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Can Cultural Competency Reduce Racial And Ethnic Health Disparities? A Review And Conceptual Model
Cindy Brach
Agency for Healthcare Research and Quality
Irene Fraser
Agency for Healthcare Research and Quality
This article develops a conceptual model of cultural competency's potential to reduce racial and ethnic health disparities, using the cultural competency and disparities literature to lay the foundation for the model and inform assessments of its validity. The authors identify nine major cultural competency techniques: interpreter services, recruitment and retention policies, training, coordinating with traditional healers, use of community health workers, culturally competent health promotion, including family/community members, immersion into another culture, and administrative and organizational accommodations. The conceptual model shows how these techniques could theoretically improve the ability of health systems and their clinicians to deliver appropriate services to diverse populations, thereby improving outcomes and reducing disparities. The authors conclude that while there is substantial research evidence to suggest that cultural competency should in fact work, health systems have little evidence about which cultural competency techniques are effective and less evidence on when and how to implement them properly.
Key Words: cultural competency health disparities race ethnicity delivery of health care health policy
Medical Care Research and Review, Vol. 57, No. suppl 1,
181-217 (2000)
DOI: 10.1177/107755800773743655

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|
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|

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|
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|
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|
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|
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|
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|
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|
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|
 |
|

|
 |

|
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|
 |
|

|
 |

|
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|
 |
|

|
 |

|
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July 1, 2006;
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[PDF]
|
 |
|

|
 |

|
 |
 
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[Abstract]
[PDF]
|
 |
|

|
 |

|
 |
 
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[Abstract]
[PDF]
|
 |
|

|
 |

|
 |
 
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127 - 152.
[Abstract]
[PDF]
|
 |
|

|
 |

|
 |
 
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January 1, 2006;
7(1):
95 - 102.
[Abstract]
[PDF]
|
 |
|

|
 |

|
 |
 
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J Transcult Nurs,
October 1, 2005;
16(4):
298 - 311.
[Abstract]
[PDF]
|
 |
|

|
 |

|
 |
 
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Report of the ASHP Ad Hoc Committee on Ethnic Diversity and Cultural Competence
Am. J. Health Syst. Pharm.,
September 15, 2005;
62(18):
1924 - 1930.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
R. G. Robinson
Community Development Model for Public Health Applications: Overview of a Model to Eliminate Population Disparities
Health Promot Pract,
July 1, 2005;
6(3):
338 - 346.
[Abstract]
[PDF]
|
 |
|

|
 |

|
 |
 
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Ann. Fam. Med,
July 1, 2005;
3(4):
339 - 347.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
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March 1, 2005;
24(2):
424 - 434.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
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Postgrad. Med. J.,
March 1, 2005;
81(953):
141 - 147.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
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Person and Place: The Compounding Effects of Race/Ethnicity and Rurality on Health
Am J Public Health,
October 1, 2004;
94(10):
1695 - 1703.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
A. C. Beal
Policies To Reduce Racial And Ethnic Disparities In Child Health And Health Care
Health Aff.,
September 1, 2004;
23(5):
171 - 179.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
T. A. Lieu, J. A. Finkelstein, P. Lozano, A. M. Capra, F. W. Chi, N. Jensvold, C. P. Quesenberry, and H. J. Farber
Cultural Competence Policies and Other Predictors of Asthma Care Quality for Medicaid-Insured Children
Pediatrics,
July 1, 2004;
114(1):
e102 - e110.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
L. J. Cornelius, N. C. Booker, T. E. Arthur, I. Reeves, and O. Morgan
The Validity and Reliability Testing of a Consumer-Based Cultural Competency Inventory
Research on Social Work Practice,
May 1, 2004;
14(3):
201 - 209.
[Abstract]
[PDF]
|
 |
|

|
 |

|
 |
 
C. C. Kamath, W. M. O'Fallon, K. P. Offord, B. P. Yawn, and J. M. Bowen
Provider Satisfaction in Clinical Encounters With Ethnic Immigrant Patients
Mayo Clin. Proc.,
November 1, 2003;
78(11):
1353 - 1360.
[Abstract]
[PDF]
|
 |
|

|
 |

|
 |
 
C. A. Sarkisian, A. F. Brown, K. C. Norris, R. L. Wintz, and C. M. Managione
A Systematic Review of Diabetes Self-Care Interventions for Older, African American, or Latino Adults
The Diabetes Educator,
May 1, 2003;
29(3):
467 - 479.
[Abstract]
[PDF]
|
 |
|

|
 |

|
 |
 
M. W. Kreuter, S. N. Lukwago, D. C. Bucholtz, E. M. Clark, and V. Sanders-Thompson
Achieving Cultural Appropriateness in Health Promotion Programs: Targeted and Tailored Approaches
Health Educ Behav,
April 1, 2003;
30(2):
133 - 146.
[Abstract]
[PDF]
|
 |
|

|
 |

|
 |
 
G. D. Stevens and L. Shi
Racial and Ethnic Disparities in the Primary Care Experiences of Children: A Review of the Literature
Med Care Res Rev,
March 1, 2003;
60(1):
3 - 30.
[Abstract]
[PDF]
|
 |
|

|
 |

|
 |
 
B. J. Warren
The Interlocking Paradigm of Cultural Competence: A Best Practice Approach
Journal of the American Psychiatric Nurses Association,
December 1, 2002;
8(6):
209 - 213.
[Abstract]
[PDF]
|
 |
|

|
 |

|
 |
 
G. R. Alexander, M. D. Kogan, and S. Nabukera
Racial Differences in Prenatal Care Use in the United States: Are Disparities Decreasing?
Am J Public Health,
December 1, 2002;
92(12):
1970 - 1975.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
C. V. Browne, K. L. Braun, N. Mokuau, and L. McLaughlin
Developing a Multisite Project in Geriatric and/or Gerontological Education With Emphases in Interdisciplinary Practice and Cultural Competence
Gerontologist,
October 1, 2002;
42(5):
698 - 704.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
T. A. Lieu, P. Lozano, J. A. Finkelstein, F. W. Chi, N. G. Jensvold, A. M. Capra, C. P. Quesenberry, J. V. Selby, and H. J. Farber
Racial/Ethnic Variation in Asthma Status and Management Practices Among Children in Managed Medicaid
Pediatrics,
May 1, 2002;
109(5):
857 - 865.
[Abstract]
[Full Text]
[PDF]
|
 |
|
|
|