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Providers with cultural competence affirm community health workers

When primary care providers and their staff showed greater cultural competence and preparedness, they asserted more positive perceptions of community health workers abilities to reduce health care disparities, according to a study.

Researchers surveyed 119 providers (physicians and nurse practitioners) and clinical staff (nurses, medical assistants and others) from six primary care practices in metropolitan Baltimore between April and December 2011. The researchers used logistic regression adjusting for age, race, gender, provider/staff status and years of practice to calculate the associations between provider and staff cultural preparedness and competency and positive attitudes toward community health workers’ proficiency at decreasing health care inequalities.

The researchers assessed the participants’ cultural competencies in the areas of motivation to learn about other cultures (cultural motivation), attitudes toward power and assimilation, frequency of culturally competent behavior and self-reported preparedness to deliver cross-cultural care. The researchers based the survey on a community health worker intervention as part of Project ReD CHiP (Reducing Disparities and Controlling Hypertension in Primary Care) and the ACT (Achieving Blood Pressure Control Together) study. As a result, the survey also included questions on how the community health worker affected health care quality and patient outcomes.

Providers and staff demonstrating greater cultural motivation perceived community health workers as helpful for reducing health care discrepancies, (OR=9.66; 95% CI, 3.48-28.8), as did those who displayed cultural competency, (OR=3.58; 95% CI, 1.61-7.92). Participants who showed cultural preparedness perceived community health workers as useful (OR=2.33; 95% CI, 1.21-4.51). The participants’ outlooks on power and assimilation did not affect their perceptions of community health workers, according to researchers.

“Because [community health workers] are not health care providers, but agents from the community … [they are] able to bridge cultural gaps between a diverse patient population and the health care system,” researchers wrote. “Primary care clinics employing [community health workers] could consider provider and staff education about the important roles [community health workers] play in order to improve services to diverse populations.”

Disclosure: The researchers report receiving grants from the National Heart, Lung and Blood Institute.