Improving cultural competence of healthcare workers in First Nations communities: a narrative review of implemented educational interventions in 2015–20
Chris Rissel
A * , Lynette Liddle B , Courtney Ryder C , Annabelle Wilson C , Barbara Richards B and Madeleine Bower D
+ Author Affiliations
- Author Affiliations
A Rural and Remote Health Northern Territory, Flinders University, Royal Darwin Hospital campus, Rocklands Drive, Tiwi, NT 0810, Australia.
B Rural and Remote Health Northern Territory, Flinders University, PO Box 4066, Alice Springs, NT 0871, Australia.
C Public Health, College of Medicine and Public Health, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia.
D Rural and Remote Health Northern Territory, Flinders University, PO Box 433, Katherine, NT 0850, Australia.
* Correspondence to: Chris.rissel@flinders.edu.au
Australian Journal of Primary Health 29(2) 101-116 https://doi.org/10.1071/PY22020
Submitted: 4 February 2022 Accepted: 29 March 2022 Published: 15 June 2022
© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
Abstract
Background: Cultural competency is often promoted as a strategy to address health inequities; however, there is little evidence linking cultural competency with improved patient outcomes. This article describes the characteristics of recent educational interventions designed to improve cultural competency in healthcare workers for First Nations peoples of Australia, New Zealand, Canada and the USA.
Methods: In total, 13 electronic databases and 14 websites for the period from January 2015 to May 2021 were searched. Information on the characteristics and methodological quality of included studies was extracted using standardised assessment tools.
Results: Thirteen published evaluations were identified; 10 for Australian Aboriginal and Torres Strait Islander peoples. The main positive outcomes reported were improvements in health professionals’ attitudes and knowledge, and improved confidence in working with First Nations patients. The methodological quality of evaluations and the reporting of methodological criteria were moderate.
Conclusions: Cultural competency education programs can improve knowledge, attitudes and confidence of healthcare workers to improve the health of First Nations peoples. Providing culturally safe health care should be routine practice, particularly in places where there are concentrations of First Nations peoples, yet there is relatively little research in this area. There remains limited evidence of the effectiveness of cultural education programs alone on community or patient outcomes.
Keywords: Aboriginal, access to care, cross-cultural issues, cultural competence, cultural safety, First Nations, Indigenous, narrative review.
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