Semansky Rafael M, Goodkind Jessica, Sommerfeld David H, Willging Cathleen E
Health Care Consultant.
University of New Mexico.
J Community Psychol. 2013 Apr;41(3):378-393. doi: 10.1002/jcop.21544.
In 2005, New Mexico created a single health plan to administer all publicly-funded behavioral health services. Our mixed-method study combined surveys, document review, and ethnography to examine this reform's influence on culturally competent services (CCS). Participants were executives, providers, and support staff of behavioral healthcare agencies. Key variables included language access services and organizational supports, i.e., training, self-assessments of CCS, and maintenance of client-level data. Survey and document review suggested minimal effects on statewide capacity for CCS during the first three years of the reform. Ethnographic research helped explain these findings: (1) state government, the managed behavioral health plan and agencies failed to champion CCS; and (2) increased administrative requirements minimized time and financial resources for CCS. There was also insufficient appreciation among providers for CCS. Although agencies made progress in addressing language assistance services, availability and quality remained limited.
2005年，新墨西哥州制定了一项单一的健康计划，以管理所有由公共资金资助的行为健康服务。我们的混合方法研究结合了调查、文件审查和人种志，以考察这一改革对文化能力服务（CCS）的影响。参与者包括行为医疗保健机构的管理人员、提供者和支持人员。关键变量包括语言获取服务和组织支持，即培训、CCS的自我评估以及客户层面数据的维护。调查和文件审查表明，在改革的头三年里，对全州范围内CCS能力的影响微乎其微。人种志研究有助于解释这些发现：（1）州政府、管理式行为健康计划和机构未能倡导CCS；（2）行政要求的增加减少了用于CCS的时间和财政资源。提供者对CCS的认识也不足。尽管各机构在提供语言援助服务方面取得了进展，但服务的可获得性和质量仍然有限。
