Nurse practitioners’ contributions to cultural competence in primary care settings


Mary A. Matteliano, PhD, OTR/L, Department of Rehabilitation Science, University at Buffalo, State University of New York, 515 Kimball Tower, 3435 Main St., Buffalo, NY 14214-3079. Tel: 829-6728; E-mail:


Purpose: To document unique ways Nurse Practitioners (NPs) contribute to the delivery of culturally competent healthcare to diverse and underserved patient populations in urban primary care practices.

Data Sources: Data are from a multi-year, multi-site study and includes 50 intensive interviews with healthcare professionals and repeated observations at three urban primary health clinics in a Northeastern U.S. city.

Conclusions and Implications for Practice: Different healthcare professionals reported common perspectives on cultural competence dealing with distinctive patient communities, including altruistic motivations, advocacy, and addressing root causes while treating diverse patients. What made NPs distinct among healthcare workers in this study was the comprehensiveness of their cultural competence approaches, both in patient interactions and within healthcare teams. NPs established culturally sensitive partnerships with patients, encouraged self-advocacy, addressed contextual considerations, and adjusted practices to meet the patient needs. They also developed niches in multidisciplinary teams that emphasized holistic approaches to establish trust and to cross cultural boundaries, both with other health professionals and their diverse patients.