Cultural Competence in Providing Care

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Providing quality care means providing culturally competent care. When communicating with, providing treatment for, or interacting in any way with someone different than you (by culture, race/ethnicity, gender, age, belief system, and other), you will be less effective in doing so without a better understanding of the other person’s perspectives. You will also less likely engender their trust, which could mean deleterious impacts on their treatment outcomes and your pharmacy business. In the U.S., racial/ethnic minorities account for disproportionate disease and death from type 2 diabetes, hypertension, and obesity; however, interventions with measured efficacy in comparative effectiveness research are often not adopted or used widely in those communities.

Rashid et al conducted a study to assess implementation and effects of comparative effectiveness research-proven interventions translated for minority communities at a federally qualified community health center in Chicago and a group of public housing facilities for seniors in Houston. They employed virtual training institutes where intervention staff learned cultural competency methods of adapting effective interventions. Health educators delivered the Health Empowerment Lifestyle Program (HELP) in Chicago; community pharmacists delivered the MyRx Medication Adherence Program in Houston. Participation rates, satisfaction with interventions, and pre- to post-intervention changes in knowledge, diet, and clinical outcomes were analyzed. In Chicago, patients experienced statistically significant reductions in hemoglobin A1c and systolic blood pressure, increased knowledge of hypertension management, and improved dietary behaviors. In Houston, subsidized housing residents had improvements in knowledge of self-management and adherence to medication for diabetes and hypertension and high levels of participation in pharmacist home visits and group education classes.

Adaptation, adoption, and implementation of HELP and MyRx demonstrated important post-intervention changes among racial/ethnic participants in Chicago and Houston. The results were positive but suggested the need for implementation studies of longer duration to sustain long-term interventions on a community-wide scale. 

While individual pharmacists have to take considerable responsibility for honing their cultural competence skills, managers can and should make hiring decisions based in part on employees’ cultural competence, can establish a mission and values statements that embrace cultural competence, and establish an organizational structure that rewards cultural competent care and likewise market this to potential clients.

Additional information about Human Resources Management Functions and Organizational Structure and Behavior can be found in Pharmacy Management: Essentials for All Practice Settings, 5e. If you or your institution subscribes to AccessPharmacy, use or create your MyAccess Profile to sign-in to Pharmacy Management: Essentials for All Practice Settings, 5e. If your institution does not provide access, ask your medical librarian about subscribing. 

1Rashid JR, Leath BA, Truman BI, et al. Translating Comparative Effectiveness Research Into Practice: Effects of Interventions on Lifestyle, Medication Adherence, and Self-care for Type 2 Diabetes, Hypertension, and Obesity Among Black, Hispanic, and Asian Residents of Chicago and Houston, 2010 to 2013. J Public Health Manag Pract. 2017;23:468-476.  

Shane Desselle

Professor of Social and Behavioral Pharmacy, Touro University California