Generating evidence-based data on the clinical utility of increasing cultural competency among health care providers serving medically underserved areas

Biases and prejudices were named as key contributors to health disparities in the IOM 2002 report. Recognizing the importance of cultural competency in increasing the quality of healthcare delivery, federal and state oversight bodies in health education and accreditation now require training in cultural competency. While the literature on culturally competent health interventions has proliferated immensely, there is very little on outcome measures to document and track the efficacy of such training.

The Maryland's legislature has passed a bill in 2006 entitled the “Cultural Competency and Health Outcomes – Pilot Program” (HB 1455). The measure requires that the State's Department of Health and Mental Hygiene partners with community based hospitals to implement cultural competency training of medical providers while tracking improvements in health indices related to diabetes, cardiac disease or cancer. The measure requires that the community-based hospital operates in a medically underserved area and has an accredited medical residency training program.

Community-based hospitals were selected in diverse areas of the Baltimore Metropolitan area serving large ethnic/racial minority communities. The project seeks to track specified health indices of the target population before and after the educational intervention. The cultural competency level of health care providers will also be evaluated before and after educational intervention. Correlations between the two will be assessed using multivariate analysis while controlling for SES, insurance source and educational level of the target population. Standardized cultural competency training modules and evaluation tools will be used.