Cultural competence and perceptions of community health workers' effectiveness for reducing health care disparities.

Journal Article (Journal Article)

INTRODUCTION: Community health worker (CHW) interventions improve health outcomes of patients from underserved communities, but health professionals' perceptions of their effectiveness may impede integration of CHWs into health care delivery systems. Whether health professionals' attitudes and skills, such as those related to cultural competence, influence perceptions of CHWs, is unknown. METHODS: A questionnaire was administered to providers and clinical staff from 6 primary care practices in Maryland from April to December 2011. We quantified the associations of self-reported cultural competence and preparedness with attitudes toward the effectiveness of CHWs using logistic regression adjusting for respondent age, race, gender, provider/staff status, and years at the practice. RESULTS: We contacted 200 providers and staff, and 119 (60%) participated. Those reporting more cultural motivation had higher odds of perceiving CHWs as helpful for reducing health care disparities (odds ratio [OR] = 9.66, 95% confidence interval [CI] = 3.48-28.80). Those reporting more frequent culturally competent behaviors also had higher odds of believing CHWs would help reduce health disparities (OR = 3.58, 95% CI = 1.61-7.92). Attitudes toward power and assimilation were not associated with perceptions of CHWs. Cultural preparedness was associated with perceived utility of CHWs in reducing health care disparities (OR = 2.33, 95% CI = 1.21-4.51). CONCLUSIONS: Providers and staff with greater cultural competence and preparedness have more positive expectations of CHW interventions to reduce healthcare disparities. Cultural competency training may complement the use of CHWs and support their effective integration into primary care clinics that are seeking to reduce disparities.

Full Text

Duke Authors

Cited Authors

  • Mobula, LM; Okoye, MT; Boulware, LE; Carson, KA; Marsteller, JA; Cooper, LA

Published Date

  • January 2015

Published In

Volume / Issue

  • 6 / 1

Start / End Page

  • 10 - 15

PubMed ID

  • 24986493

Pubmed Central ID

  • PMC7086339

Electronic International Standard Serial Number (EISSN)

  • 2150-1327

Digital Object Identifier (DOI)

  • 10.1177/2150131914540917


  • eng

Conference Location

  • United States