Cultural competence training for multidisciplinary health care teams: Salud para Todos

Salud para Todos represents a community partnership to enhance cultural competence among health workers and increase access to care for Hispanics in four counties (one urban, three rural) of west Tennessee. Networking partners included the Tennessee Public Health Association and the Rural Health Association of Tennessee, as well as major hospitals and educational institutions. Interactive workshops were conducted with 788 participants of three target groups: 1) multidisciplinary teams of medical and allied health professionals (physicians, nurses, dentists, pharmacist, social workers); 2) hospital workers who are sometimes overlooked but often have the initial and most frequent interaction with individuals of different cultures (food service, security, housekeeping); and 3) students entering health professions (medicine, nursing, dentistry, pharmacy, and allied health careers). Topics included cultural characteristics and values shared by Hispanics; cultural beliefs of illness and disease; acculturation and effects on health; health communication and health-seeking behavior; diversity among Hispanics; and working effectively with medical interpreters. Outcomes included pre-post measures of knowledge and skills pertaining to health beliefs and expectations; communication patterns; and social interactions. Paired t-tests on participants with complete data (n=582) indicated a significant knowledge increase (p <0.0001). Analyses on each of the three participant subgroups showed significant knowledge increases for health professionals (p< 0.0001) and students (p< 0.0001), but not for hospital associates (p=0.14). There were also significant differences in gains between groups. Students demonstrated the greatest knowledge increase, followed by health professionals. Partnerships among public health, healthcare organizations, and educational institutions are effective strategies for promoting cultural competence.