Increase Cultural Competence Research Articles

Assessing global partnerships in graduate nursing

North-South partnerships in graduate nursing education can prepare students to address global healthcare issues, increase cultural competence, and build research capacity. However, the current literature does not include a critical and systematic assessment of partnerships using established guidelines. This paper has two objectives: 1) Find and refine a suitable measure to assess a North-South inter-institutional research and clinical partnership in nursing; 2) Pilot test an assessment measure and describe the results of a systematic institutional self-evaluation of a developing North-South research and clinical partnership within a graduate nursing program. The first objective was addressed by searching for, examining and selecting an assessment measure. The second objective was obtained by applying the assessment measure to a developing graduate-level research and clinical partnership between a Canadian School of Nursing and a Malawian College of Nursing; qualitative data collected included information from a document review and subjective experiences of partners. Results showed that when appropriate revisions are made to an existing guideline, it is applicable to use as an assessment measure for North-South inter-institutional research and clinical partnerships. Recommendations for improvement were made, allowing the guideline to be more specific for research and clinical partnerships. Results demonstrated that the existing Canadian-Malawian partnership was strongest in the guideline category of "shaping the purpose and scope of the partnership," and weakest in "partnership implementation and context." This paper implies that: 1) evaluation can strengthen partnerships and enhance educational experience for nursing students; 2) research comparing and contrasting different genres of partnerships could help determine which type is the most appropriate for an institutions' particular outcome goals; and 3) effective establishment and maintenance of North-South partnership occurs through an on-going process of evaluation.

Equity in Care: Picking Up the Pace

Eliminating disparities in healthcare is a goal of every American hospital. Despite our best efforts, we know that race, ethnicity, and language preference continue to affect the chance that patients will receive the care they need and the outcomes they deserve. For example, Hispanic adults with diabetes are far less likely to receive recommended preventive services and African American women are more likely to die after they are diagnosed with breast cancer than are their white counterparts. Because each hospital comprises and serves a unique community, increasing both the collection and the use of race, ethnicity, and language preference (REAL) data is an essential part of achieving equity in care for all Americans. With good data, hospitals can test the validity of their assumptions about the quality of care they provide. That care may be ideal, but without measurement, it is impossible to know. With careful measurement, every provider can document whether differences in outcomes and opportunities exist so it can improve the quality of care delivered by implementing customized approaches using evidence-based care. Supporting hospital efforts to eliminate disparities is one reason the American Hospital Association is a founding partner in the National Call to Action to Eliminate Health Care Disparities. With our partners, the American College of Healthcare Executives, Association of American Medical Colleges, Catholic Health Association of the United States, and National Association of Public Hospitals and Health Systems, we set out to achieve three interrelated goals: increase collection of REAL data, increase cultural competency training, and increase diversity in leadership. We have set up the Equity of Care website (http://www.equityofcare.org) to help hospitals, health systems, clinicians, and others improve the quality of care for each and every patient by sharing resources and best practices. We believe that most healthcare providers are moving in the right direction and that many are taking important steps to make care more equitable. But given the speed of change in our communities, we feel that this process must be accelerated, and information sharing is an important way to facilitate that. Healthcare providers must begin with a basic understanding of the population trends in the community they serve. American communities are undergoing huge demographic changes that may not immediately appear in the patient population of a given provider--but most surely will in the future. For the first time last year, most babies born in the United States were nonwhite. As health insurance coverage increases, each provider will be challenged to provide the best possible care to a unique patchwork of patient populations with different beliefs, lifestyles, family structures and support, and healthcare experiences. Planning for equitable care involves developing ongoing relationships with community organizations that can support providers' efforts to build cultural competency in delivering that care. Providers must anticipate community needs to, for example, ensure access to those with no or limited English proficiency or to develop patient education materials that consider differences in both language and culture. With careful measurement of REAL data, quality indicators, and patient outcomes--and using that information to constantly improve the quality of the care for each patient and for the community at large--providers will position themselves for future success. Measures of clinical quality and patient experience have increased significantly in recent years, and they are driving improvements across the board. But overall national quality measures cannot be readily broken down by race, ethnicity, and language preference. Recently, the Institute for Diversity in Health Management surveyed hospitals and found that 81 percent of hospitals collect REAL data, but only 18 percent used these data for quality interventions. …

Comunicación intercultural. Un estudio de caso sobre la prensa local extranjera en España

Through the analysis of a case study (weekly paper Costa Blanca Nachrichten) we tried to accede in an indirect way to the guidelines of cultural interaction of a foreign community in Spain. In a global context that determines the local strategies of communication (glocalization), the contents of the media shows the vision of the local culture of the German residents, and the efforts of uncertainty reduction and increase cultural competence in this new social-cultural space. The structure of the contents presents the studied weekly paper as a mediator in the sense of an intermediate space between two cultures, and in the sense of a performer of the social realities in an asymmetric system of interchange of meaning.

Training to Increase Cultural Competence.

Training to Increase Cultural Competence.

Does Service-Learning Increase Cultural Competency, Critical Thinking, and Civic Engagement?

To prepare for community engagement and partnerships with diverse communities, nursing students must understand the principles of service-learning, as well as the essential skills needed to work within a democracy. The purposes of these two pilot tests were to develop a 15-hour service-learning intervention; refine the 15-hour service-learning intervention; and explore whether participation in the intervention made a difference in the critical thinking, cultural competence, and civic engagement of nursing student participants. Although the sample was small (n = 14), results of paired t tests found that, after the intervention, critical thinking scores measured by the California Critical Thinking Disposition Inventory were significantly lower (t = -2.23, p = .04), particularly on the self-confidence subscale (t = 2.29, p = .039); cultural competence scores measured by the Inventory for Assessing the Process of Cultural Competence Among Healthcare Professionals were significantly lower (t = 4.83, p = .000); and civic engagement scores significantly increased (t = -3.54, p = .004).

Culture and Sexual Orientation

Culture and Sexual Orientation

Improving Access to and Utilization of Genetic Services in Arizona’s Hispanic Population

This abstract presents a model project aimed to train community lay health workers about genetics, increase cultural competency of genetic services providers, and provide local access to genetic services in primarily Hispanic communities in the state of Arizona. Health Start, a community-based prenatal outreach program, served as the basis for providing genetic education and services. A genetics training curriculum was developed and training of community lay health workers was provided. Cultural and Spanish language training was provided for all genetic services providers. Pediatric genetics outreach clinics were established in eight communities. Community-based lay health workers eagerly incorporate genetic information into their public health knowledge base, but this may not lead to acceptance of these personnel by local health care providers as sources of referrals for specialized health services such as genetics. Cultural competence training of genetic service providers is enthusiastically accepted and utilized in the provision of locally accessible genetics clinics.