Increase Cultural Competence Research Articles

Promoting Global Health Knowledge and Cultural Competence of Swedish and Somali Nursing Students Through Collaborative Virtual Seminars: A Qualitative Descriptive Study.

Engaging nursing students in transdisciplinary learning and collaborative activities will prepare them for future roles in promoting global health knowledge and cultural competence. The purpose of this study was to describe undergraduate nursing students' experiences of participating in collaborative virtual seminars intended to promote global health knowledge and increase cultural competence between a university in Sweden and a university in Somaliland. A qualitative descriptive study using semi-structured individual interviews and focus group discussions was conducted. Notably, 27 nursing students who participated in a collaborative virtual seminar were included. Data were analyzed using inductive qualitative content analysis. Nursing students reported having gained profound comprehension of and a broadened perspective on global health, cultural awareness, and curiosity crucial for their roles as future global nurses. Fostering global health knowledge and cultural competence among nursing students through collaborative virtual seminars is advantageous as it enhances their cultural competence in nursing.

Southern California Asian Americans and the Obesity Epidemic: A Qualitative Study to Improve Understanding and Cultural Competence

ABSTRACT Background Obesity continues to be a public health concern in the United States, yet limited research exists on the impact of obesity and weight gain among Asian Americans. Purpose The purpose of this study was to illuminate the lived realities and physical, mental, and social impacts of obesity on overweight and obese Asian Americans in Southern California. Methods A basic qualitative exploratory approach was used. Twenty-five participants were interviewed, leveraging a protocol derived from the health belief model (HBM). Results Six themes highlight obesity’s impact among Asian Americans in Southern California: physical and mental health disadvantages, motivation and consistency, taboo nature of being overweight or obese, model minority misnomer, cultural incongruence, and perception of BMI as an outdated measure. Discussion Findings reveal obesity’s impact among Asian Americans to be complex, linked to both internal and external factors, and suggest that this population is as important as others when discussing obesity prevention. Translation to Health Education Practice Health Educators and health professions need to improve their understanding of the complexities and impact obesity has among Asian Americans and increase cultural competence to develop more responsive obesity and weight interventions and Health Education content. A AJHE Self-Study quiz is online for this article via the SHAPE America Online Institute (SAOI) http://portal.shapeamerica.org/trn-Webinars

Reproductive health of refugees: barriers to accessing healthcare systems in host countries

Refugees around the world face numerous challenges when it comes to accessing healthcare services, particularly in the area of reproductive health. This narrative review aims to explore the barriers that refugees encounter when trying to access healthcare systems in their host countries. These barriers include language and cultural differences, lack of knowledge about the healthcare system, limited access to transportation, financial constraints, and stigma. Comprehensive healthcare services, including healthcare access, nutrition, and mental health support, are crucial to prevent and manage chronic diseases and improve health outcomes for refugees, particularly those with diabetes who may face restricted availability of medications and monitoring devices. It is essential to ensure refugees diagnosed with diabetes have sufficient access to insulin supplies and equipment to administer it securely. We also highlight the impact of these barriers on the reproductive health of refugees, including inadequate prenatal care, lack of access to contraception and family planning services, and increased risk of sexually transmitted infections. The findings of this review underscore the urgent need for policymakers and healthcare providers to address the unique challenges that refugees face when accessing reproductive healthcare. Efforts must be made to improve access to information, increase cultural competency among healthcare providers, and address financial and transportation barriers. By addressing these challenges, we can ensure that refugees have the necessary support and resources to maintain their reproductive health and well-being. No conflict of interests was declared by the authors.

Uncovering Barriers to Engagement in Substance Use Disorder Care for Medicaid Enrollees.

The authors aimed to uncover factors that affect engagement in substance use disorder treatment among Medicaid beneficiaries in New York State. The authors conducted 40 semistructured interviews with clients, plan administrators, health care providers, and policy leaders directly involved with substance use care in New York State. Data were analyzed with thematic analysis. Main themes resulting from analysis of the 40 interviews showed that most stakeholders agreed that a need exists to better integrate psychosocial services into behavioral health care systems; that systemic stigma, stigma from providers, and lack of cultural responsiveness in the substance use care system hinder engagement in and provision of high-quality care; and that rural health care networks with coordinated models benefit clients' engagement in care. Stakeholders involved in care for substance use disorder perceived a lack of integration of resources to meet clients' social needs, the presence of stigma, and low levels of cultural and linguistic capacity as key factors contributing to low engagement in and low quality of care for substance use disorder. Future interventions should address social needs within the therapeutic regimen and modify curricula in clinical training to reduce stigma and increase cultural competence.

Caregiver Experiences With Oral Bilingualism in Children Who Are Deaf and Hard of Hearing in the United States: Impact on Child Language Proficiency.

Best practices recommend promoting the use of the home language and allowing caregivers to choose the language(s) that they want to use with their child who is deaf or hard of hearing (DHH). We examined whether Spanish-speaking caregivers of children who are DHH receive professional recommendations on oral bilingualism that follow best practices. We also assessed whether professional recommendations, caregiver beliefs, and language practices had an impact on child language(s) proficiency. Sixty caregivers completed a questionnaire on demographic questions, language(s) use and recommendations, beliefs on bilingualism, and child language proficiency measures in English, Spanish, and American Sign Language (ASL). Professional recommendations on oral bilingualism were reported descriptively, and linear regression was used to identify the predictors of child language(s) proficiency. We found that only 23.3% of the caregivers were actively encouraged to raise their child orally bilingual. Language practices predicted child proficiency in each language (English, Spanish, and ASL), but professional recommendations and caregiver beliefs did not. Our results revealed that most caregivers received recommendations that do not follow current best practices. Professional training is still needed to promote bilingualism and increase cultural competence when providing services to caregivers who speak languages different from English. https://doi.org/10.23641/asha.21644846.

An Innovative Approach for Using Cross-Cultural, Collaborative Simulation during Undergraduate Nursing Study Abroad Exchanges

BackgroundSimulation can be used as an innovative strategy to develop cross-cultural collaboration during study abroad exchanges. The aims of this paper are to describe the innovative process that occurred between students from two universities in the US and Thailand, lessons learned, and research outcomes from a pilot study for improving confidence and cultural competence to provide care and work with others from another culture. MethodsThe pre-/post-test design used a 26-item questionnaire with open-ended and closed items to measure confidence, satisfaction, collaboration, role implementation, and communication. ResultsStudents’ confidence increased significantly following the cross-cultural simulation, whether delivered in Thai or English. Findings supported a successful opportunity to collaborate cross-culturally which led to increased knowledge and a foundation for future work. ConclusionsStudy abroad simulation experiences are an effective pedagogy for bringing culturally different students together to increase knowledge, support confidence, increase cultural competence, and learn to work with others from a different culture. Faculty from other institutions should consider planning similar cross-cultural study abroad experiences based on lessons learned.

Efficacy of Using Interprofessional WIC Community Visits to Increase Cultural Competence

Abstract Date Presented 04/12/21 OT and physical therapy students visited Women, Infants, and Children (WIC) centers to educate families on the Centers for Disease Control and Prevention’s (CDC’s) Milestone Tracker app. A pretest-posttest design using an adapted version of the Cultural Competence Self-Assessment Checklist (N = 40) was utilized. The results indicated that while students perceived the experience as a positive one that increased their knowledge of WIC, the experience did not significantly alter self-perceptions of their cultural competence. Primary Author and Speaker: Kate Barlow Contributing Authors: Chelsea Patton, Rachel Holliday, Kassidy Abel, Ashley Abbott, Sydney Liu, Sarah Stevenson, Jalisa Mosley, Sydney Higgs, and Kaitlynn Bennett

Utilizing Mixed Methodology to Increase Cultural Competency in Research with Transgender and Gender Nonconforming Individuals.

Transgender and gender nonconforming (TGNC) individuals experience increased risk to mental and physical health concerns based on minority stress variables, including discrimination, internalized stigma, and expectations of violence. Research in this area displays a disconnect between provider and TGNC individuals seeking care. This study sought to improve cultural competency in research with TGNC individuals, with the ultimate goal to further explore cultural competency factors in work with TGNC individuals in research and clinically. Mixed methods research was conducted with trans masculine, trans feminine, and nonbinary identifying individuals to pilot survey measures before administration in a larger study.

Incorporating Photovoice in the Marketing Curriculum to Increase Cultural Competence

Images are powerful. They help make the abstract concrete and allow the viewer to share the perspective of the photographer, giving the photographer a platform to communicate what may be difficult to express with words. Educators, institutions, accreditors, and students are seeking diverse and inclusive university environments, yet we often lack the critical dialogue necessary for achieving such outcomes. In response to student and employer imperatives, we propose the inclusion of photovoice to complement existing learning outcomes in the marketing curriculum. We discuss the implementation and evaluation of including photovoice into a semester-long client-based marketing research project. Experiential learning with photovoice increased interactions with diverse others and increased metacognitive cultural intelligence in comparison with a section taught with the standard approach.

The Impact of a Teaching Activity on Cultural Competence Knowledge

Background: To determine if a teaching intervention can increase cultural competence knowledge in senior nursing students preparing to take the NCLEX-RN exam. Methods: A 90-minute lunch and learn teaching intervention was conducted related to providing culturally competent care. A 10-question quiz was administered to a group of 31 senior nursing students before and after a teaching activity. Results: Mean values for knowledge on cultural competency were significantly higher for the pretest compared to the posttest (p < 0.01). There was a decrease in the NCLEX-RN pass-rate. Conclusion: Though there was a decrease in the NCLEX-RN pass-rate, the teaching activity helped increase cultural competence knowledge in the nursing students on providing care to diverse patients. This implies that similar interventions may be used to increase knowledge related to cultural competence.

Transformative Learning in Teacher Education

This article describes a partnership between teacher education candidates in a small, rural, private university and students in a large, public, urban junior/ senior high school. This partnership utilized technology and used a Literature as a Bridge (LAAB) program to foster discussions designed to be vehicles of learning for all participants. The objectives of this program were to 1) have urban youth see higher education as an option for their future by giving them experience with college students, college expectations, and a college campus, 2) increase cultural competence by providing opportunities for teacher candidates to work with culturally and ethnically diverse students with experiences different from their own, and 3) allow literature to be a vehicle to bridge diverse groups. The dynamic relationship between teacher candidate and high school students set the stage for transformational learning for both the teacher candidates and the junior/senior high school students.

Toward a More Humanistic American Medical Profession: An Analysis of Premedical Web Sites From Ohio's Undergraduate Institutions.

In response to changes in health care, American medical schools are transforming their curricula to cultivate empathy, promote professionalism, and increase cultural competency. Many scholars argue that an infusion of the humanities in premedical and medical training may help achieve these ends. This study analyzes Web-based messaging of Ohio’s undergraduate institutions to assess premedical advising attitudes toward humanities-based coursework and majors. Results suggest that although many institutions acknowledge the humanities, most steer students toward science majors; strong advocates of the humanities tend to have religious or other special commitments, and instead of acknowledging the intrinsic value that the humanities might have for future physicians, most institutions promote the humanities because entrance exams now contain related material.

Reshaping curricula: Culture and mental health in undergraduate health degrees.

Australia is a country rich in cultural diversity, with Indigenous Australians having specific cultural values and a variety of spoken languages. In addition, the increasing number of people from migrant and refugee backgrounds requires that health professionals be able to communicate effectively with people from a wide range of cultural backgrounds. This is particularly relevant when undertaking a mental health assessment, because members of diverse communities often face the dual vulnerability of marginalization and stigmatization. This paper reports on the development and evaluation of a virtual teaching and learning resource that prepares health students to be culturally competent in mental health assessment. Four online interprofessional learning journeys were developed. Evaluation of the learning resources was conducted across three participating Australian universities. Quantitative evaluation involved pre- and post-testing using an empathy scale, the Mental Health Nursing Clinical Confidence Scale, and the Cultural Competence Questionnaire informed by the theory of planned behaviour. Qualitative data from focus group interviews explored participants' experiences of using the guided learning journey. Participants reported changes from pretest to post-test in their empathy and attitudes towards culturally and linguistically diverse consumers with significant positive changes in cultural competence, empathy, and attitudes. There was strong satisfaction with the learning materials, indicating that participants valued this 'real world' learning experience. Results require cautious interpretation, given recruitment difficulties in the evaluation phase. However, these learning journeys appear to have potential to be an effective way to challenge attitudes and perceptions, as well as increase cultural competence towards culturally and linguistically diverse consumers.

Combining Online Education with International Service Learning to Increase Cultural Competence

PURPOSE: Although international service learning has the capacity to promote a variety of important professional behaviors, merely visiting another country does not automatically result in these benefits. METHODS: This article describes an evidenced-based course which used pre-trip preparation in combination with a nine day service learning trip to Ecuador to develop cultural competence among 6 occupational and 6 physical therapy students. Pre-trip preparation included online and in-person components to increase self-awareness, awareness of other cultures, knowledge about Ecuadorian culture and skill-building. On-site activities included exploration of the physical and social context in addition to providing occupational and physical therapy treatment in a variety of settings. The authors collected qualitative information by reviewing responses to prompts on an online forum. A pre-test/post-test format using the Inventory for Assessing the Process of Cultural Competence Among Healthcare Professionals-Student Version (IAPCC-SV) was used to gather quantitative information. RESULTS: A paired-samples t-test was used to compare the group’s pre-test and post-test scores on the IAPCC-SV. There was a statistically significant difference in the scores between the pre-test (M=57.72, SD+ 6.66) and post-test (M=67.54, SD+ 3.55) with the change in mean score of 9.81 resulting in t= -491, df = 10 and p ≤.001. DISCUSSION: The results showed a change in students from the level of culturally aware to culturally competent based on the scale provided in IAPCC-SV. The experience resulted in an increased desire to continue intercultural practice. Health care professionals have a responsibility to be culturally competent. This article will assist health care professionals to reflect on the advantages of joining an international service learning trip to expand their self-awareness and awareness of other cultures. Professors may reflect on how pre-trip preparation may enhance existing service learning experiences.

Using Films to Increase Cultural Competence in Working With LGBTQ Clients

Using Films to Increase Cultural Competence in Working With LGBTQ Clients

Latina and Black/African American Women's Perspectives on Cancer Screening and Cancer Screening Reminders.

Racial and ethnic disparities continue to exist in cancer screening rates, especially among US Latina and Black/African American populations. We conducted six focus groups among 41 women from these communities in order to better understand their preferences about cancer screening reminders and the motivators and deterrents they face in obtaining recommended breast, cervical, and colon cancer screening. Using self-reported patient race/ethnicity from electronic medical records of a large, integrated health care system in Seattle, we recruited women ages 30-60 to participate in one of five 2-hour focus groups. Using verbatim transcripts from these discussions, we conducted a qualitative analysis to identify common themes. The focus group participants were primarily strong endorsers and utilizers of recommended breast, cervical, and colon cancer screening services. Insurance and belief in preventive care were the most common motivators that they cited in obtaining cancer screening. However, they still reported multiple barriers to getting recommended cancer screening for themselves and community members, including lack of time, conflicting information about screening intervals, distrust in the health care system, and a lack of understanding of the benefits of preventive care. Efforts to improve understanding about the benefits of cancer screening, clarify cancer screening guideline recommendations, increase cultural competency among health care professionals, and expand the times and locations where cancer screening is available are all options that may improve cancer screening rates among Latinas and Black/African American women.

Racial/ethnic differences in the relative risk of receipt of specific treatment among men with prostate cancer

ObjectiveAfrican-American (AA) men have excess mortality from prostate cancer compared with White men, which has remained unchanged over several decades. The purpose of this study is to determine if race/ethnicity is an independent predictor of receipt of any definitive treatment vs. watchful waiting/active surveillance (WW/AS). Methods and materialsMen diagnosed with prostate cancer from 2004 to 2011 were identified from the Surveillance, Epidemiology, and End-Results program. Multinomial logistic regression analysis was performed to determine the relative risk ratio (RRR) of receipt of radical prostatectomy (RP), external beam radiation therapy (RT), brachytherapy, cryotherapy, or combination therapy vs. WW/AS. ResultsCompared with White men, AA men were significantly less likely to receive RP (RRR = 0.53, P<0.001), brachytherapy (RRR = 0.72, P<0.001), cryotherapy (RRR = 0.84, P = 0.001), and combination therapy (RRR = 0.70, P<0.001), and more likely to receive RT (RRR = 1.03, P = 0.041) vs. AS/WW. Hispanic men were significantly less likely to receive RP (RRR = 0.84, P<0.001) and brachytherapy (RRR = 0.77, P<0.001), and more likely to receive RT (RRR = 1.08, P<0.001), and cryotherapy (RRR = 1.19, P = 0.005) vs. AS/WW compared with White men. ConclusionsThe disparate risk of receiving definitive treatment among AA and Hispanic men represents a significant public health issue that requires efforts to improve physician education, increase cultural competency, and ensure equitable access.

Assessing the Utility of a Toolkit for Modifying Evidence-Based Practice to Increase Cultural Competence: A Comparative Case Study

ABSTRACT The United States is an increasingly diverse nation, and there is a need to consider culturally modifying interventions to better serve clients. In this study, the Toolkit for Modifying Evidence-Based Practices to Increase Cultural Competence was used to culturally modify evidence-based practices (EPBs) in two agencies. Research questions addressed whether the Toolkit model could be implemented as written with no additional guidance and whether administrators believed the culturally modified interventions would benefit clients. Both agencies found the Toolkit worthwhile. Working groups at both sites were able to successfully complete modification projects by culturally modifying and implementing an EBP.

Reflections on an International Immersion Experience: A Doctor of Physical Therapy Student’s Perspective

Background and Purpose. This case report presents the perspective of a Doctor of Physical Therapy (DPT) degree student on the qualitative value of a short-term international immersion experience. The need for culturally competent practitioners in a society of growing diversity is evident. Activities in low-resourced, international locations during entry-level training increase cultural competence and broaden perspectives. Very little has been published from a student’s perspective on an international experience. Therefore, this case report provides one such vantage with comparisons to the methods and findings from other authors. Case Description. The student used an ethnographic approach to gather data from an immersion experience in the Republic of Suriname. Data resulted from formal classroom learning with host students, observation of physical therapy practice in several settings, formal and informal social gatherings, visits to important local sites, and participation in a wellness dance program for seniors. Information was extracted through student observation, reflective journaling, artifact collection, faculty-guided feedback sessions, and emotional recall. Major themes were identified by prevalence and compared to relevant literature. Outcomes. After immersion, both personal and professional growth were noted with the following themes: (1) genuine warmth of hosts, (2) similarities between the practice of physical therapy in Suriname and the United States (US), (3) ease of acknowledging, accepting, and talking about diversity, and (4) enhanced appreciation for the value of a US education. Discussion and Conclusion. Identified themes were similar to those reported by other authors. This student perspective adds to the international immersion literature and strengthens the potential support for programs considering international integration.

Use of Avatars and a Virtual Community to Increase Cultural Competence

This study compared learning objectives achieved in hybrid/online social work courses through MSW student use of avatars and virtual communities (n = 25) to those achieved in a traditional course (n = 22). Learning outcomes were compared through students' reflections on “cocktail party” exercises occurring either in virtual communities or in class. The potential for and barriers to successful implementation of virtual communities in social work education are discussed. In summary, virtual communities and avatars present a vital opportunity for individuals to experience different perspectives, which, in turn, can nurture culturally competent skill building.