Risk factors for reporting poor cultural competency among patients with diabetes in safety net clinics

Academic Article

Abstract

  • Background: The Consumer Assessment of Healthcare Providers and Systems Cultural Competency Item Set assesses patient perceptions of aspects of the cultural competence of their health care. Objective: To determine characteristics of patients who identify the care they receive as less culturally competent. Research Design: Cross-sectional survey consisting of face-to-face interviews. Subjects: Safety-net population of patients with type 2 diabetes (n = 600) receiving ongoing primary care. Measures: Participants completed the Consumer Assessment of Healthcare Providers and Systems Cultural Competency and answered questions about their race/ethnicity, sex, age, education, health status, depressive symptoms, insurance coverage, English proficiency, duration of relationship with primary care provider, and comorbidities. Results: In adjusted models, depressive symptoms were significantly associated with poor cultural competency in the Doctor Communication-Positive Behaviors domain [odds ratio (OR) 1.73, 95% confidence interval, 1.11-2.69]. African Americans were less likely than whites to report poor cultural competence in the Doctor Communication-Positive Behaviors domain (OR 0.52, 95% CI, 0.28-0.97). Participants who reported a longer relationship (≥3y) with their primary care provider were less likely to report poor cultural competence in the Doctor Communication-Health Promotion (OR 0.35, 95% CI, 0.21-0.60) and Trust domains (OR 0.4, 95% CI, 0.24-0.67), whereas participants with lower educational attainment were less likely to report poor cultural competence in the Trust domain (OR 0.51, 95% CI, 0.30-0.86). Overall, however, sociodemographic and clinical differences in reports of poor cultural competence were insignificant or inconsistent across the various domains of cultural competence examined. Conclusions: Cultural competence interventions in safety-net settings should be implemented across populations, rather than being narrowly focused on specific sociodemographic or clinical groups. Copyright © 2012 by Lippincott Williams & Wilkins.
  • Published In

  • Medical Care  Journal
  • Digital Object Identifier (doi)

    Author List

  • Seligman HK; Fernandez A; Stern RJ; Weech-Maldonado R; Quan J; Jacobs EA
  • Volume

  • 50
  • Issue

  • 9 SUPPL. 2