Chapter 10 – Evidence-Based Practice Questions
This activity contains 3 questions.
Evidence for Effective Leadership and Management
Citation: Chin, M., Walters, A., Cook, S. & Huang, E. (2007). Review of interventions
to reduce racial and ethnic disparities in health care. Medical Care Research and Review,
64, October, 29S–100S.
Overview: This systematic review of more than 200 published articles addresses the
question: What actually works for reducing racial and ethnic disparities in healthcare?
The review focused on care for patients with cardiovascular disease, diabetes, depression,
and breast cancer and disparities. The conclusions indicate that the following strategies
are often part of successful interventions: multifaceted programs that include providers,
patients, and the community; a focus on cultural relevancy or culturally tailored
interventions to ensure that the patient’s culture is included; and nurse-led programs.
Application: As has been discussed in this chapter and by the Institute of Medicine
reports on diversity, there is a major problem with health disparities. Much more needs to
be known about the impact of culture on care and what interventions can be more
effective. What needs to be considered to redesign interventions so that they include
cultural issues? Cultural leverage is identified by this study as very relevant to care
delivery. This is “a focused strategy for improving the health of racial and ethnic
communities by using their cultural practices, products, philosophies, or environments as
vehicles that facilitate behavior change of patients and practitioners. Building upon prior
strategies, cultural leverage proactively identifies the areas in which a cultural
intervention can improve behaviors and then actively implements the solution” (Fisher et
al., 2007: 245S).
Source: Fisher, T., Burnet, D., Huang, E., Chin, M., & Cagney, K. (2007). Cultural
leverage: interventions using culture to narrow racial disparities in health care. Medical
Care Research and Review, 64 (5 Suppl.), 243S–282S.
What is your opinion of “cultural leverage”?
What has been your experience with the impact of culture on patient care?
Why do you think nurse-led programs are considered successful strategies?