Validation of a Patient-Centered Culturally Sensitive Health Care Office Staff Inventory

Patient-centered cultural sensitivity involves interacting with patients in ways that enable them to feel comfortable, respected, and trusting in the health care process. The majority of available research pertaining to cultural sensitivity and cultural competence focuses exclusively on health care providers. Provider cultural sensitivity has been positively associated with patient satisfaction, treatment adherence, and health outcomes. Yet, today's health care experience encompasses much more than isolated patient-provider interactions. It is the health care clinic office staff who make the first impression on patients regarding the quality (including the cultural sensitivity) of the health care that they will experience at a health care clinic. Given the documented links between patient-centered cultural sensitivity in health care and patients' health care satisfaction, there is clearly a need for research to assess the level of patient-centered cultural sensitivity displayed by health care clinic office staff. Despite this, there is a paucity of research pertaining to health care office staff and no studies investigate the isolated role of office staff cultural sensitivity in patient empowerment, health care satisfaction, treatment adherence, or health outcomes. The absence of such research is likely related to the lack of reliable measures available to assess the cultural sensitivity of office staff. Thus, the present study was conducted to determine the factor structure and reliability of a newly developed inventory called the Tucker Culturally Sensitive Health Care Office Staff Inventory – Patient Form (T-CSHCOSI-PF). This 32-item inventory is designed for patients to use to evaluate the level of patient-centered cultural sensitivity that they perceive as displayed by their clinic office staff. The study sample consisted of a nationally representative sample of 1,648 adult patients. The sample included 1,052 women, 527 men, and 69 with unreported gender, of whom 20% self-identified as African American, 32% as White, and 30% as Hispanic. Exploratory and confirmatory factor analyses revealed that the T-CSHCOSI-PF has two factors and high internal consistency and reliability (Cronbach's alpha =.97). This instrument will likely promote needed research on the level of patient-centered cultural sensitivity displayed by health care clinic office staff and serve as an important tool in evaluating patient perceived office staff cultural sensitivity.