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Cultural competence education for health professionals

  1. Lidia Horvat1,2,*,
  2. Dell Horey3,
  3. Panayiota Romios4,
  4. John Kis-Rigo2

Editorial Group: Cochrane Consumers and Communication Group

Published Online: 5 MAY 2014

Assessed as up-to-date: 10 FEB 2014

DOI: 10.1002/14651858.CD009405.pub2

How to Cite

Horvat L, Horey D, Romios P, Kis-Rigo J. Cultural competence education for health professionals. Cochrane Database of Systematic Reviews 2014, Issue 5. Art. No.: CD009405. DOI: 10.1002/14651858.CD009405.pub2.

Author Information

  1. 1

    Department of Health, Sector Performance, Quality and Rural Health Branch, Melbourne, VIC, Australia

  2. 2

    La Trobe University, Cochrane Consumers and Communication Review Group, School of Public Health and Human Biosciences, Bundoora, Vic, Australia

  3. 3

    La Trobe University, Faculty of Health Sciences, Bundoora, VIC, Australia

  4. 4

    Australian Red Cross, Carlton, VIC, Australia

*Lidia Horvat, Sector Performance, Quality and Rural Health Branch, Department of Health, 50 Lonsdale Street, Melbourne, VIC, 3000, Australia.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 5 MAY 2014



References to studies included in this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
  5. References to other published versions of this review
Harmsen 2005 {published and unpublished data}
  • Harmsen H,  Bernsen R,  Meeuwesen L,  Thomas S,  Dorrenboom G,  Pinto D,  et al. The effect of educational intervention on intercultural communication: results of a randomised controlled trial. British Journal of General Practice 2005;55(514):343-50.
Majumdar 2004 {published data only (unpublished sought but not used)}
Sequist 2010 {published and unpublished data}
  • Sequist TD,  Fitzmaurice GM,  Marshall R,  Shaykevich S,  Marston A,  Safran DG,  et al. Cultural competency training and performance reports to improve diabetes care for black patients: a cluster randomized, controlled trial. Annals of Internal Medicine 2010;152(1):40-6.
Thom 2006 {published and unpublished data}
  • Thom DH,  Tirado MD,  Woon TL,  McBride MR. Development and evaluation of a cultural competency training curriculum. BMC Medical Education 2006;6:38.
Wade 1991 {published data only (unpublished sought but not used)}
  • Wade P, Bernstein BL. Culture sensitivity training and counselor's race: effects on black female clients' perceptions and attrition. Journal of Counseling Psychology 1991;38(1):9-15.

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
  5. References to other published versions of this review
Afuwape 2010 {published data only}
  • Afuwape SA,  Craig TK,  Harris T,  Clarke M,  Flood A,  Olajide D,  et al. The Cares of Life Project (CoLP): an exploratory randomised controlled trial of a community-based intervention for black people with common mental disorder. Journal of Affective Disorders 2010;127(1-3):370-4.
Berlin 2010 {published data only}
Bhattacharyya 2010 {published data only}
  • Bhattacharyya O,  Harris S,  Zwarenstein M,  Barnsley J. Controlled trial of an intervention to improve cholesterol management in diabetes patients in remote Aboriginal communities. International Journal of Circumpolar Health 2010;69(4):333-43.
Bhui 1998 {published data only}
Bloch 2012 {published data only}
  • Bloch C. Cultural Competency Intervention Program for Healthcare Workers (Thesis). Azusa, California: Azusa Pacific University, 2012.
Bremner 2011 {published data only}
  • Bremner S, Barnes N, Choudhury A, Cook V, Devine A, Eldridge S, et al. Oedipus: a cluster randomized trial of education for south Asians with asthma, and their primary and secondary care physicians, to reduce unscheduled care. American Thoracic Society International Conference, ATS 2011 Denver, CO United States. 2011.
Butterfloss 2002 {published data only}
  • Butterfoss FD,  Francisco VT. Evaluation to practice department: culturally competent program evaluation. Health Promotion Practice 2002;3(2):117-9.
Choi 2012 {published data only}
  • Choi I, Zou J, Titov N, Dear BF, Li S, Johnston L. Culturally attuned internet treatment for depression amongst Chinese Australians: a randomised controlled trial. Journal of Affective Disorders 2012;3:459-68.
Christensen 1984 {published data only}
Cooper 2009 {published data only}
  • Cooper LA,  Roter DL,  Bone LR,  Larson SM,  Miller ER,  Barr MS,  et al. A randomized controlled trial of interventions to enhance patient-physician partnership, patient adherence and high blood pressure control among ethnic minorities and poor persons: study protocol NCT00123045. Implementation Science 2009;19(4):7.
Cooper 2010 {published data only}
  • Cooper LA,  Roter DL,  Carson KA,  Bone LR,  Larson SM,  Miller ER,  et al. A randomized trial to improve patient-centered care and hypertension control in underserved primary care patients. Journal of General Internal Medicine 2011;26(11):1297-304.
Cortese-Peske 2013 {published data only}
  • Cortese-Peske MA. Improving Cultural Competency and Disease Awareness Among Oncology Nurses Caring for Adult T-Cell Leukemia and Lymphoma Patients (Thesis). New York, NY: Icahn School of Medicine at Mount Sinai, 2013.
Crenshaw 2011 {published data only}
  • Crenshaw K,  Shewchuk RM,  Qu H,  Staton LJ,  Bigby JA,  Houston TK,  et al. What should we include in a cultural competence curriculum? An emerging formative evaluation process to foster curriculum development. Academic Medicine 2011;86(3):333-41.
Fossli Jensen 2000 {published data only}
  • Fossli Jensen B,  Gulbrandsen P,  Dahl FA,  Krupat E,  Frankel RM,  Finset A. Effectiveness of a short course in clinical communication skills for hospital doctors: results of a crossover randomized controlled trial (ISRCTN22153332). Patient Education and Counseling 2011;84(2):163-9.
Gendron 2013 {published data only}
  • Gendron T, Maddux S, Krinsky L, White J, Lockeman K, Metcalfe Y, et al. Cultural competence training for healthcare professionals working with LGBT older adults. Educational Gerontology 2013;39(6):454-63.
Greenberg 2013 {published data only}
  • Greenberg NE. A project to increase faculty's cultural competence in mentoring English as a second language nursing students. Teaching and Learning in Nursing 2013;8(4):128-35.
Greer 2007 {published data only}
  • Greer JA,  Park ER,  Green AR,  Betancourt JR,  Weissman JS. Primary care resident perceived preparedness to deliver cross-cultural care: an examination of training and specialty differences. Journal of General Internal Medicine 2007;22(8):1107-13.
Heitzler 2011 {published data only}
  • Heitzler ET. Enhancing the Cultural Competence of Women's Health Nurses via Online Continuing Education (Thesis). Las Vegas: School of Nursing, University of Nevada, 2011.
Jackson 2000 {published data only}
  • Jackson J,  Kennedy BL,  Mandel D,  Carlson M,  Cherry BJ,  Fanchiang SP,  et al. Derivation and pilot assessment of a health promotion program for Mandarin-speaking Chinese older adults. International Journal of Aging and Human Development 2000;50(2):127-49.
Javier 2013 {published data only}
  • Javier JR, Hendriksz T, Chamberlain LJ, Stuart E. Cross-cultural training in pediatric residency: every encounter Is a cross-cultural encounter. Academic Pediatrics 2013;13:495-8.
Khanna 2009 {published data only}
  • Khanna SK,  Cheyney M,  Engle M. Cultural competency in health care: evaluating the outcomes of a cultural competency training among health care professionals. Journal of the National Medical Association 2009;101(9):886-92.
Kopke 2012 {published data only}
  • Köpke S, Mühlhauser I, Gerlach A, Haut A, Haastert B, Möhler R, et al. Effect of a guideline-based multicomponent intervention on use of physical restraints in nursing homes: a randomized controlled trial. JAMA 2012;307(20):2177-84.
Kutob 2009 {published data only}
  • Kutob RM,  Senf JH,  Harris JM. Teaching culturally effective diabetes care: results of a randomized controlled trial. Family Medicine 2009;41(3):167-74.
Kutob 2013 {published data only}
  • Kutob RM, Bormanis J, Crago M, Harris Jr JM, Senf J, Shisslak CM. Cultural competence education for practicing physicians: lessons in cultural humility, nonjudgmental behaviors, and health beliefs elicitation. The Journal of Continuing Education in the Health Professions 2013;33:164-73.
Lasser 2010 {published data only}
  • Lasser KE,  Murillo J,  Lisboa S,  Casimir AN,  Valley-Shah L,  Emmons KM,  et al. Colorectal cancer screening among ethnically diverse, low-income patients: a randomized controlled trial. Archives of Internal Medicine 2011;171(10):906-12.
Manfredi 1998 {published data only}
  • Manfredi C,  Czaja R,  Freels S,  Trubitt M,  Warnecke R,  Lacey L. Prescribe for health. Improving cancer screening in physician practices serving low-income and minority populations. Archives of Family Medicine 1998;7(4):329-37.
Marra 2010 {published data only}
  • Marra J,  Covassin T,  Shingles RR,  Canady RB,  Mackowiak T. Assessment of certified athletic trainers' levels of cultural competence in the delivery of health care. Journal of Athletic Training 2010;45(4):380-5.
Martey 1995 {published data only}
  • Martey JO,  Elkins TE,  Wilson JB,  Adadevoh SW,  MacVicar J,  Sciarra JJ. Innovative community-based postgraduate training for obstetrics and gynecology in West Africa. Obstetrics and Gynecology 1995;85(6):1042-6.
Maxie 2006 {published data only}
McCabe 2006 {published data only}
  • McCabe JA. An assignment for building an awareness of the intersection of health literacy and cultural competence skills. Journal of the Medical Library Association 2006;94(4):458.
Miranda 2003 {published data only}
  • Miranda J,  Duan N,  Sherbourne C,  Schoenbaum M,  Lagomasino I,  Jackson-Triche M,  et al. Improving care for minorities: can quality improvement interventions improve care and outcomes for depressed minorities? Results of a randomized, controlled trial. Health Services Research 2003;38(2):613-30.
Mostow 2010 {published data only}
  • Mostow C,  Crosson J,  Gordon S,  Chapman S,  Gonzalez P,  Hardt E,  et al. Treating and precepting with RESPECT: a relational model addressing race, ethnicity, and culture in medical training. Journal of General Internal Medicine 2010;25(S2):S146-54.
Naeem 2011 {published data only}
  • Naeem F. Preliminary evaluation of culturally sensitive CBT for depression in Pakistan: findings from Developing Culturally-Sensitive CBT Project (DCCP). Behavioural and Cognitive Psychotherapy 2011;39:165-73.
Nagel 2009a {published data only}
Nagel 2009b {published data only}
  • Nagel T, Thompson C, Spencer N, Judd J, Williams R. Two way approaches to Indigenous mental health training: brief training in brief interventions. Australian e-Journal for the Advancement of Mental Health 2009;8(2):1-6.
Newland 2008 {published data only}
  • Newland J. Promising practice for diverse populations. Nurse Practitioner 2008;33(2):5.
O'Brien 1977 {published data only}
  • O'Brien GE, Plooij D. Comparison of programmed and prose culture training upon attitudes and knowledge. Journal of Applied Psychology 1977;62(4):499-505.
Omer 2008 {published data only}
  • Omer K,  Mhatre S,  Ansari N,  Laucirica J,  Andersson N. Evidence-based training of frontline health workers for door-to-door health promotion: a pilot randomized controlled cluster trial with Lady Health Workers in Sindh Province, Pakistan. Patient Education and Counseling 2008;72(2):178-85.
Palmer 2011 {published data only}
  • Palmer RC,  Samson R,  Triantis M,  Mullan ID. Development and evaluation of a web-based breast cancer cultural competency course for primary healthcare providers. BMC Medical Education 2011;11:59.
Park 2013 {published data only}
  • Park M, Kweon Y. Effects of a cultural competence promotion program for multicultural maternity nursing care: case-based small group learning. Journal of Korean Academy of Nursing 2013;43:626-35.
Prescott-Clements 2013 {published data only}
  • Prescott-Clements L, Schuwirth L, van der Vleuten C, Hurst Y, Whelan G, Gibb E, et al. The cultural competence of health care professionals: conceptual analysis using the results from a national pilot study of training and assessment. Evaluation & the Health Professions 2013;36:191-203.
Resnick 2009 {published data only}
  • Resnick B,  Cayo J,  Galik E,  Pretzer-Aboff I. Implementation of the 6-week educational component in the Res-Care intervention: process and outcomes. Journal of Continuing Education in Nursing 2009;40(8):353-60.
Roberts-Thomson 2010 {published data only}
  • Roberts-Thomson KF,  Slade GD,  Bailie RS,  Endean C,  Simmons B,  Leach AJ,  et al. A comprehensive approach to health promotion for the reduction of dental caries in remote Indigenous Australian children: a clustered randomised controlled trial. International Dental Journal 2010;60(3S2):245-9.
Rogers 2000 {published data only}
  • Rogers A. Literacy comes second: working with groups in developing societies. Development in Practice 2000;10(2):236-9.
Schim 2006 {published data only}
  • Schim SM,  Doorenbos AZ,  Borse NN. Enhancing cultural competence among hospice staff. American Journal of Hospice& Palliative Medicine 2006;23(5):404-11.
Schouten 2005 {published data only}
  • Schouten BC, Meeuwesen L, Harmsen HAM. The impact of an intervention in intercultural communication on doctor–patient interaction in The Netherlands. Patient Education and Counseling 2005;58:288-95.
Sheikmoonesi 2011 {published data only}
  • Sheikhmoonesi F, Zarghami M, Tirgari A, Khalilian A. The effect of transactional analysis education to nurses on patient’s satisfaction in Iran. Asian Journal of Psychiatry (Poster presentations) 2011; Vol. 4S1:S71.
Sheridan 1982 {published data only}
  • Sheridan KM. Counseling Across Cultures: A White Awareness Approach (Thesis). Norman: University of Oklahoma, 1982.
Sixta 2007 {published data only}
  • Sixta CS. Border Intervention by Promotores for Type 2 Diabetes (Thesis). Houston: University of Texas, 2007.
Sixta 2008 {published data only}
Smith 2001 {published data only}
  • Smith L. Evaluation of an educational intervention to increase cultural competence among registered nurses. Journal of Cultural Diversity 2001;8(2):50.
Thomas 2000 {published data only}
  • Thomas V,  Richardson A,  Saleem T,  Baylav A,  Hall A,  Richards M,  et al. The efficacy of bilingual health advocacy in ethnic minority patients with cancer. Nursing Standard 2000;14(26):32-3.
Tozer 2010 {published data only}
  • Tozer R, Aubrey L, Gill PS, Jones C, Patel MG, Zaidi Q, et al. Developing cultural competence across communities: a coronary heart disease training programme for health advocates and trainers. Diversity in Health and Care 2010;7:177-88.
Witter 2012 {published data only}
  • Witter J. Mentoring of Medical Surgical Nurses, Assessment of Patients, Clinical Decision-Making, Cultural Competency, Commitment to Professional Nursing Standards, Positive Feelings about Nursing at this Hospital, and Willingness to Remain in the Nursing Profession (Thesis). School of Education, Dowling College, 2012.
Xu 2010 {published data only}
  • Xu Y,  Shen J,  Bolstad AL,  Covelli M,  Torpey M. Evaluation of an intervention on socio cultural communication skills of international nurses. Nursing Economics 2010;28(6):386-92, 408.

References to ongoing studies

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
  5. References to other published versions of this review
Clark 2010 {unpublished data only}
  • NCT01251523: Improving Asthma Outcomes Through Cultural Competence Training for Physicians. Ongoing study November 2010.

Additional references

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
  5. References to other published versions of this review
Abbey 2013
  • [Abbey, Nicholas]. Teachers. Melbourne: School Improvement and Governance Network, (Accessed 25 January 2013).
Ahmann 2002
  • Ahmann E. Developing cultural competence in health care settings: National Center for Cultural Competence. Pediatric Nursing 2002;28(2):133-7.
Alexander 2008
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Anderson 2003
  • Anderson L, Scrimshaw S, Fullilove M, Fielding JE, Normand J. Culturally competent healthcare systems, a systematic review. American Journal of Preventative Medicine 2003;24(3S):68-79.
Baer 2012
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Beach 2005
  • Beach MC, Price EG, Gary TL, Robinson KA, Gozu A, Palacio A, et al. Cultural competence: a systematic review of healthcare provider education interventions. Medical Care 2005;43(4):356-73.
Beach 2006
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Bean 2006
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Betancourt 2003
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Betancourt 2010
Brach 2002
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Brennan 2009
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Campbell 2000
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Chiarenza 2012
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Divi 2007
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Flores 2005
Forsetlund 2009
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Grant 2013
Grote 2008
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Harmsen 2006
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Hasnain 2009
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Johnstone 2006
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  • Lie DA, Lee-Ray E, Gomez A, Bereknyei S, Braddock CH. Does cultural competency training of health professionals improve patient outcomes? A systematic review and proposed algorithm for future research. Journal of General Internal Medicine 2010;26(3):317-25.
Like 2011
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Mladovsky 2012
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References to other published versions of this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
  5. References to other published versions of this review
Horvat 2011
  • Horvat L, Horey D, Romios P, Kis-Rigo J. Cultural competence education for health professionals. Cochrane Database of Systematic Reviews 2011, Issue 10. [DOI: 10.1002/14651858.CD009405]