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Cultural Competence Training Program For African Immigrants
Chidinma Ogundu
School of Nursing, Touro University
DNP 761
Dr. Calaiselvy Elumalai
Dr. Jessica Grimm
May 4, 2021
Search Terms
Comment by Jessica Grimm: Please follow the format of the rubric. Background is not required in this section. You may be able to integrate some of your writing here into other sections that are required.
Cultural Competence Training Program For African Immigrants Comment by Jessica Grimm: Please submit the same document each time- just add to your previous paper so we can have the context of what was previously written. We will only grade from that section on.
Background Comment by Jessica Grimm: Is this supposed to be a review synthesis? I’m not following what the intent of this section is. Please clarify with a new heading that reflects a rubric heading.
Purnell and Fenkl (2019) explain that the need for cultural competence for African immigrants is increasing day by day among health care providers and health related organizations in the United states, since African immigrants deserve respect both as individuals and within their cultural framework. Seck (2015) explained that health care providers have to give undivided attention to cultural diversity and inclusion as well as cultural competency every time they are dealing with African immigrants. Clough et al. (2013) explained that cultural competence will be essential in attaining high quality services for this group, achieving health equity, and eliminating disparities as well as improving the health of the group. Comment by Elumalai, Calaiselvy - SRDH: Paragraph should be indented 0.5 inches
The creation of a social and physical environment that promotes good health for African immigrants is hugely reliant on the health care providers’ cultural competence (Allison et al., 2016). Cultural competence will not only enable health care providers to promote the quality of lives of African immigrants but develop healthy behaviors that cuts across all other groups as well (Wamwayi & Murray, 2019).Venters et al. (2019) explain that African immigrant group is underrepresented in the research in healthcare and this is the reason why health care providers are not cultural competent in regard to the group. After moving into the United states, health care providers group African immigrants either as Black or African American without paying attention to any cultural practices that are unique to the group (Omenka, Watson, & Hendrie, 2020). This hinders the delivery of health care services to the African immigrant group (Omenka, Watson, & Hendrie, 2020). Comment by Elumalai, Calaiselvy - SRDH: Paragraph should be indented 0.5 inches
Encouraging cultural competence among health care providers for African immigrants will help in highlighting the group’s complex cultural identities and help them in responding to the unique issues that are represented by African immigrants (Asare & Sharma, 2012). African immigrants poses distinct African values, ideologies and knowledge, all which impact their views on healthcare experience. Practitioners and researchers should both aim at being culturally competent in regard to the group if the success of health of the group is to be achieved (Kirmayer, 2012). Comment by Elumalai, Calaiselvy - SRDH: Same here
Some of the most important areas where health care providers have to invest a lot of time and effort in include issues of language barrier, religious practices, and the difference in meanings of concepts (Okudo & Ross, 2016). Training of health care providers in relation to cultural competence for African immigrants should be aimed at exposing health care providers to information about this specific cultural group, assess the professionals’ current perceived competence, and develop ways of improving their cultural competence (Betancourt & Green, 2010).
However, even though the studies discuss the importance of cultural competence for African immigrants, they do not provide information about how a cultural competence program for African immigrants can be developed. The studies discuss the impacts of lack of cultural competence and its benefits but no specific focus is directed towards how the program can be developed. This is the gap that the present study will be aimed at. The present study will aim at the development of a cultural competence program for African immigrants aimed at improving their health care experiences and outcomes.
Methods Comment by Elumalai, Calaiselvy - SRDH: My Review begins here
For bringing together research on the topic, a qualitative systematic review approach was used. The systematic review was registered at PROSPERO, which is an international database of prospectively registered systematic reviews in healthcare and social care (Cornell University Library, 2021). This systematic review was reported using Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Comment by Jessica Grimm: Your writing should be left justified. Comment by Elumalai, Calaiselvy - SRDH: Rephrase this sentence
Search Strategy Comment by Jessica Grimm: This entire section should be about 1-2 paragraphs. Please cut down what you write here to be concise. You may work with OASIS to assist.
The search strategy included the use of databases, search terms, and keywords. The databases included MEDLINE (PubMed), Web of Science, Google Scholar, and CINAHL Complete. The keywords used were based on the PICO framework. The participants were “African immigrants”, “African incomers”, and “African in-migrants”. The intervention was “cultural competence”, “competence in cultures”, “cultural awareness”, “intercultural competence”, “culturally responsive”, “cultural literacy”, and “culturally informed”. The outcomes were “improved health care”, “better health care”, “enhanced health”, and “raised health care status”. Search terms were also combined using Boolean operators to broaden or narrow the results and the specific Boolean operators used were “OR” and “AND”. Citation lists of included studies were reviewed for the identification of additional studies for potential inclusion and this was aimed at minimizing the potential omission of relevant studies. Under the search strategy, the balancing of the sensitivity of the search (which is how many potentially relevant articles would be found) and the specifity (which is how many definitely-relevant articles will be found) was a priority. Comment by Elumalai, Calaiselvy - SRDH: Same here- formatting error Comment by Elumalai, Calaiselvy - SRDH: Spelling error
Inclusion And Exclusion Criteria
Predetermined criteria for inclusion and exclusion had already been established and all the citations were reviewed against it. Various types of study designs were included and these include systematic reviews, cross sectional studies, and case reports and series. All included studies specifically addressed how cultural competence among health care providers would be useful in improving the health outcomes of African immigrants or how lack of cultural competence among health care providers contributed to the poor health of African immigrants. The definition of cultural competency along with all its elements were based on the United States National Library of Medicine-National Institutes of Health (National Library of Medicine, 2019). Comment by Elumalai, Calaiselvy - SRDH: Review APA guidelines for paragraph formatting
The library defines cultural competency among health care providers as the ability to collaborate effectually with individuals from different cultures with the aim of improving their health care experience and outcomes Health (National Library of Medicine, 2019). The studies included also specifically compared the cultural competency of health care providers to the health outcomes and experiences of African immigrants. All potential settings such as hospitals, clinics, community settings, and others that were related to the studies were included. The studies included specifically had their participants as African immigrants and no other group was substituted for the participants.
Studies were excluded based on the following reasons. (a)The study population was not exclusively African immigrants or there was no separate reporting of the results of African immigrants. (b) The study discussed African-Americans instead of African immigrants. (c) The study did not have its core focus as cultural competence among health care providers in relation to African immigrants. (d) The intervention targeted the health care system or the health care providers instead of the patients. However, no studies were excluded on the basis of participant age or sex, or article language.
Study Selection
In the study selection, a decision of whether to include or exclude a study based on previously determined criteria was made after reviewing the study’s title and abstract. At this stage, over-inclusion was practiced to help in the prevention of incorrect removal of relevant papers (Cornell University Library, 2021). For studies to be excluded, they had to be either clearly not relevant or did not meet one of the inclusion criteria or more. Studies that were successful in the first stage was screened for the assessment before they qualified for full text review in the inclusion. Full text review of the articles was then done with reference to the inclusion and exclusion criteria. After this, the identification of the final set of articles that had attained eligibility for inclusion was made. Comment by Elumalai, Calaiselvy - SRDH: You are not performing a systematic review. This is simply a literature review to determine what information is published regarding your topic. Please review all the literature you have retrieved and included for your project, what are the common themes that arise in the literature? Please review the rubric and let it guide you as you write. Synthesis of pertinent available literature is well developed and accurate. A brief description of review approach includes discussion of types of studies reviewed and chosen, and themes identified. The project topic is systematically described in the context of broader relevant scholarly literature. Best practice standard as it relates to current evidence around the project problem is distinguished and the gap in quality is clearly delineated
Data Extraction Comment by Jessica Grimm: Please delete
Once all the studies to be included were identified, the next step was to extract the data contained in those studies. Since this was a qualitative systematic review, a summary of finding tables and bias/evidence quality figures was created. The extraction of data was based on the previously-defined interventions and outcomes that had been established during the research question, inclusion/exclusion criteria, and search protocol development. An extraction form that was filled in for each included study was created. Qualtrics and Microsoft Excel software programs were used to create a survey and then statistics tables and figures out of the data.
Risk of Bias/Quality
AHRQ checklist for Risk Bias Assessment was used for examining there is quality/bias in the included studies. This tool was used in ensuring that assumptions and limitations are understood and taken into account during the interpretation of validity and generalizability (Cornell University Library, 2021). This helped to ensure that various types of biases such as selection, performance, detection, and reporting was prevented. Additionally, the Grading of Recommendations Assessment Development and Evaluation (GRADE) criteria was used in assessing the overall quality of the included studies. Comment by Elumalai, Calaiselvy - SRDH: Spell out Comment by Elumalai, Calaiselvy - SRDH: Review spacing in this sentence
Results
273 was the total number of citations that the search from the various databases mentioned above retrieved. 185 of these abstracts remained after the removal of duplicates. 39 out of these articles were selected for full text review after the completion of the abstract review. In the end, 18 articles out of these 39 articles were the ones which attained eligibility for inclusion in the systematic review and all were scholarly sources that were peer reviewed. Comment by Jessica Grimm: Hi Chidinma, Thank you for your efforts on this assignment. I can see that you worked very hard and have included a lot of information here. However, the information you included is way too detailed and offers writing on only search techniques. The assignment requires multiple elements that are not completed here. I recommend that you take what you have here and condense it down to 1-2 paragraphs under the heading “Search Terms. Please see rubric and watch the video for what you are required to do.
Review Synthesis Comment by Jessica Grimm: For review synthesis, please address the following: Best practice standard as it relates to current evidence around the project problem is distinguished and the gap in quality is clearly delineated.
Review of Study Methods
Literature Themes
Language Barriers and Cultural Competence Comment by Jessica Grimm: Examples of themes you can use
The Impact of Cultural Competence Training on Health Care Workers
References
Adekeye, O. A., Adesuyi, B. F., & Takon, J. G. (2018). Barriers to healthcare among African immigrants in Georgia, USA. Journal of immigrant and minority health, 20(1), 188-193.
Allen, K. M., Jackson, I., & Knight, M. G. (2012). Complicating culturally relevant pedagogy: Unpacking African immigrants' cultural identities. International Journal of Multicultural Education, 14(2).
Allison, K. W., Echemendia, R. J., Crawford, I., & Robinson, W. L. (2016). Predicting cultural competence: Implications for practice and training. Professional Psychology: Research and Practice, 27(4), 386.
Asare, M., & Sharma, M. (2012). ROLE OF HEALTH BELIEF MODEL ON SEXUAL COMMUNICATION AMONG AFRICAN IMMIGRANTS. American Journal of Health Studies, 27(2).
Betancourt, J. R., & Green, A. R. (2010). Commentary: linking cultural competence training to improved health outcomes: perspectives from the field. Academic Medicine, 85(4), 583-585.
Centers for Disease and Prevention. (2021, February). Health Equity Considerations & Racial & Ethnic Minority Groups. https://www.cdc.gov/coronavirus/2019-ncov/community/health-equity/race-ethnicity.html
Clough, J., Lee, S., & Chae, D. H. (2013). Barriers to health care among African immigrants in the United States: a traditional review. Journal of health care for the poor and underserved, 24(1), 384-403.
Cornell University Library. (2021, April). Systematic Reviews. newcatalog.library.cornell.edu/catalog/11667585
Delgado, D. A., Ness, S., Ferguson, K., Engstrom, P. L., Gannon, T. M., & Gillett, C. (2013). Cultural competence training for clinical staff: Measuring the effect of a one-hour class on cultural competence. Journal of Transcultural Nursing, 24(2), 204-213.
Kamya, H. A. (2017). African immigrants in the United States: The challenge for research and practice. Social Work, 42(2), 154-165.
Kirmayer, L. J. (2012). Rethinking cultural competence.
National Library of Medicine. (2019). Improving Cultural Competence to Reduce Health Disparities. https://www.ncbi.nlm.nih.gov/books/NBK361128/
Omenka, O. I., Watson, D. P., & Hendrie, H. C. (2020). Understanding the healthcare experiences and needs of African immigrants in the United States: a scoping review. BMC public health, 20(1), 1-13.
Price, E. G., Beach, M. C., Gary, T. L., Robinson, K. A., Gozu, A., Palacio, A., ... & Cooper, L. A. (2015). A systematic review of the methodological rigor of studies evaluating cultural competence training of health professionals. Academic Medicine, 80(6), 578-586.
Purnell, L. D., & Fenkl, E. A. (2019). Transcultural diversity and health care. In Handbook for culturally competent care (pp. 1-6). Springer, Cham.
Seck, M. M. (2015). West African immigrants in the United States: Challenges and empowering strategies. Social Development Issues, 37(2), 68-79.
Schouler-Ocak, M., Graef-Calliess, I. T., Tarricone, I., Qureshi, A., Kastrup, M. C., & Bhugra, D. (2015). EPA guidance on cultural competence training. European Psychiatry, 30(3), 431-440.
Takougang, J., & Tidjani, B. (2019). Settlement patterns and organizations among African immigrants in the United States. Journal of Third World Studies, 26(1), 31-40.
Venters, H., Adekugbe, O., Massaquoi, J., Nadeau, C., Saul, J., & Gany, F. (2019). Health concerns among African immigrants. Journal of Immigrant and Minority Health, 13(4), 795-797.
Wamwayi, M. O., Cope, V., & Murray, M. (2019). Service gaps related to culturally appropriate mental health care for African immigrants. International journal of mental health nursing, 28(5), 1113-1121.
World Health Organization. (2020, March). Health Equity.
https://www.who.int/health-equity