1. Does Mandating Training Have an Impact on Attitudes About Cultural Competency? Guadalupe Pacheco, MSW Project Officer, Think Cultural Health HHS Office of Minority Health

2. Overview Introduction –HHS Office of Minority Health –Cultural competency legislative mandates –A Physicians Practical Guide to Culturally Competent Care Assessing the impact of cultural competency mandates Implications of research findings on potential for cultural competency mandates

3. HHS Office of Minority Health Mission: To improve the health of racial and ethnic minority populations through the development of health policies and programs that will eliminate health disparities National Standards for Culturally and Linguistically Appropriate Services in Health Care (CLAS Standards)

4. Think Cultural Health from the HHS Office of Minority Health Continuing education programs that equip health professionals with awareness, knowledge, and skills to treat diverse patients Up-to-date information on issues related to cultural competency and health disparities Tracking of cultural competency legislation around the country

5. Legislative Mandates on Cultural Competency Training Dark Blue denotes legislation requiring (WA, CA, NJ, NM) or strongly recommending (MD) cultural competence training, which was signed into law. Purple denotes legislation which has been referred to committee and is currently under consideration. Royal Blue denotes legislation which died in committee or was vetoed.

6. Mandatory cultural competency education garners some criticism; however, many feel that it will improve patient-provider interactions, compliance, and patient satisfaction. New Jersey: A case study on the implications of legislation for cultural competency curricula Legislative Mandates on Cultural Competency Training

7. A Physicians Practical Guide to Culturally Competent Care Free, online program accredited for physicians, physician assistants, and nurse practitioners Designed to equip physicians with the awareness, knowledge and skills to treat diverse patients and improve quality of care

8. Two-year evaluation results: Curriculum participation results in development of knowledge, awareness and skills related to cultural competency. The curriculum shows the potential for improving health outcomes and ultimately mitigating racial and ethnic health disparities. A Physicians Practical Guide to Culturally Competent Care

9. Assessing the Impact of Cultural Competency Mandates Mandatory training may be an ideal way to promote cultural competency as an effective strategy to eliminate health disparities: –Higher exposure to cultural competency due to legislative requirements –Higher exposure to cultural competency creates a workforce equipped to provide quality care to diverse patients

10. New Jersey mandated 6 hours of cultural competency continuing education for physician relicensure. Examination of differences in attitudes about cultural competency between individuals who self-select to take the program and those who take it to fulfill a mandate. Assessing the Impact of Cultural Competency Mandates

11. Self-reflection components of the curriculum were compared among mandated and non- mandated individuals. Physicians attitudes related to cultural competency were similar for mandated and non-mandated participants. Assessing the Impact of Cultural Competency Mandates

12. Large increases in New Jersey physician participation in the cultural competency curriculum New Jersey physician participants 1 year prior to the mandate 156 1 year following the mandate 9,078 Assessing the Impact of Cultural Competency Mandates

13. Mandatory cultural competency education garners some criticism, including the idea that forced training will create negative reactions to cultural differences or cross-cultural efficacy. However, these concerns seem to be unfounded based on these results. Cultural Competency Mandates

14. Implications – Potential for Cultural Competency Mandates Completion of the physicians curriculum, whether mandated or not, increases cultural competency knowledge and may improve practice behavior.

15. This negates criticism that mandatory cultural competency training is ineffective because mandated providers will show reluctance in grasping cultural competency concepts. Mandates may be an ideal way to help improve care and ultimately help eliminate health disparities. Implications – Potential for Cultural Competency Mandates

16. Summary Cultural competency education has the potential to improve patient-provider interactions, compliance, and patient satisfaction. Through cultural competency education mandates, policy can play a vital role in eliminating health disparities.

18. For information, contact: Guadalupe Pacheco, MSW Office of Minority Health, HHS Guadalupe.Pacheco@hhs.gov