Table 2 Characteristics of the systems level interventions and measures to improve cultural competence
Publication | Aim | Implementation | Strategies | Outcomes | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
First Author Year | Increased cultural competency | User engagement | Organisational readiness/commitment | Multiple sites of delivery | Audit and quality improvement | Organisation-level policies or strategies | Organisational systems | Client/practitioner encounter | Health outcomes | National outcomes | ||||||||||||
Develop resources, tools and guidelines | Implementation of audit and monitoring | Cultural protocol or policy | Workforce diversity/ communication | Workforce CC training | Tailored services/programs | Org. environment: support, access, resource | Advocacy for cultural, economic & social | Promoted national CC standards implementn | Increase quality/access/participation | Improved resources/tools for providing cc | Identification of needs for improvement | Healthcare outcomes | Cultural respect/ communication | Client/family satisfaction | Practitione outcomes/satisfaction | Health outcomes or reduced disparity | Informed national standards | |||||
Chong in 2011 [36] | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✗ | ✓ | ✗ | ✓ | ✓ | ✗ | ✓ | ✗ | ~ | ✗ | ✓ |
Freeman 2014 [37] | ✓ | ✓ | ✓ | ✓ | ✗ | ✗ | ✓ | ✓ | ✗ | ✓ | ✓ | ✓ | ✗ | ✗ | ✗ | ✓ | ✗ | ✓ | ✓ | ~ | ✗ | ✗ |
Liaw 2015 [38] | ✓ | ✓ | ~ | ✓ | ✓ | ✓ | ✗ | ✓ | ✓ | ✓ | ✓ | ✗ | ✗ | ✗ | ✓ | ✓ | ✓ | ✓ | ✗ | ✗ | ✗ | ✗ |
Lieu 2004 [43] | ✓ | ✗ | ✓ | ✓ | ✗ | ✗ | ✓ | ✓ | ✓ | ✗ | ✓ | ✗ | ✓ | ✓ | ✗ | ✓ | ✓ | ~ | ✓ | ✗ | ✓ | ✗ |
Noe 2014 [42] | ✓ | ✗ | ✓ | ✓ | ✗ | ✗ | ✗ | ✗ | ~ | ✓ | ~ | ✗ | ✗ | ~ | ~ | ✓ | ✗ | ~ | ✗ | ~ | ✗ | ✗ |
O’Brien 2004 [39] | ✓ | ✓ | ~ | ✓ | ✓ | ✓ | ✓ | ✓ | ~ | ✓ | ~ | ~ | ✓ | ✓ | ✓ | ✓ | ✓ | ~ | ✓ | ~ | ✗ | ~ |
O’Brien 2007 [40] | ✓ | ✓ | ~ | ✓ | ✓ | ✓ | ✓ | ~ | ~ | ✓ | ~ | ~ | ✓ | ✓ | ✓ | ✓ | ✓ | ~ | ✓ | ✓ | ✗ | ~ |
Reibel 2010 [41] | ✓ | ✓ | ~ | ✓ | ✓ | ✓ | ✓ | ✓ | ✗ | ✓ | ✓ | ✗ | ✗ | ✓ | ✓ | ✓ | ~ | ✓ | ~ | ✗ | ✗ | ✗ |
Weech-Maldonado 2012b [13] | ✓ | ✗ | ✓ | ✓ | ✗ | ✗ | ~ | ✓ | ✓ | ✓ | ✓ | ✗ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✗ | ✗ | ✗ |
Whelan 2008 [44] | ✓ | ✗ | ✓ | ✓ | ✗ | ✗ | ✓ | ✓ | ✗ | ✗ | ✓ | ✗ | ✗ | ✗ | ✓ | ✓ | ✗ | ✗ | ✗ | ✗ | ✗ | ✗ |
Whitman 2008 [45] | ✓ | ✗ | ✓ | ✓ | ✗ | ✗ | ✓ | ~ | ~ | ✗ | ~ | ✗ | ✓ | ✓ | ✗ | ✓ | ✗ | ✓ | ✗ | ✗ | ✗ | ✗ |
Wiley 2009 [18] | ✓ | ✓ | ✓ | ✗ | ✗ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✗ | ✓ | ✗ | ✓ | ✓ | ✓ | ✗ | ~ | |
O’Brien 2003 [46] | ✓ | ~ | ~ | ✓ | ✓ | ✓ | ✓ | ~ | ~ | ✓ | ✓ | ~ | ✓ | ✓ | ✓ | ✓ | ✗ | ~ | ✗ | ✗ | ✗ | |
Siegal 2003 [47] | ✓ | ✓ | ~ | ✓ | ✓ | ✗ | ✓ | ✓ | ✓ | ✓ | ✓ | ✗ | ✓ | ✓ | ✓ | ~ | ✗ | ~ | ✗ | ✗ | ✗ | |
Weech-Maldonado 2012c [48] | ✓ | ✓ | ✓ | ✓ | ✓ | ✗ | ✓ | ✓ | ✓ | ✓ | ✓ | ✗ | ✓ | ✓ | ✓ | ~ | ✗ | ~ | ✗ | ✗ | ✗ | |