title: Culturally competent healthcare systems. A systematic review.
abstract: Culturally competent healthcare systems-those that provide culturally and linguistically appropriate services-have the potential to reduce racial and ethnic health disparities. When clients do not understand what their healthcare providers are telling them, and providers either do not speak the client's language or are insensitive to cultural differences, the quality of health care can be compromised. We reviewed five interventions to improve cultural competence in healthcare systems-programs to recruit and retain staff members who reflect the cultural diversity of the community served, use of interpreter services or bilingual providers for clients with limited English proficiency, cultural competency training for healthcare providers, use of linguistically and culturally appropriate health education materials, and culturally specific healthcare settings. We could not determine the effectiveness of any of these interventions, because there were either too few comparative studies, or studies did not examine the outcome measures evaluated in this review: client satisfaction with care, improvements in health status, and inappropriate racial or ethnic differences in use of health services or in received and recommended treatment.
authors.affiliation: Division of Prevention Research and Analytic Methods, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA. LAA1@cdc.gov
authors.forename: Laurie M
authors.initials: LM
authors.lastname: Anderson
authors.forename: Susan C
authors.initials: SC
authors.lastname: Scrimshaw
authors.forename: Mindy T
authors.initials: MT
authors.lastname: Fullilove
authors.forename: Jonathan E
authors.initials: JE
authors.lastname: Fielding
authors.forename: Jacques
authors.initials: J
authors.lastname: Normand
mesh_terms: D003144:Communication Barriers; D018864:Cultural Diversity; D003469:Culture; D003695:Delivery of Health Care; D006282:Health Personnel; D006801:Humans; D007802:Language; D010043:Outcome and Process Assessment, Health Care; D011787:Quality of Health Care; D014481:United States