Improving Cultural Competence in Primary Care Providers Through Cultural Awareness Training

Problem: Culturally and linguistically diverse patients have limited healthcare access when compared to the majority of the population. Patients are often confronted with barriers such as language, differences in beliefs, and a complex healthcare system. Developing interventions to offer culturally and linguistically appropriate care, such as provider training programs and cross-cultural education, could help to improve access and reduce health care disparities.Methods:A quality improvement project was developed to assess and improve the levels of cultural competence among primary care providers in the clinical setting. Using the Campinha-Bacote Model of Cultural Competence, an educational presentation for primary care providers and a brochure were developed. The areas of cultural awareness, cultural skill, cultural knowledge, cultural encounter, and cultural desire were incorporated to increase providers' ability and efficiency in working in a culturally diverse environment. This project aimed to: (a) improve the primary care providers' knowledge and awareness through cultural awareness training; (b) assess the impact that this educational intervention had on their clinical practice; and (c) explore the feasibility of providing this training to primary care providers as part of their ongoing professional development.The setting of this project was a community clinic in Centerville, Utah. Six primary care providers (PCPs) voluntarily participated in this project. As part of the initial assessment, participants self-reported cultural awareness, knowledge, encounter, and desire as 2 measured by the Clinical Cultural Competency Questionnaire (CCCQ) developed by the Center for Healthy Families and Cultural Diversity of the Robert Wood Johnson Medical School. Following the cultural awareness training presentation, its applicability and adaptability were assessed by participant feedback in a post-presentation survey. A month after the presentation, the impact of the educational presentation was evaluated with a second post-survey. Results:Post-survey results reported that 100% (n=6) of the PCPs who responded thought that it is important for professionals to effectively communicate across cultures;100% (n=6) reported that accepting and embracing cultural differences between patients is important for providing quality care; and 100% (n=6)found the cultural competence training useful in understanding how culture affects health. When reporting the likelihood of using one of the cultural competence communication models, providers favored Kleiman's 8 Question Model, with the LEARN model following closely behind.Conclusions:Results indicate that PCPs agree that cultural awareness training can improve their daily practice. Results showed that providers identified the need for an official PCP cultural awareness training, and additional bilingual providers and staff. Screening forms such as PHQ9 and GAD7 in different languages, more interpreters, and more continuing cultural training opportunities were identified as the resources needed to support cultural competency in their daily practice and ability to improve health care to minorities and diverse populations.