title: Cultural competence and social relationships: a social network analysis.
abstract: OBJECTIVE
  This study investigated the role of social relationships in the sharing of cultural competence by testing two hypotheses: cultural competence is a socially shared behaviour; and central healthcare professionals are more culturally competent than non-central healthcare professionals.
  
  
  BACKGROUND
  Sustaining cultural competence in healthcare services relies on the assumption that being culturally competent is a socially shared behaviour among health professionals. This assumption has never been tested.
  
  
  BACKGROUND
  Organizational aspects surrounding cultural competence are poorly considered. This therefore leads to a heterogeneous implementation of cultural competence - especially in continental Europe.
  
  
  METHODS
  We carried out a social network analysis in 24 Belgian inpatient and outpatient health services. All healthcare professionals (ego) were requested to fill in a questionnaire (Survey on social relationships of health care professionals) on their level of cultural competence and to identify their professional relationships (alter). We fitted regression models to assess whether (1) at the dyadic level, ego cultural competence was associated with alter cultural competence, and (2) health professionals of greater centrality had greater cultural competence.
  
  
  RESULTS
  At the dyadic level, no significant associations were found between ego cultural competence and alter cultural competence, with the exception of subjective exposure to intercultural situations. No significant associations were found between centrality and cultural competence, except for subjective exposure to intercultural situations.
  
  
  CONCLUSIONS
  Being culturally competent is not a shared behaviour among health professionals. The most central healthcare professionals are not more culturally competent than less central health professionals.
  Culturally competent health care is not yet a norm in health services. Health care and training authorities should either make cultural competent health care a licensing criteria or reward culturally competent health care.
authors.affiliation: Institute of Health and Society, Université catholique de Louvain, Brussels, Belgium.
authors.forename: M
authors.identifier: http://orcid.org/0000-0003-1612-6348
authors.initials: M
authors.lastname: Dauvrin
authors.affiliation: Institute of Health and Society, Université catholique de Louvain, Brussels, Belgium.
authors.forename: V
authors.initials: V
authors.lastname: Lorant
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001530:Belgium; D054521:Cultural Competency; D018864:Cultural Diversity; D065246:Culturally Competent Care; D005260:Female; D006801:Humans; D008297:Male; D012919:Social Behavior; D012944:Social Support; D011795:Surveys and Questionnaires
keywords: Belgium; Cultural Competence; Health Professionals; Popularity; Social Network Analysis; Social Relationships; Socialness