title: Cultural competency assessment tool for hospitals: evaluating hospitals' adherence to the culturally and linguistically appropriate services standards.
abstract: BACKGROUND
  The U.S. national standards for culturally and linguistically appropriate services (CLAS) in health care provide guidelines on policies and practices aimed at developing culturally competent systems of care. The Cultural Competency Assessment Tool for Hospitals (CCATH) was developed as an organizational tool to assess adherence to the CLAS standards.
  
  
  OBJECTIVE
  First, we describe the development of the CCATH and estimate the reliability and validity of the CCATH measures. Second, we discuss the managerial implications of the CCATH as an organizational tool to assess cultural competency.
  
  
  METHODS
  We pilot tested an initial draft of the CCATH, revised it based on a focus group and cognitive interviews, and then administered it in a field test with a sample of California hospitals. The reliability and validity of the CCATH were evaluated using factor analysis, analysis of variance, and Cronbach's alphas.
  
  
  RESULTS
  Exploratory and confirmatory factor analyses identified 12 CCATH composites: leadership and strategic planning, data collection on inpatient population, data collection on service area, performance management systems and quality improvement, human resources practices, diversity training, community representation, availability of interpreter services, interpreter services policies, quality of interpreter services, translation of written materials, and clinical cultural competency practices. All the CCATH scales had internal consistency reliability of .65 or above, and the reliability was .70 or above for 9 of the 12 scales. Analysis of variance results showed that not-for-profit hospitals have higher CCATH scores than for-profit hospitals in five CCATH scales and higher CCATH scores than government hospitals in two CCATH scales.
  
  
  CONCLUSIONS
  The CCATH showed adequate psychometric properties. Managers and policy makers can use the CCATH as a tool to evaluate hospital performance in cultural competency and identify and target improvements in hospital policies and practices that undergird the provision of CLAS.
authors.affiliation: Department of Health Services Administration, University of Alabama, Birmingham, USA. rweech@uab.edu
authors.forename: Robert
authors.initials: R
authors.lastname: Weech-Maldonado
authors.forename: Janice L
authors.initials: JL
authors.lastname: Dreachslin
authors.forename: Julie
authors.initials: J
authors.lastname: Brown
authors.forename: Rohit
authors.initials: R
authors.lastname: Pradhan
authors.forename: Kelly L
authors.initials: KL
authors.lastname: Rubin
authors.forename: Cameron
authors.initials: C
authors.lastname: Schiller
authors.forename: Ron D
authors.initials: RD
authors.lastname: Hays
mesh_terms: D002140:California; D054521:Cultural Competency; D005163:Factor Analysis, Statistical; D017144:Focus Groups; D019983:Guideline Adherence; D006297:Health Services Accessibility; D006761:Hospitals; D006801:Humans; D007407:Interviews as Topic; D007857:Leadership; D010865:Pilot Projects; D011594:Psychometrics; D011795:Surveys and Questionnaires / Q000592:standards; D014175:Translating