Online Program

Assessing health disparities and staff cultural competency within a Connecticut community health center network

Monday, November 4, 2013 : 5:10 p.m. - 5:30 p.m.

Sisi Wang, BS, School of Public Health, Yale University, New Haven, CT
Mary D'Alimonte, MPH candidate, School of Public Health, Yale University, New Haven, CT
Adam Eldahan, M.P.H., School of Public Health, Yale University, New Haven, CT
Athena Samaras, BA, School of Nursing, Yale University, New Haven, CT
Rosalyn Chan, MD, School of Public Health, Yale University, New Haven, CT
Margaret Lippitt, BA, School of Public Health, Yale University, New Haven, CT
Alix Pose, MD, MPH, Department of Quality Assurance/Performance Improvement, Optimus Health Care, Bridgeport, CT
Debbie Humphries, PhD, MPH, Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT
Judith Lichtman, PhD, MPH, Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT
BACKGROUND: In 2011, Optimus Health Care – a network of 14 federally qualified health centers (FQHCs) in Southwestern Connecticut – served over 50,000 patients, 85.26% who were racial or ethnic minorities and 97.78% who were at or below 200% of the federal poverty level. Culturally competent care is associated with improved patient experiences, and therefore holds immense potential for reducing health disparities in the Optimus patient population. This study seeks to (1) identify disparities in health outcomes related to diabetes, hypertension, and hyperlipidemia among Optimus patients and (2) evaluate Optimus staff knowledge regarding cultural competency. METHODS: Using Optimus electronic medical records data, this study will analyze disparities in blood pressure, total cholesterol, and HbA1c levels while controlling for clinical and demographic characteristics. Cultural competency of Optimus staff will be evaluated by using a validated cultural competency survey. RESULTS: Nationally, health disparities are marked among racial and ethnic minorities, and it is expected that Optimus patients will also demonstrate health disparities. Furthermore, while Optimus staff are required to complete periodic web-based cultural competency trainings, it is anticipated that opportunities for improvement in staff knowledge, awareness, attitudes, and skills regarding cultural diversity will be identified. CONCLUSIONS: This study will assess disparities in patient outcomes and staff cultural competency in the Optimus network. Results will identify particular cultural issues or clinic locations needing additional resources. Ultimately, this study will make recommendations to enhance cultural competency trainings at FQHCs, with the goal of reducing health disparities and improving quality of services provided.

Learning Areas:

Administration, management, leadership
Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Diversity and culture
Provision of health care to the public

Learning Objectives:
Identify disparities among demographic groups in health outcomes related to diabetes, hyperlipidemia, and hypertension that commonly exist among federally qualified community health center (FQHC) patients. Describe components of FQHC staff cultural competency that present opportunities for strengthening. Explain barriers to achieving optimal staff cultural competency among agencies providing care for the medically underserved. Formulate recommendations for health care administrators to increase efficacy of cultural competency trainings for staff with the goal of reducing health disparities.

Keyword(s): Health Disparities, Cultural Competency

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was one of five students who conducted this research as part of a community health practicum course at Yale School of Public Health. I am an MPH graduate student studying Chronic Disease Epidmiology and have experience in nutrition, epidemiology, global health, and health disparities.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.