Horevitz Elizabeth, Lawson Jennifer, Chow Julian C C
Department of Psychiatry, University of California, San Francisco, CA 94143, USA.
School of Social Welfare, University of California, Berkeley, USA.
Health Soc Work. 2013 Aug;38(3):135-45. doi: 10.1093/hsw/hlt015.
This article examines and unpacks the "black box" of cultural competence in health interventions with racial and ethnic minority populations. The analysis builds on several recent reviews of evidence-based efforts to reduce health disparities, with a focus on how cultural competence is defined and operationalized. It finds that the use of multiple similar and indistinct terms related to cultural competence, as well as the lack of a mutually agreeable definition for cultural competence itself, has resulted in an imprecise concept that is often invoked but rarely defined and only marginally empirically validated as an effective health intervention. This article affirms the centrality of cultural competence as an essential values-based component of optimal social work practice, while also suggesting future directions for operationalizing, measuring, and testing cultural competence to build an evidence base on whether and how it works to reduce health disparities.
本文审视并剖析了针对少数族裔人群的健康干预中文化能力这一“黑匣子”。该分析建立在近期几项关于减少健康差距的循证努力的综述基础之上,重点关注文化能力是如何被定义和实施的。研究发现,与文化能力相关的多个相似且模糊的术语的使用,以及文化能力本身缺乏一个普遍认可的定义,导致了一个概念模糊不清,虽常被提及,但很少被明确界定,且仅在极小程度上通过实证验证其作为一种有效的健康干预措施。本文肯定了文化能力作为最佳社会工作实践中基于价值观的重要组成部分的核心地位,同时也为文化能力的实施、衡量和测试提出了未来方向,以建立一个关于其是否以及如何有效减少健康差距的证据基础。