed practice ready. However, the impact of training programmes are not widely explored. Aim: This study aimed to assess the impact of a mandatory 8-week online subject focussed on the development of culturally safe practices among midwifery students. Methods: The Ganngaleh nga Yagaleh cultural safety assessment tool was used to collect online quantitative data from post graduate midwifery students at the commencement and completion of an online subject. Results: Through a purposive sample (n = 10) participant perceptions of culturally safe practices remained relatively unchanged, except for three items of the Ganngaleh nga Yagaleh cultural safety assessment tool. Discussion: Findings demonstrate that when post graduate midwifery students are exposed to Aboriginal and Torres Strait Islander perspectives of Australia’s colonial history it impacts their sense of optimism, personal values and beliefs about the healthcare they will provide to Aboriginal and Torres Strait Islander peoples. However, midwifery students who self-identified as Aboriginal and/or Torres Strait Islander people, reported a decline in optimism when imagining a healthcare system free of racism. Conclusion: The subject did not impact on cultural safety scores. This may be due to prior learning of student midwives. Educators should consider building on prior knowledge in post graduate midwifery to ensure the content is contextualised to midwifery.

Awareness of Nurses Regarding Culturally Competent Care in Hospitals of Punjab: Cross Sectional Study

Background: Nursing profession is one of the professions which is continuously developing and uniformly acclimatizing to not only new medical treatments and expansions but also adapting the socio-cultural norms and expectations. Aim: To analyze the level of nurses’ awareness regarding culturally competent care in three selected hospitals of Punjab. Study design: Cross-sectional study. Methodology: Study setting was public hospitals of Punjab-Pakistan after ethical review committee’s (ERC) approval. Data was collected from nurses (n=133) by using self-administered questionnaire that was adapted from cultural awareness assessment tool. They were selected from three hospitals through non-probability convenient sampling technique. Statistical analysis: Data was analyzed by using SPSS version-20. To summarize the results, mean ± SD, frequencies, percentages and graphs were used. Results: Overall average score of cultural competence was 24.31 ± 3.457 which was on the lower side. Scores of Muzaffar Garh nurses was statistically significantly higher than both hospitals (p-value <0.001). This variation is due to years of experience (4-6 years) of nurses in Muzaffar Garh. Perhaps, comparatively long period of experience made them aware of the cultural practices of the people. Conclusion: We concluded that frequent and long-term interaction of nurses with patient which may help nurses in developing understanding of client’s culture because novice nurses are not able to understand point of view of the patients with diverse culture as they are not prepared to deal with the problems of cultural diversity. Keywords: Nursing Profession, Cultural Norms, Trans-cultural Nursing Care and Awareness.

Cross-cultural Adaptation and Validation of Patient Safety Culture Assessment Tool for Clinical Staff in Kazakhstan

BACKGROUND: Modern healthcare systems lack empirical models and appropriate tools to evaluate the safety culture, which encourages the need for their development. The national healthcare system of Kazakhstan has no empirically tested robust tools to evaluate the safety culture. AIM: The present paper aims at performing translation, cross-cultural adaptation, and validation of the “Patient safety culture” tool (from here – the tool) as a means for evaluating safety culture in healthcare establishments of the Republic of Kazakhstan. METHODS: The study design was cross-sectional. The original “Patient safety culture” tool is an integrated evaluation framework consisting of 7 scales and 62 items (6 general questions and 56 targeted questions) and reflecting different aspects of risk-related components of safety culture. The Cronbach’s alpha coefficient ranging from 0.0 to 1.0 was used to measure the internal consistency of the tool. To evaluate the tool’s reproducibility, we performed a test-retest assessment after 15 days and evaluated it using Pearson’s correlation coefficient. RESULTS: The overall Cronbach’s alpha for different scales ranged from 0.27 to 0.75. Subscales “Safety procedures” and “Safety Training” had the lowest coefficients. At test-retest, the Pearson’s correlation coefficient ranged from 0.934 to 0.969 among the scales. CONCLUSION: The study is dedicated to cross-cultural adaptation and validation of the “Patient safety culture” tool and describes the development of a translation protocol with subsequent cognitive debriefing and field testing. The field testing helped to confirm good validity, reliability, and reproducibility. The tool might undergo additional modification after further testing.

Perception of just culture and its association with work-related psychosocial factors in an Iranian industrial setting: Implications for prevention of errors.

A just culture is one in which the reporting of errors and near misses is supported without fear of retribution. The relationship of just culture and psychosocial factors at work has not been explored sufficiently in the literature. To investigate the perception of just culture and its association with socio-demographic and work-related psychosocial factors among 302 employees in an industrial setting in Iran. Just culture was assessed using the Just Culture Assessment Tool, and the Copenhagen Psychosocial Questionnaire was used for evaluation of psychosocial work factors (including influence at work, meaning of work, commitment to the workplace, predictability, rewards, quality of leadership, social support from supervisors, trust, and justice and respect). Data were analysed using t test, analysis of variance (ANOVA), and general linear regression analysis. The results indicated that the employees had a fairly positive view on their organisation's just culture, though there were some areas such as trust and balance that needed further attention. The psychosocial issues (particularly commitment to the workplace, meaning of work, social support from supervisors, and rewards) were not adequate from the employees' perspective. Predictability, rewards, and quality of leadership, were the significant psychosocial predictors of just culture in a multivariate regression model. The findings highlight the areas that need to be considered to improve the experience of organisational just culture, which is important from the point of view of prevention of safety errors and incidents.

Rethinking Race, Ethnicity, and the Assessment of Intercultural Competence in Higher Education

This qualitative study aims to explore the limitations of using a cultural assessment tool in higher education with the goal of preparing students to thrive in a highly demanding, diverse, and global community. Colleges and universities are potentially important sites of cross-cultural and cross-racial engagement and socialization, and cultural competence is arguably one of the critical skills that many higher education institutions are embracing to prepare students for our diverse, but increasingly polarized, global society. In particular, this study discusses the use of the intercultural development inventory (IDI), a cultural assessment tool that has not been validated in the U.S. for racial, ethnic, or social class differences, and which leaves out the role of structural inequalities in intercultural relationships. Findings reveal that interview data from black, indigenous, and people of color (BIPOC) did not align with their IDI results and that the tool dismisses the complex experiences of BIPOC students. These findings jeopardize the tool’s purpose and validity. Finally, this study reveals the importance of educating students about structural competence to improve empathy and understanding of a diverse student body.

Breast Implant-Associated Anaplastic Large Cell Lymphoma Online Education Tools: A Multimetric Analysis.

In light of highly publicized media coverage on breast implant recalls and Food and Drug Administration hearings on breast implant safety, online searches of these topics have surged. It is thus critical to determine whether such searches are providing meaningful information for those who use them. Patient/laywomen-directed online education materials on breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) must not only be comprehensible but also accurate, actionable, and culturally concordant, especially as more diverse populations turn to the internet for breast implant-related information. This study assessed the overall suitability of BIA-ALCL patient-directed educational text and video-based materials online. This was a cross-sectional, multimetric investigation of online text- and video-based patient-directed educational materials for BIA-ALCL using multiple validated measures. Two reviewers assessed each resource. Kruskal-Wallis and Fisher exact analyses were used as appropriate to compare text- and video-based online resources. In total, 30 websites and 15 videos were evaluated, more than half (56%) of which were from academic/physician or governmental/nonprofit sources. Overall, website and video content, as well as quality, varied by source. Academic/physician or governmental/nonprofit sources tended to be more comprehensive and have higher-quality information than commercial/media outlet sources. Median actionability of websites was 38%, well below the threshold of 70% used in the literature to identify actionable resources. The median suitability score for BIA-ALCL websites was 57%, which is considered "adequate" based on published thresholds. The mean overall Cultural Sensitivity Assessment Tool score for websites was 2.4; Cultural Sensitivity Assessment Tool scores higher than 2.5 are generally regarded as culturally sensitive. In general, videos were more understandable than websites. Substantial interrater reliability across the validated tools used in this study was noted using Pearson correlation coefficients. Online resources varied in content and quality by source. As BIA-ALCL becomes an increasingly salient topic among both providers and patients, it is important to empower women with accurate information about this implant-associated cancer. Of available resources, providers should refer patients or those seeking more information to websites from governmental/academic organizations (".gov" or ".org" domains) and videos from academic/physician or governmental sources, given that among high-quality resources, these were most clear/comprehensible. Overall, there is a need for improved online content on this topic.

Structural Disadvantage and Culture, Race, and Ethnicity in Early Psychosis Services: International Provider Survey.

Little is known about provider perspectives on programmatic responses to structural disadvantage and cultural differences within early intervention in psychosis (EIP) services, programs, and models. The primary objective of this study was to investigate providers' perspectives on the impacts of disadvantage and minority race, ethnicity, and culture and to describe current practices and perceived gaps and concerns. An online survey of specialized EIP providers was disseminated in the United Kingdom, United States, Canada, Australia, and Chile. A total of 164 providers, representing 110 unique sites, completed the survey. Closed-ended questions gathered demographic and program data, including information on formal assessment of trauma or adversity, integration of trauma-informed care, integration of formal cultural assessment tools, training focused on culture, programmatic changes to address culture-related issues, and consultation with cultural insiders. Open-ended questions addressed the demographic mix of the program's client population; the perceived role and influence of trauma, structural disadvantage, and cultural differences; and concerns and needs related to these topics. Frequencies were examined for closed-ended items; open-ended responses were systematically coded. Overall, survey findings suggested low levels of implementation of a variety of assessment and support practices related to cultural diversity in EIP programs. Coding of open-ended responses revealed numerous concerns regarding the impacts of disadvantage and cultural difference on clients and perceived gaps in policy and implementation. An expansion of research and service development aimed at better meeting the disadvantage- and culture-related needs of young people with early psychosis and their families should be a priority for the field.

Influence of knowledge-based safety culture in the construction industry: a stakeholder's perspective

PurposeSafety in construction projects is essential and requires more attention towards minimizing the accident rate. Problems concerning awareness of safety risks, procedures and practices still exist in the industry, which indicate a shortfall in diffusion of safety-related knowledge in construction industry. Also, there is dearth of studies on knowledge management strategies to prevent reoccurrence of accidents and thereby improve safety culture in construction industry. This study attempts to unveil aspects of knowledge management that are ignored in considering safety culture and discern the differences in the perception of key stakeholders of construction industry. Therefore, the objective of this study is to identify and measure knowledge-based safety culture elements.Design/methodology/approachIn this paper, the focus is on the application of a reliable, valid and sensitive knowledge-based safety culture assessment tool on key stakeholders operational in construction industry. Research method adopted is a questionnaire-based survey to seek responses from industry professionals. A total of 199 responses were obtained from 106 different companies operational in Indian construction industry. Statistical analyses including ranking analysis, t-test, correlation analysis, and ANOVA test are utilized for comparing and identifying the differences in view of stakeholder's perceptions concerning workplace safety.FindingsThis study helps to identify and rank critical knowledge-based safety culture elements from the perspective of key stakeholders of construction industry. This contributes in identifying the most critical and neglected variables among the key stakeholders regarding aspects of safety culture. Also, the study shows the importance of knowledge dimension in developing overall safety culture in construction industry.Originality/valueResults of this study offer valuable insight in enabling key stakeholders of construction industry to examine and enhance their safety performance. The implications of this study contribute new knowledge in assessing conditions that will improve worker safety in the construction industry. The paper should be of interest to researchers and practitioners in the area of occupational health and safety management.

Assessing Patient Safety Culture: Application of the Safety Attitudes Questionnaire in a Kenyan Setting

Background: Patient safety has recently been declared a global health priority. Achievement and sustenance of a culture of patient safety require a regular and timely assessment of the organization. The Safety Attitudes Questionnaire is a patient safety culture assessment tool whose usefulness has been established in countries, but a few studies have been published from Africa, more so, in Kenyan settings. Objective: To evaluate the reliability of the Safety Attitudes Questionnaire in assessing the patient safety culture in a Kenyan setting and to assess healthcare workers' perceptions of patient safety culture. Methods: A descriptive quantitative approach was utilized whereby the Safety Attitudes Questionnaire was administered to 241 healthcare workers in two public hospitals. The Cronbach’s α was calculated to determine the internal consistency of the SAQ. Descriptive and inferential statistics were used to analyze and describe the data on patient safety culture. Results: The total scale Cronbach’s alpha of the SAQ was 0.86, while that of the six dimensions was 0.65 to 0.90. The overall mean score of the total SAQ was 65.8 (9.9). Participants had the highest positive perception for Job Satisfaction with a mean score of 78.3 (16.1) while the lowest was evaluated for Stress Recognition with a mean score of 53.8 (28.6). Conclusion: The SAQ demonstrated satisfactory internal consistency and is suitable for use in the Kenyan context. The perception of patient safety culture in the Kenyan hospital is below international recommendations. There is a need for implementation of strategies for the improvement of the organization culture in Kenyan hospitals.

Exploratory factor analysis of the Just Culture Assessment Tool for nursing education.

Just culture has been identified as a vital component of safety culture by national and international organisations. In a just culture, emphasis is not placed on blaming individuals for errors but rather on examining personal and system processes that can best support safety and prevent reoccurrence. Although those in the practice arena have worked to implement the concepts of just culture, the same is not true in nursing education, leaving nursing students lacking the pre-requisite knowledge, skills and attitudes to implement just culture in practice on graduation. Assessment of this phenomena is the essential first step to align nursing education with practice in promoting just culture as a mechanism for patient safety. The purpose of this paper is to further refine the Just Culture Assessment Tool-Nursing Education through exploratory factor analysis. The Just Culture Assessment Tool-Nursing Education was adapted from the Just Culture Assessment Tool, an instrument created for the practice setting. Validity and reliability were established for the Just Culture Assessment Tool-Nursing Education in a study of 800 nursing students to assess their perceptions and understanding of just culture with their nursing programmes. Using the previously conducted data, an exploratory factor analysis was conducted. Factor analysis supports six subscales, similar to that of the Just Culture Assessment Tool. However, individual items were loaded into different subscales. All subscales demonstrated good reliability. Factor analysis supported further refinement of two items to improve the instrument's ability to capture data. Perceptions of just culture differ between experienced providers and nursing students; nursing students have less experience with reporting errors. Factor analysis of Just Culture Assessment Tool-Nursing Education items demonstrated these differences, supporting modification of items by the instrument developers. An 'if' statement for students to consider their possible actions rather than experience was added to two items to better capture data from nursing students when completing the assessment.

Commentary: Exploratory factor analysis of the Just Culture Assessment Tool for nursing education.

Commentary: Exploratory factor analysis of the Just Culture Assessment Tool for nursing education.

The Multi-Method Tool ‘PAST’ for Evaluating Cultural Routes in Historical Cities: Evidence from Cagliari, Italy

Thematic paths are a central aspect of urban policies for cultural heritage valorization. In fact, thematic paths are central spatial features for structuring the image of a historical landscape. Hence, this study proposes the cultural paths assessment tool (PAST) as a methodological framework for individuating a network of routes connecting cultural heritage components and for assessing their usefulness. Usefulness is herein defined as the potential of a street network to support the meaningful experience of a historical urban landscape. PAST combines space syntax techniques, a geographic information system, and a qualitative analysis within a multi-criteria analysis framework for addressing four aspects of connecting cultural heritage components, including: (i) the individuation of relevant assets; (ii) the identification of the sub-network of most central street segments; (iii) the definition of the street network of thematic routes; (iv) the assessment of the usefulness of thematic paths, according to the criteria of usability, imageability, and accessibility. The proposed methodology, applied to the historical district of Marina in the city of Cagliari in Italy, supports planning and design processes in two ways: (1) by identifying street segments and squares comprising a network of thematic routes; (2) by individuating high-leverage interventions for improving the usefulness of thematic routes. Consequently, the proposed study addresses the need to establish methodologies and analytic tools that support decision making processes for conserving, managing, and valorizing historic urban landscapes.