Add wos sample results library

02-data/intermediate/wos_sample/a88160c7ed180d67506c35e826e78c7c-horvat-lidia-and-ho/info.yaml

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+abstract: 'Background
+
+  Cultural competence education for health professionals aims to ensure
+
+  all people receive equitable, effective health care, particularly those
+
+  from culturally and linguistically diverse (CALD) backgrounds. It has
+
+  emerged as a strategy in high-income English-speaking countries in
+
+  response to evidence of health disparities, structural inequalities, and
+
+  poorer quality health care and outcomes among people from minority CALD
+
+  backgrounds. However there is a paucity of evidence to link cultural
+
+  competence education with patient, professional and organisational
+
+  outcomes. To assess efficacy, for this review we developed a
+
+  four-dimensional conceptual framework comprising educational content,
+
+  pedagogical approach, structure of the intervention, and participant
+
+  characteristics to provide consistency in describing and assessing
+
+  interventions. We use the term `CALDparticipants'' when referring to
+
+  minority CALD populations as a whole. When referring to participants in
+
+  included studies we describe them in terms used by study authors.
+
+  Objectives
+
+  To assess the effects of cultural competence education interventions for
+
+  health professionals on patient-related outcomes, health professional
+
+  outcomes, and healthcare organisation outcomes.
+
+  Search methods
+
+  We searched: MEDLINE (OvidSP) (1946 to June 2012); Cochrane Central
+
+  Register of Controlled Trials (CENTRAL, The Cochrane Library) (June
+
+  2012); EMBASE (OvidSP) (1988 to June 2012); CINAHL (EbscoHOST) (1981 to
+
+  June 2012); PsycINFO (OvidSP) (1806 to June 2012); Proquest
+
+  Dissertations and Theses database (1861 to October 2011); ERIC (CSA)
+
+  (1966 to October 2011); LILACS (1982 to March 2012); and Current
+
+  Contents (OvidSP) (1993 Week 27 to June 2012).
+
+  Searches in MEDLINE, CENTRAL, PsycINFO, EMBASE, Proquest Dissertations
+
+  and Theses, ERIC and Current Contents were updated in February 2014.
+
+  Searches in CINAHL were updated in March 2014.
+
+  There were no language restrictions.
+
+  Selection criteria
+
+  We included randomised controlled trials (RCTs), cluster RCTs, and
+
+  controlled clinical trials of educational interventions for health
+
+  professionals working in health settings that aimed to improve: health
+
+  outcomes of patients/consumers of minority cultural and linguistic
+
+  backgrounds; knowledge, skills and attitudes of health professionals in
+
+  delivering culturally competent care; and healthcare organisation
+
+  performance in culturally competent care.
+
+  Data collection and analysis
+
+  We used the conceptual framework as the basis for data extraction. Two
+
+  review authors independently extracted data on interventions, methods,
+
+  and outcome measures and mapped them against the framework. Additional
+
+  information was sought from study authors. We present results in
+
+  narrative and tabular form.
+
+  Main results
+
+  We included five RCTs involving 337 healthcare professionals and 8400
+
+  patients; at least 3463 (41\%) were from CALD backgrounds. Trials
+
+  compared the effects of cultural competence training for health
+
+  professionals, with no training. Three studies were from the USA, one
+
+  from Canada and one from The Netherlands. They involved health
+
+  professionals of diverse backgrounds, although most were not from CALD
+
+  minorities. Cultural background was determined using a validated scale
+
+  (one study), self-report (two studies) or not reported (two studies).
+
+  The design effect from clustering meant an effective minimum sample size
+
+  of 3164 CALD participants. No meta-analyses were performed. The quality
+
+  of evidence for each outcome was judged to be low.
+
+  Two trials comparing cultural competence training with no training found
+
+  no evidence of effect for treatment outcomes, including the proportion
+
+  of patients with diabetes achieving LDL cholesterol control targets
+
+  (risk difference (RD) -0.02, 95\% CI -0.06 to 0.02; 1 study, USA, 2699
+
+  ``black{''''} patients, moderate quality), or change in weight loss
+
+  (standardised mean difference (SMD) 0.07, 95\% CI -0.41 to 0.55, 1
+
+  study, USA, effective sample size (ESS) 68 patients, low quality).
+
+  Health behaviour (client concordance with attendance) improved
+
+  significantly among intervention participants compared with controls
+
+  (relative risk (RR) 1.53, 95\% CI 1.03 to 2.27, 1 study, USA, ESS 28
+
+  women, low quality). Involvement in care by ``non-Western{''''} patients
+
+  (described as ``mainly Turkish, Moroccan, Cape Verdean and Surinamese
+
+  patients{''''}) with largely ``Western{''''} doctors improved in terms of
+
+  mutual understanding (SMD 0.21, 95\% CI 0.00 to 0.42, 1 study, The
+
+  Netherlands, 109 patients, low quality). Evaluations of care were mixed
+
+  (three studies). Two studies found no evidence of effect in: proportion
+
+  of patients reporting satisfaction with consultations (RD 0.14, 95\% CI
+
+  -0.03 to 0.31, 1 study, The Netherlands, 109 patients, low quality);
+
+  patient scores of physician cultural competency (SMD 0.11 95\% CI -0.63
+
+  to 0.85, 1 study, USA, ESS 68 ``Caucasian{''''} and ``non-Causcasian{''''}
+
+  patients (described as Latino, African American, Asian and other, low
+
+  quality). Client perceptions of health professionals were significantly
+
+  higher in the intervention group (SMD 1.60 95\% CI 1.05 to 2.15, 1
+
+  study, USA, ESS 28 ``Black{''''} women, low quality).
+
+  No study assessed adverse outcomes.
+
+  There was no evidence of effect on clinician awareness of ``racial{''''}
+
+  differences in quality of care among clients at a USA health centre (RR
+
+  1.37, 95\% CI 0.97 to 1.94. P = 0.07) with no adjustment for clustering.
+
+  Included studies did not measure other outcomes of interest. Sensitivity
+
+  analyses using different values for the Intra-cluster coefficient (ICC)
+
+  did not substantially alter the magnitude or significance of summary
+
+  effect sizes.
+
+  All four domains of the conceptual framework were addressed, suggesting
+
+  agreement on core components of cultural competence education
+
+  interventions may be possible.
+
+  Authors'' conclusions
+
+  Cultural competence continues to be developed as a major strategy to
+
+  address health inequities. Five studies assessed the effects of cultural
+
+  competence education for health professionals on patient-related
+
+  outcomes. There was positive, albeit low-quality evidence, showing
+
+  improvements in the involvement of CALD patients. Findings either showed
+
+  support for the educational interventions or no evidence of effect. No
+
+  studies assessed adverse outcomes. The quality of evidence is
+
+  insufficient to draw generalisable conclusions, largely due to
+
+  heterogeneity of the interventions in content, scope, design, duration,
+
+  implementation and outcomes selected.
+
+  Further research is required to establish greater methodological rigour
+
+  and uniformity on core components of education interventions, including
+
+  how they are described and evaluated. Our conceptual framework provides
+
+  a basis for establishing consensus to improve reporting and allow
+
+  assessment across studies and populations. Future studies should measure
+
+  the patient outcomes used: treatment outcomes; health behaviours;
+
+  involvement in care and evaluations of care. Studies should also measure
+
+  the impact of these types of interventions on healthcare organisations,
+
+  as these are likely to affect uptake and sustainability.'
+affiliation: 'Horvat, L (Corresponding Author), Dept Hlth, Qual \& Rural Hlth Branch,
+  Sect Performance, Melbourne, Vic, Australia.
+
+  Horvat, Lidia, Dept Hlth, Qual \& Rural Hlth Branch, Sect Performance, Melbourne,
+  Vic, Australia.
+
+  Horvat, Lidia; Kis-Rigo, John, La Trobe Univ, Sch Publ Hlth \& Human Biosci, Cochrane
+  Consumers \& Commun Review Grp, Bundoora, Vic, Australia.
+
+  Horey, Dell, La Trobe Univ, Fac Hlth Sci, Bundoora, Vic, Australia.
+
+  Romios, Panayiota, Australian Red Cross Soc, Carlton, Vic, Australia.'
+article-number: CD009405
+author: Horvat, Lidia and Horey, Dell and Romios, Panayiota and Kis-Rigo, John
+author-email: lidia.horvat@health.vic.gov.au
+author_list:
+- family: Horvat
+  given: Lidia
+- family: Horey
+  given: Dell
+- family: Romios
+  given: Panayiota
+- family: Kis-Rigo
+  given: John
+da: '2023-09-28'
+doi: 10.1002/14651858.CD009405.pub2
+eissn: 1361-6137
+files: []
+issn: 1469-493X
+journal: COCHRANE DATABASE OF SYSTEMATIC REVIEWS
+keywords-plus: 'INTERCULTURAL COMMUNICATION; PROMOTION PROGRAM; CONTROLLED-TRIAL;
+
+  DIABETES CARE; LOW-INCOME; INTERVENTION; ETHNICITY; OUTCOMES; RACE;
+
+  DISPARITIES'
+language: English
+number: '5'
+number-of-cited-references: '113'
+orcid-numbers: Horey, Dell/0000-0001-7594-7694
+papis_id: 253eaaaf96854e66c3afbcb2c81ca5ff
+ref: Horvat2014culturalcompetence
+researcherid-numbers: Horey, Dell/AAE-1918-2021
+tags:
+- review
+times-cited: '241'
+title: Cultural competence education for health professionals
+type: Review
+unique-id: WOS:000336657000018
+usage-count-last-180-days: '5'
+usage-count-since-2013: '105'
+web-of-science-categories: Medicine, General \& Internal
+year: '2014'