A systematic literature search of cultural competence indicators and interventions targeting Indigenous peoples in Australia, New Zealand, United States and Canada

McCalman, Janya, Bainbridge, Roxanne, Clifford, Anton, and Tsey, Komla (2013) A systematic literature search of cultural competence indicators and interventions targeting Indigenous peoples in Australia, New Zealand, United States and Canada. Report. UNSPECIFIED.

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Why is cultural competence important?

Internationally, concerns about inequalities in health care access and service provision have prompted regulatory bodies and health services to examine how they can better meet the health care needs of different cultural groups. Improving cultural competency in health services is one way of making health services more responsive to Indigenous and other minority ethnic/racial groups.

What is cultural competence?

Cultural competence is the capacity of a health system to improve health and wellbeing by integrating cultural practices and concepts into health service delivery (Australian Government National Health and Medical Research Council, 2005). It involves acknowledging and responding to the differences and diversity between and within cultural groups at organisational and individual health practitioner levels. For health organisations, cultural competence requires behaviours, attitudes, practices, policies and structures that combine to enable the system, agency and professionals to work effectively in culturally diverse situations (Cross et al., 1989). For individual health practitioners, cultural competence requires an ability to function effectively in the context of cultural differences (Finger Lakes Health Systems Agency, 2003). Capacity for organisational and individual cultural competence is influenced by: values and attitudes; cultural sensitivity; communication; policies and procedures; training and staff development; facility characteristics infrastructure; intervention and treatment models; family and community participation; and monitoring, evaluation and research (U.S. Department of Health and Human Services Office of Minority Health, 2001a).

Scope of the review

This report is a systematic review of peer reviewed and grey literature publications on cultural competence from Australia, New Zealand, Canada and the United States for the period 2002-2012 (July inclusive). This systematic review will: 1) identify and describe indicators (measures and measurement instruments), of cultural competence, including those relating to racial disparities in healthcare; 2) examine the relationship between cultural competency and health care outcomes; and 3) identify evaluations of strategies to improve cultural competency, describe the characteristics of strategies and critique the quality of their evaluation design.


A qualified librarian systematically searched 17 electronic databases and relevant websites for scientific and grey literature publications relating to cultural competence and the delivery of health services in Australia, New Zealand, Canada or the United States, identifying 1165 publications. Reference lists of review papers identified were hand-searched, resulting in an additional six relevant publications. Examination of the abstracts of these 1171 publications identified 137 publications relevant to this review.

Item ID: 24624
Item Type: Report (Report)
Keywords: cultural competence, Indigenous, Australian, New Zealand, United States, Canada, indicators, interventions
Funders: Sax Institute for the Mental Health Drug and Alcohol Office
Date Deposited: 26 Sep 2013 23:36
FoR Codes: 13 EDUCATION > 1303 Specialist Studies in Education > 130399 Specialist Studies in Education not elsewhere classified @ 100%
SEO Codes: 92 HEALTH > 9203 Indigenous Health > 920301 Aboriginal and Torres Strait Islander Health - Determinants of Health @ 100%
Downloads: Total: 11
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