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Interventions to improve cultural competency in health care for Indigenous peoples of Australia, New Zealand, Canada and the USA: A systematic review

journal contribution
posted on 2018-06-13, 00:00 authored by A Clifford, Janya MccalmanJanya Mccalman, Roxanne Bainbridge, K Tsey
Purpose: This article describes the characteristics and reviews the methodological quality of interventions designed to improve cultural competency in health care for Indigenous peoples of Australia, New Zealand, Canada and the USA. Data sources: A total of 17 electronic databases and 13 websites for the period of 2002-13. Study selection: Studies were included if they evaluated an intervention strategy designed to improve cultural competency in health care for Indigenous peoples of Australia, New Zealand, the USA or Canada. Data extraction: Information on the characteristics and methodological quality of included studies was extracted using standardized assessment tools. Results of data synthesis: Sixteen published evaluations of interventions to improve cultural competency in health care for Indigenous peoples were identified: 11 for Indigenous peoples of the USA and 5 for Indigenous Australians. The main types of intervention strategies were education and training of the health workforce, culturally specific health programs and recruitment of an Indigenous health workforce. Main positive outcomes reported were improvements in health professionals' confidence, and patients' satisfaction with and access to health care. The methodological quality of evaluations and the reporting of key methodological criteria were variable. Particular problems included weak study designs, low or no reporting of consent rates, confounding and nonvalidated measurement instruments. Conclusion: There is a lack of evidence from rigorous evaluations on the effectiveness of interventions for improving cultural competency in health care for Indigenous peoples. Future evaluations should employ more rigorous study designs and extend their measurement of outcomes beyond those relating to health professionals, to those relating to the health of Indigenous peoples. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

History

Volume

27

Issue

2

Start Page

89

End Page

98

Number of Pages

10

eISSN

1464-3677

ISSN

1353-4505

Publisher

Oxford University Press

Peer Reviewed

  • Yes

Open Access

  • No

Cultural Warning

This research output may contain the names and images of Aboriginal and Torres Strait Islander people now deceased. We apologize for any distress that may occur.

External Author Affiliations

University of Queensland; James Cook University

Era Eligible

  • Yes

Journal

International Journal for Quality in Health Care