Cultural Adaptations in Clinical InteractiONs (CoACtION): a multi-site comparative study to assess what cultural adaptations are made by clinicians in different settings

Abstract

Culture influences models of mental illness, help-seeking behaviours and outcomes of interventions. Cultural competency training has been developed to improve clinician practice in addressing these issues. The study aims to identify to what extent culturally competent and informed interactions are used by clinicians in England and how patients experience these interaction. Clinicians and non-white western patients were recruited to complete a questionnaire on culturally adapted practice in 25 areas of England. Clinicians are much more likely to rate their practice as clinically competent whereas patients were more likely to disagree that services were completely culturally competent. Length of time working as clinicians, receipt of specific cultural competence training and a higher percentage of caseload from non-white western backgrounds all increased clinician’s perception that their practice was culturally competent. Clinicians recognised the importance of cultural competency but the disparity between their assessment of whether they achieved this and that of patients must be addressed. Ethics approval was obtained via proportionate review from the London – Central Research Ethics Committee (REC Ref no: 17/LO/1962).

Study registration: UK Clinical Research Network Portfolio: 36744

Keywords:

• Mental Health
• cultural adaptations
• cultural competency

Acknowledgements

This project has been funded by the Pakistani Association of Cognitive Therapists (PACT). The views and opinions expressed therein are those of the authors and do not necessarily reflect those of funders, NIHR, NHS or the RCPsych or CRN. The study is sponsored by Southern Health NHS Foundation Trust.

Authors’ contributions

SR is the grant holder and along with PP and EG contributed to the concept and design of the study. SR is the CI and led the development of the study protocol and study documentation and made a significant contribution to the manuscript. KT completed statistical analysis. DK edited the final manuscript. All authors contributed to elaboration and refinement of the study protocol and approved the final manuscript.

Disclosure statement

None of the authors have declared a competing interest.

Data availability

All data relevant to the study are included in the article or uploaded as supplementary information.

Additional information

Funding

This project has been funded by a grant from the Pakistan Association of Cognitive Therapists; Global Funding Call PACT/20170501/3698.