1. Presented by Mona Lisa Chavez –Esqueda SW 7113
Do Cultural Competency Interventions Work? A Systematic Review on Improving Rehabilitation Outcomes for Ethnically and Linguistically Diverse Individual with Disabilities Rooshey Hasnain, EdD, Diane M. Kondratowicz, PhD, Eugene Borokhovski, PhD, Chad Nye PhD, Fabricio Balcasar, PhD, Nelson Portillo, PhD, Katherine Hanz, MA, MLIS, Tim Johnson, PhD and Robert Gould, MS
Presented by
Mona Lisa Chavez –Esqueda
SW 7113

2. diverse individuals with disabilities.
Summary of Protocol
The proposed review will involve the first comprehensive look at the way that elements of culturally
adapted competency interventions impact rehabilitation service outcomes for ethnically and culturally
diverse individuals with disabilities.
The primary objective of the review will be to examine whether or not the effects of such
interventions have an impact on rehabilitation outcomes. The second objective will be to examine how the
addictive use of culturally adapted interventions results in beneficial outcomes in a wide variety of areas.
In fact, Lewis (2007) claims that ethnic and cultural minorities have a disproportionately high rate of
disability compared to White, with Blacks and Latinos being particularly overrepresented in disability
categories.
As a consequence of these marked demographic changes and noteworthy projected trends,
rehabilitation and health care practitioners are more likely than ever before to encounter individuals from
diverse ethnic and linguistic backgrounds who have disabilities and/or chronic health conditions.
Census projections for the foreseeable future, particularly the mid-century point, indicate that the
nation will become increasingly diverse, both ethnically and culturally (U.S. Census Bureau, 2008). By
2042, it is expected that minorities will make up 54% of the U.S. population,
Regarding the quality of care received, ethnic and immigrant minorities receive a significantly lower
quality of care than White Americans, even when they have the same insurance provision and are at the same
income level (Smedley et al., 2002).

3. Question
Do culturally adapted competency interventions improve rehabilitation outcomes for ethnically and linguistically diverse individuals with disabilities? If so, for whom and under what conditions do they work?

4. Cultural Competence in Action
Framework suggested and implemented by authors.
CA indidivual/provider reflect on personal biases toward people: includes becoming familiar and having knowledge of others beliefs, values, history, etc.
SD professional training and development, education, practice and experience to attain cultrural competency
OS policies and practices implemented that support staff members to engage and interact with clients in culturally competent way

5. Keywords Cultural competency Educational Interventions Disability
cultur*; cultural competenc*; culturally competent; transcultural*;
cultural literacy; cultural awareness; cross-cultural training cultural education
cultural characteristics; cultural diversity; cultural sensitivity; ethnic groups
Educational Interventions
intervention* educat* train* professional education, professional training, educational initiatives
Disability
disab*, disorder*, disease*, health*

6. Databases Databases included US, Australia, UK and Canada
Interdisciplinary Databases, ProQuest Dissertations and Theses, Academic Premier
Other databases such as MEDLINE/PubMed, CINAHL, PsychINFO, Social Work Abstracts, Health Source and REHABDATA
ERIC and Web based searches in Google and Yahoo
1)Focus was comprehensive and reviewers desired to include more than US databases
2)focus specifically on health care, disability, mental health, rehabilitation, and the social sciences,
3)Google searches include grey literature

8. Inclusion Criteria Be published since 1980 in any language
Include participants aged 18 and older identified as having a disability
Use a culturally adapted competency intervention
Conduct the intervention in a rehabilitation, health-care, or community-based setting
Include consumer outcome measures
Use a randomized controlled trial (RCT) research design
Report data that could be used to calculate effect size
Explain cultural competency strategies reported
Did not include substance abuse interventions

9. Exclusion Criteria
No culturally adapted intervention and/or no control group
One group pre- and post-design or quasi experimental design
Data are missing or inadequate to enable meta analysis
Outcomes are at the level of provider or system rather than client
Uses only biological/physiological outcomes
Health promotion/preventative studies
Unit of analysis is at the family,provider,organizational or systems level
Inadequate data are provided to calculate an effect size

10. Strategies for Data Analysis
Date Range: 1980-present
Age: 18 and over
Type : RCT, Meta analysis, Review
Five Categories to consider as Disability
Sensory
Cognitive/Intellectual
Physical Disabilities
Chronic Health Conditions
Mental Health Conditions
Items 2 and 3 include TBI (Traumatic Brain Injury)
Item number 4 includes breast cancer, diabetes, HIV/AIDS
Item number 5 examples, depression, schizophrenia

11. Outcome
Effect size calculated using standardized mean difference (SMD)

12. Implications and Conclusions
Explore critical components or mechanisms that make cultural adaptations work
Understanding moderating variables effects when developing and implementing future interventions
Researchers need to account for phenomenon when evaluating programs or services
Cultural competence in researchers
Address cost effectiveness of cultural competent interventions
Positive effects in three of five category
Conclude culturally adapted competency interventions can improve rehabilitation and service outcomes
Side 1, (1) Educational and behavioral skills, language and communication support, adapted interventions and ethnic match
(2) Family and cultural practices
(3) cultural competency & delivery of svc
(4) gaining skill and understanding to gain trust of minority individuals to have better results