Cultural competence in occupational therapy to reduce health disparities: a systematic literature review
Bibliographic record
Abstract
Background/Aims Despite agreement about the relationship between cultural competence and health equality, there is a lack of clear guidance within occupational therapy about what it means to be culturally competent and how it can be achieved. This literature review aims to critically appraise qualitative research to explore occupational therapists' experience of working cross culturally. By comparing these experiences, this review aims to identify ways in which occupational therapists individually, and occupational therapy as a profession, can increase the efficacy of the interventions they provide within cross-cultural situations, so all clients can be supported to achieve equal health outcomes. Methods The following databases were searched between 2010 and 2020: ASSIA (Applied Social Science Index), CINAHL (Cumulative Index to Nursing and Allied Health Literature), Cochrane, Embase, Medline Pubmed. The resultant papers were appraised using the Critical Appraisal Skills Programme checklist and thematic analysis was used to identify three themes. Results The six papers included in this review present the experiences of occupational therapists and occupational therapy students working in cross-cultural situations in the UK, Canada, South Africa, USA, Australia and Ireland. Three major themes emerged that explore the relationship between client-centred practice and cultural competence, theory–practice links, and strategies and barriers to working in a culturally competent way. Conclusions Cultural competence is strongly aligned with some of the core principles of occupational therapy: occupational justice and occupational identity. However, theoretical knowledge and confidence among occupational therapists in this area is lacking, implying that their impact could be greater if there was a more concrete definition of cultural competence and standardised guidelines for practice. Further research is needed to build on the strategies and overcome barriers, so that occupational therapists can fulfil the professional obligation they have to work effectively with all populations.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".