April 4-6, 2024 • Hyatt Regency • Lexington, KY
Innovations in Health Communication
Innovations in Health Communication
Abstract: Healing Health Care Disparities: Pilot Testing of an Online Cultural Competency Training Utilizing an Intersectionality Framework
Cultural competency training is needed and necessary for physicians to connect with patients and to control their own biases such that they are equipped to provide care to a diverse patient population (Brown et al., 2016; Periyakoil, 2020; Spitzberg & Changnon, 2009). We invoked intersectionality (Crenshaw, 1991) at the outset to build a cultural competency training that addresses multiple forms of oppression, recognizes in-group differences, and compels individuated care. The training consists of three core modules with additional patient population “spotlights,” with the first centering Black maternal health. Black mothers face intersectional disparities when seeking and receiving all stages of maternal care, a persistent health crisis in the United States (Bond et al., 2021; Davis, 2020). Cultural competency is a tripartite framework consisting of cognitive (knowledge), affective (attitudes), and behavioral (skills) elements (AAMC, 2005; Spitzberg & Changnon, 2009). Hence, following the training, we expect:
H1: Knowledge about Black maternal health care disparities will increase pre-training to post-training.
H2: Attitudes toward addressing implicit bias and cultural competence will improve pre-training to post-training.
H3: Communication efficacy to provide culturally competent health care will improve pre-training to post-training.
We recruited U.S. medical students, residents, and physicians to participate. Their mean age was 29 years (SD = 8.70). Most identified as women (n = 10; 58.8%; men, n = 7, 41.12%). Participants reported their race as Asian (n = 6, 35.29%), White (n = 6, 35.29%), Asian and White (n = 3, 17.65%), and Black/African American (n = 2, 11.76%). Most were medical students (n = 12, 70.59%), followed by resident physicians (n = 3, 17.65%), and physicians (n = 2, 11.76%).
Participants completed the study online. The pre- and post-training surveys comprised of demographic items, measures for assessing the hypotheses, open- and close-ended items about physicians’ own biases and previous bias training, and open- and close-ended items regarding evaluations of the training (Afifi et al., 2005; Corley et al., 2016; Crosson et al., 2004; Gonzalez et al., 2021; Levett-Jones et al., 2017). We provided participants a $50 Amazon e-gift card as compensation.
Paired samples t-tests comparing pre- to post-training knowledge (H1), attitudes (H2), and communication efficacy (H3) revealed significantly higher post-training scores. Thus, H1, H2, and H3 were supported. Additionally, we were interested in participants’ evaluations of the training to improve its future iterations. Overall, participants rated the training as effective, M = 4.19, SD = .68 (on a scale of 1 to 5). Participants said the training “promotes self-reflection” and provides useful communication tools. They suggested more real-life scenarios and quizzes, spotlights on stigmas such as substance abuse and weight, and advice for managing biases patients hold against them.
In summary, findings demonstrated that participants’ knowledge, attitudes, and communication efficacy improved from pre- to post-training, a promising initial step in providing a comprehensive approach to cultural competency training in health care. We aim to revise and further assess the training’s impact, taking seriously behavioral outcomes of the training beyond efficacy beliefs about communication to assessing actual communication behavior.
H1: Knowledge about Black maternal health care disparities will increase pre-training to post-training.
H2: Attitudes toward addressing implicit bias and cultural competence will improve pre-training to post-training.
H3: Communication efficacy to provide culturally competent health care will improve pre-training to post-training.
We recruited U.S. medical students, residents, and physicians to participate. Their mean age was 29 years (SD = 8.70). Most identified as women (n = 10; 58.8%; men, n = 7, 41.12%). Participants reported their race as Asian (n = 6, 35.29%), White (n = 6, 35.29%), Asian and White (n = 3, 17.65%), and Black/African American (n = 2, 11.76%). Most were medical students (n = 12, 70.59%), followed by resident physicians (n = 3, 17.65%), and physicians (n = 2, 11.76%).
Participants completed the study online. The pre- and post-training surveys comprised of demographic items, measures for assessing the hypotheses, open- and close-ended items about physicians’ own biases and previous bias training, and open- and close-ended items regarding evaluations of the training (Afifi et al., 2005; Corley et al., 2016; Crosson et al., 2004; Gonzalez et al., 2021; Levett-Jones et al., 2017). We provided participants a $50 Amazon e-gift card as compensation.
Paired samples t-tests comparing pre- to post-training knowledge (H1), attitudes (H2), and communication efficacy (H3) revealed significantly higher post-training scores. Thus, H1, H2, and H3 were supported. Additionally, we were interested in participants’ evaluations of the training to improve its future iterations. Overall, participants rated the training as effective, M = 4.19, SD = .68 (on a scale of 1 to 5). Participants said the training “promotes self-reflection” and provides useful communication tools. They suggested more real-life scenarios and quizzes, spotlights on stigmas such as substance abuse and weight, and advice for managing biases patients hold against them.
In summary, findings demonstrated that participants’ knowledge, attitudes, and communication efficacy improved from pre- to post-training, a promising initial step in providing a comprehensive approach to cultural competency training in health care. We aim to revise and further assess the training’s impact, taking seriously behavioral outcomes of the training beyond efficacy beliefs about communication to assessing actual communication behavior.