Cultural Competence in Health Care: Examining the Role of Information and Communication Technologies in Reducing Healthcare Disparities for Immigrant Patients

Abstract

Background: Much research consistently shows that there are disparities in healthcare delivery. Healthcare disparities affect individuals across a broad range of demographics such as gender, race or ethnicity, and it is also related to socioeconomic factors such as income levels, access to health benefits and insurance, and health literacy. Recent immigrants to Canada encounter a different and unfamiliar healthcare system. This situation presents challenges to the practice of health care delivery. Therefore, it is crucial that innovative strategies be identified to reduce disparities in health care to promote the overall quality of care and public health services. Purpose: The purpose of this dissertation research was two-fold: (1) to examine cultural competence strategies, if any, that are used by healthcare organizations to improve interaction and communication between healthcare providers and their immigrant patients with the purpose to reduce healthcare disparities; and specifically, (2) to explore the use of Information and Communications Technologies (ICTs) to improve communication between healthcare providers and immigrant patients with the objective of reducing healthcare disparities. Methods: This dissertation research employed a mixed methods approach for data collection and analysis. The research was carried out in three phases. In the first phase, a series of focus group discussions with a sample of recent immigrants was conducted. In the second phase, an online survey was conducted to gain insights from healthcare providers regarding the role of ICTs in improving communication with immigrant patients to help reduce healthcare disparities. In the third phase, healthcare providers who participated in the survey were invited to participate in face-to-face, in-depth semi-structured interviews to further reflect on and extend the survey responses. Campinha-Bacote's Cultural Competence Model and Unified Theory of Acceptance and Use of Technology were employed for this dissertation research as its theoretical framework. Results: The findings indicated that the absence of effective communication as well as cultural and language barriers were major issues related to communication between healthcare providers and immigrant patients. The findings also indicated that immigrant patients might need to improve their digital and health literacy skills in order to improve their communication with their healthcare providers. Further, the findings indicated that it was important for healthcare providers to have access to more demographic data on immigrant patients because such data will allow healthcare providers to be better informed on how to most effectively tailor their healthcare services to this population group. Conclusion: Findings obtained from this dissertation research shed light on cross cultural communication issues related to working with immigrant patients that may lead to disparities in health care. Healthcare organizations may use these findings to better inform their decision making with regard to effective patient-provider communication. Finally, the findings bear important implications for the line of research that examines patient-provider communication from immigrant patients' perspectives. They can inform the design of cultural competence strategies for healthcare organizations.