Background

The term “cultural competency” in healthcare is meant to convey an understanding of cultural and linguistic differences that exist within and between distinct social groups and a sensitivity to these differences that may allow for improved health care outcomes to occur. The medical literature has validated the importance of cultural competency training to medical education and its possible influence on patient health status and outcomes. Many pre-licensure cultural competency training programs have emerged due to the perceived benefits for healthcare delivery and outcomes. However, few studies have evaluated the clinical impact and success of these training programs. In this brief and limited review, we examine 10 pre-licensure cultural competency training programs for measures of outcomes and analyze the programs with respect to six domains of cultural competency identified by our literature review.

Methods

Fifteen programs were identified through web-based search engines and the medical literature. A comparison was then performed among 10 programs and analyzed based on six domains that the literature review found to be important.

Results

This brief review revealed that a majority of pre-licensure cultural competency training programs are still heavily focused on implementing non-patient centered self-assessments to evaluate effectiveness.

Discussion

If training programs constrain the assessment tools to only non-patient centered approaches, then it becomes more difficult to quantify the medical impact of cultural competency on patient health. The authors propose a unified approach to measure the efficacy of cultural competency programs. They identify four important characteristic outcomes as:

1. Non-patient centered: Fact-based knowing

2. Non-patient centered: Self-Assessments

3. Patient-centered assessments

4. Healthcare resource utilization

Conclusion

Though this approach has yet to be tested, the authors believe that incorporating these four assessments will better enable healthcare professionals to design a new form of cultural competency training that fosters deeper clinical reasoning for providers and improves patient outcomes.

Here we offer an open exchange / evaluation of our experience as facilitator and editor (Bianca) and writer and collaborator (Sara) during the inaugural Women of Color Sexual Health Network Curriculum Lab which took place November 2017 in New Orleans, LA. In two months, 7 women and femmes of color who are sexuality educators wrote a robust curriculum for our communities that centers pleasure, social emotional learning competencies as early Freedom Schools implemented, sex and pleasure positive, using an intersectional framework and praxis, disability justice framework, inclusive of LGBTQ communities, and does not assume HIV negative status. This is one of the first collaborative curricula to fill in the gaps of the insufficient evidenced-based federally funded curricula. We offer a conversation that highlights how collaborative curricula for sexuality education classes supporting participants of color is a form of healing and community restitution for educators and facilitators.

Tyanez C. Jones is the Senior Editor of the Journal of Critical Thought and Praxis.

In this book review, Dr. Monic Behnken reviews Just Medicine: A cure for Racial Inequality in American Health Care by Dana Bowen Matthew a recently published work on health inequalities.

Project Resilience: A community-based Resilience Initiative to engage rural adolescents towards healthy functioning

Project Resilience, a community-based resilience initiative was developed to address public concern. In the first part of the year of 2012 in a rural Mid-Atlantic state, eight adolescents and young adults died by suicide. Concerned public officials asked the Centers for Disease Control and Prevention (CDC) to assist with the epidemiologic investigation of these deaths. Mental health problems were found to be a significant contributing factor to the fatal suicide attempts. The scope of this paper will explore the potential influence of rural stress, trauma and violence among adolescents and the lack of access to care and mental health services as being a relevant factor. Project Resilience will be introduced in exploring how this community resilience model can help prepare youth and young adults to utilize inner strengths and mobilize family, community, and cultural resources when faced with adversity. Grounded in an ecological perspective, Project Resilience is a strengths-based initiative which incorporates traditional counseling and psychotherapy techniques. Project Resilience also can minimize barriers associated with seeking mental health services in rural communities, including stigma and limited access to mental health services. Relevant implications and recommendations will be offered on how Project Resilience can be one effective intervention tool in working with this population.