Defining cultural competence: A practical framework for addressing racial/ethnic disparities in health and health care
Defining cultural competence: A practical framework for addressing racial/ethnic disparities in health and health care
复制标题
DOI：
10.1093/phr/118.4.293
复制
发表时间：
2003-07-01
影响因子：
3.3
通讯作者：
Ananeh-Firempong, O
中科院分区：
文献类型：
--
作者：
Betancourt, JR;Green, AR;Ananeh-Firempong, O
目标。美国在健康方面的种族/民族差异已经得到了很好的描述。“文化能力”领域已经成为解决这些差异的一种策略。在回顾相关文献的基础上，作者提出了文化能力的定义，确定了干预的关键组成部分，并描述了一个实施措施的实用框架，以解决健康和医疗保健中的种族/民族差异。作者对学术、基金会和政府出版物进行了文献综述，重点关注护理的社会文化障碍、发生特定障碍的卫生保健系统水平以及解决这些障碍的文化能力努力。在组织（领导/劳动力）、结构（护理过程）和临床（提供者-患者接触）层面确定了护理的社会文化障碍。一个文化能力干预的框架——包括少数民族进入卫生专业，发展翻译服务和适合语言的卫生教育材料，以及跨文化问题的提供者教育——出现了分类策略，以解决卫生和卫生保健中的种族/民族差异。预计今后十年人口结构的变化将使解决保健和保健方面的种族/族裔差异的重要性更加突出。组织、结构和临床文化能力干预的框架可以促进消除这些差异，并改善对所有美国人的护理。
Objectives. Racial/ethnic disparities in health in the U.S. have been well described. The field of "cultural competence" has emerged as one strategy to address these disparities. Based on a review of the relevant literature, the authors develop a definition of cultural competence, identify key components for intervention, and describe a practical framework for implementation of measures to address racial/ethnic disparities in health and health care.Methods. The authors conducted a literature review of academic, foundation, and government publications focusing on sociocultural barriers to care, the level of the health care system at which a given barrier occurs, and cultural competence efforts that address these barriers.Results. Sociocultural barriers to care were identified at the organizational (leadership/workforce), structural (processes of care), and clinical (provider-patient encounter) levels. A framework of cultural competence interventions-including minority recruitment into the health professions, development of interpreter services and language-appropriate health educational materials, and provider education on cross-cultural issues-emerged to categorize strategies to address racial/ethnic disparities in health and health care.Conclusions. Demographic changes anticipated over the next decade magnify the importance of addressing racial/ethnic disparities in health and health care. A framework of organizational, structural, and clinical cultural competence interventions can facilitate the elimination of these disparities and improve care for all Americans.