title: Providing culturally competent care: residents in HRSA Title VII funded residency programs feel better prepared.
abstract: BACKGROUND
  The Health Resources and Services Administration (HRSA) funds primary care residency programs through its Title VII training grants, with a goal of ensuring a well-prepared, culturally competent physician workforce. The authors sought to determine whether primary care residents in Title VII-funded training programs feel better prepared than those in nonfunded programs to provide care to culturally diverse patients.
  
  
  METHODS
  The authors analyzed data from a national mailed survey of senior resident physicians conducted in 2003-2004. Of 1,467 randomly selected family medicine, internal medicine, and pediatrics residents, 866 responded--403 in Title VII-funded programs and 463 in nonfunded programs (response rate = 59%). The survey included 28 Likert-response questions about residents' preparedness and perceived skills to provide cross-cultural care, sociodemographics, and residency characteristics.
  
  
  RESULTS
  Residents in Title VII-funded programs were more likely than others to report being prepared to provide cross-cultural care across all 8 measures (odds ratio [OR] = 1.54-2.61, P < .01) and feeling more skilled in cross-cultural care for 6 of 10 measures (OR = 1.30-1.95, P < .05). Regression analyses showed that characteristics of the Title VII-funded residency training experience related to cross-cultural care (e.g., role models, cross-cultural training, and attitudes of attending physicians) accounted for many of the differences in self-reported preparedness and skills.
  
  
  CONCLUSIONS
  Senior residents in HRSA Title VII-funded primary care residency training programs feel better prepared than others to provide culturally competent care. This may be partially explained by better cross-cultural training experiences in HRSA Title VII-funded programs.This article is part of a theme issue of Academic Medicine on the Title VII health professions training programs.
authors.affiliation: The Disparities Solutions Center at The Institute for Health Policy, Massachusetts General Hospital, Boston, Massachusetts, USA. argreen@partners.org
authors.forename: Alexander R
authors.initials: AR
authors.lastname: Green
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Betancourt
authors.forename: Elyse R
authors.initials: ER
authors.lastname: Park
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Greer
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Donahue
authors.forename: Joel S
authors.initials: JS
authors.lastname: Weissman
mesh_terms: D001291:Attitude of Health Personnel; D054521:Cultural Competency / Q000193:education*; D003625:Data Collection; D004503:Education, Medical, Graduate / Q000191:economics*; D005194:Family Practice; D005260:Female; D005380:Financing, Government / Q000191:economics / Q000331:legislation & jurisprudence; D006801:Humans; D007388:Internal Medicine; D007396:Internship and Residency; D008297:Male; D010372:Pediatrics; D010821:Physicians, Family / Q000193:education*; D011361:Professional Competence; D015397:Program Evaluation; D014146:Training Support / Q000191:economics / Q000331:legislation & jurisprudence; D014481:United States; D014488:United States Health Resources and Services Administration / Q000191:economics / Q000331:legislation & jurisprudence