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Risk Factors for Reporting Poor Cultural Competency Among Patients With Diabetes in Safety Net Clinics

개인저자
Seligman, Hilary K. MD, MAS
수록페이지
S56–S61 p.
발행일자
2012.09.20
출판사
Lippincott
초록
Background: The Consumer Assessment of Healthcare Providers and Systems Cultural Competency Item Set assesses patient perceptions of aspects of the cultural competence of their health care. Objective: To determine characteristics of patients who identify the care they receive as less culturally competent. Research Design: Cross-sectional survey consisting of face-to-face interviews. Subjects: Safety-net population of patients with type 2 diabetes (n=600) receiving ongoing primary care. Measures: Participants completed the Consumer Assessment of Healthcare Providers and Systems Cultural Competency and answered questions about their race/ethnicity, sex, age, education, health status, depressive symptoms, insurance coverage, English proficiency, duration of relationship with primary care provider, and comorbidities. Results: In adjusted models, depressive symptoms were significantly associated with poor cultural competency in the Doctor Communication—Positive Behaviors domain [odds ratio (OR) 1.73, 95% confidence interval, 1.11–2.69]. African Americans were less likely than whites to report poor cultural competence in the Doctor Communication—Positive Behaviors domain (OR 0.52, 95% CI, 0.28–0.97). Participants who reported a longer relationship (≥3 y) with their primary care provider were less likely to report poor cultural competence in the Doctor Communication—Health Promotion (OR 0.35, 95% CI, 0.21–0.60) and Trust domains (OR 0.4, 95% CI, 0.24–0.67), whereas participants with lower educational attainment were less likely to report poor cultural competence in the Trust domain (OR 0.51, 95% CI, 0.30–0.86). Overall, however, sociodemographic and clinical differences in reports of poor cultural competence were insignificant or inconsistent across the various domains of cultural competence examined. Conclusions: Cultural competence interventions in safety-net settings should be implemented across populations, rather than being narrowly focused on specific sociodemographic or clinical groups.