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Health Equity: Cultural Competency Training for Healthcare Providers

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What the CPSTF Found

About The Systematic Review

The CPSTF finding is based on evidence from a systematic review of one study (search period 1965 - 2001).

The review was conducted on behalf of the CPSTF by a team of specialists in systematic review methods, and in research, practice, and policy related to promoting health equity.

Summary of Results

Detailed results from the systematic review are available in the published evidence review pdf icon [PDF - 730 KB].

The systematic review included one study.

  • Clients in the intervention group reported greater satisfaction with counseling than did controls, independent of the counselor’s race.
  • Clients who met with culturally sensitive counselors returned for more sessions than did those assigned to the other counselors (difference of 33%).

Summary of Economic Evidence

An economic review of this intervention was not conducted because the CPSTF did not have enough information to determine if the intervention works.

Applicability

Applicability of this intervention across different settings and populations was not assessed because the CPSTF did not have enough information to determine if the intervention works.

Evidence Gaps

The CPSTF identified several areas that have limited information. Additional research and evaluation could help answer the following questions and fill remaining gaps in the evidence base. (What are evidence gaps?)

  • Do interventions improve satisfaction with care, reduce ethnic differentials in utilization and treatment, and improve health status?
  • What are intervention effects on knowledge, attitudes, use of services, receipt of treatments, and changes in health outcomes?
  • What are the unintended consequences of, and potential barriers to these interventions?
  • What are the relative contributions of improvements in linguistic competence and cultural sensitivity skills to reducing miscommunication and the resulting medical errors?
  • Are linguistically and culturally appropriate health education materials more effective than standard materials in improving health outcomes?

Healthcare providers and provider organizations are concerned about the burden placed on resources by implementing interventions to improve the cultural competence of healthcare systems, particularly in the absence of proven effectiveness.

  • What role should communities play in collaborating with area healthcare organizations to communicate the needs of ethnically diverse populations? At what levels (e.g., management, provider, staff) in a healthcare organization does investment in linguistic and cultural competencies create the greatest improvement in health or other outcomes?
  • Which cultural competencies within a healthcare system increase client satisfaction and improve health outcomes?
  • Does cultural competency training of healthcare providers have a lasting effect or should it be repeated periodically?

Study Characteristics

  • The study was conducted in a metropolitan college mental health center.
  • The 80 subjects were lower-income African-American women, with a mean age of 38 years, who resided in the community.
  • The intervention consisted of four hours of cultural sensitivity training for four counselors (two white and two African American).

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