Oncology healthcare provider perspectives on caring for diverse patients fifteen years after Unequal Treatment

• Published in: Patient education and counseling Vol. 102; no. 10; pp. 1859 - 1867
• Main Authors: Villalobos, Aubrey V.K., Phillips, Serena, Zhang, Yuqing, Crawbuck, Graham S.N., Pratt-Chapman, Mandi L.
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01-10-2019
• Subjects: Cultural competence; Disparities; Identity discordance; Nursing; Oncology; Patient-provider communication; Cultural competence; Oncology; Identity discordance; Disparities; Patient-provider communication
• ISSN: 0738-3991; 1873-5134
• DOI: 10.1016/j.pec.2019.04.030

•Diversity training is associated with awareness, skills, and practices.•Language barriers, alternative health beliefs, and non-adherence are top challenges.•Knowledge and training were top reported influences on culturally sensitive care.
The purpose of this study was to provide a snapshot of U.S. oncology provider perspectives on caring for diverse patients, including self-rated awareness, comfort, skills, practices, challenges, facilitators, and barriers.
An online survey was administered to a convenience sample of multidisciplinary oncology providers. Descriptive statistics and bivariate analyses were computed for Likert-style items to investigate differences by level of past diversity training. Qualitative content analysis was conducted on open-response questions.
Roughly one-third (36.7%) of the 406 survey respondents reported receiving high levels of past diversity training, with statistically significant differences by training amount for self-rated skills and select awareness and practice items (p < 0.05). Key challenges qualitatively described included language barriers (n = 143) and alternative health beliefs (n = 52). Knowledge and training (n = 62), interpretation services (n = 53), and staff attitudes (n = 46) were the most frequently mentioned factors affecting culturally sensitive care.
Fifteen years after the publication of Unequal Treatment, the National Academies’ landmark report on healthcare disparities, oncology healthcare providers have ongoing challenges caring for diverse patients and opportunities to implement recommendations from the report.
Content of diversity trainings should focus on identified gaps and practical challenges. Multi-level supports are needed, including resources and training for oncology providers.