Providing culturally competent care: residents in HRSA Title VII funded residency programs feel better prepared.
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.
Green
Alexander R
AR
The Disparities Solutions Center at The Institute for Health Policy, Massachusetts General Hospital, Boston, Massachusetts, USA. argreen@partners.org
Betancourt
Joseph R
JR
Park
Elyse R
ER
Greer
Joseph A
JA
Donahue
Elizabeth J
EJ
Weissman
Joel S
JS
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