Assignment on Concepts of Cultural Competency Model

Running head: CONCEPTS OF CULTURAL COMPETENCY MODELS 1
Concepts of Cultural Competency Models
Alanda Charles-Sam
CUNY SPS
Leading and Managing Health Care Disparities in Underserved Populations
NUR 621-01
Professor Nokes
February 23rd 2020

CONCEPTS OF CULTURAL COMPETENCY MODEL 2
According to this, nurse
leaders at all levels must
references
I. Introduction of cultural competency models
A culturally competent healthcare service for patients integrates various factors such as
ethnicity, nationality, literacy, socioeconomic status, gender, and profession (Napier et al.,
2014). This paper will compare two cultural competency models-
“The Process of Cultural Competence in the Delivery of Healthcare Services” model by
Josepha Campinha-Bacote and "Purnell Model for Cultural Competence" by Larry D. Purnell
and their effectivity on healthcare disparities. According to the process of cultural
competence in the delivery of healthcare services, healthcare provider works efficiently by
recognising cultural competence within diverse cultural backgrounds. The model is based on
five constructs of cultural competence- awareness, skill, knowledge, desire, and encounter
(Campinha-Bacote, 2019).
Purnell’s model for cultural competence is based on different sized circles where four
outer rings consist of concepts that are global society, community, family, and patient, and
twelve small inner rings containing cultural domains based on the patient evaluation,
including- geographical background and profession, language, role of family and
organisation, barriers in workplace, ethnic and racial differences, high-risk lifestyle, nutrition,
pregnancy, death ritual, spirituality, healthcare practices and professionals (Purnell & Fenkl,
2019). This model represents an organised framework and its application in various fields of
healthcare helping healthcare professionals to assess transcultural competence in healthcare
by learning about cultural diversity. This model connects the historical background of the

CONCEPTS OF CULTURAL COMPETENCY MODEL 3
culture and global cultural perspective of the individual giving rise to culturally competent
care; therefore, it is chosen as the best cultural competency model.
II. Contrast and comparison of model concepts
For explaining the use of cultural competency models in reducing healthcare
disparity, the following concepts are discussed. In Josepha Campinha model, cultural
competence is a process not an incidence which comprises of five constructs - the first
concept is cultural awareness where healthcare provider should be aware of the patient’s
culture and respect it to avoid imposition of their own beliefs; second concept is cultural
knowledge where the healthcare provider should obtain an education on diverse culture of
patients, third concept is cultural skill where the healthcare provider conduct cultural and
physical assessment by collecting cultural data of the patient, fourth concept is cultural
encounter which motivates the healthcare provider to modify their existing beliefs on
different cultural background by interacting with the patients, the fifth concept is cultural
desire is the expression of curiosity about patient’s culture while caring for them (Isaacson,
2014). On the other hand, five concepts of Purnell’s model - first is global society which
influences people to change views about diverse culture; second is community which
assimilates people based on social concepts and dialect; third is family to which a person is
emotionally connected and the structure and roles of each individual in the family changes
based on age, socioeconomic status, marital status and migration; fourth is individual who
continually adapts to changes in the environment, society and the fifth one is health which is
considered a wellness state in ethnocultural group permeating all other concepts containing
twelve cultural domains mentioned before(Abitz, 2016).
The three current healthcare disparities in the US according to recent researches are-
firstly heart disease affects African Americans more than the non-Hispanic Whites; second

CONCEPTS OF CULTURAL COMPETENCY MODEL 4
health disparity is the gap in the life expectancy between men and women, and the third
disparity is that rate of premature death is high rural areas than urban areas (Purnell et al.,
2016). National health survey revealed that out of the total population, 13% of African
Americans were reported with poor health and high mortality rates; therefore use of bicultural
ecology concept is relevant in case of racial difference between non-Hispanic Whites and
African Americans for understanding and respecting different cultures. In a decade, mortality
rates increased in women, and the gap in life expectancy decreased from 5.1 to 4.8 years
(National Center for Health Statistics (US), 2016) therefore the concept of gender role in
family can be applied to reduce gender inequality in the population. Studies have shown that
a high number of premature deaths due to high risk of health-related activities occur in rural
areas lacking healthcare services. Appalachia is a rural area in the US whose 15% of the
residents are under the poverty line (Countyhealthrankings.org, 2020); therefore the concept
of geographical background can be used to improve healthcare practices in rural areas.
The domains not involved in solving the healthcare disparities include
communication, workforce issues, high-risk behaviours, nutrition, pregnancy, death rituals
and spirituality. This is because the disparities chosen as recent issues are not related to the
domains or discussed. The health disparities are associated with factors including race and
ethnicity, gender and sexual orientation, geographical location.
III. Expected Outcomes Impacting Healthcare Disparities after Applying
Purnell’s Model of cultural competence
To effectively use Purnell’s model, it should be practised at a higher rate by a
healthcare provider. The risk of chronic diseases such as CVD is higher in African Americans
than non-Hispanics due to racial gap; therefore, healthcare providers should emphasize
prevention and equal quality care to all patients by determining their needs and social risk

CONCEPTS OF CULTURAL COMPETENCY MODEL 5
factors to reduce the racial gap to improve health irrespective of their racial differences.
Purnell’s model addresses health inequalities in races and informs the policymakers to take
necessary actions in enhancing healthcare provisions to all (Golden et al., 2014).
Allowing health insurances and medical services to both genders will decrease the life
expectancy gap. Women visited physician less frequently than men; therefore, the physician’s
performance should be evaluated to improve outcomes of preventive services and reduce
gender disparity. Older women having health problems are isolated and denied from
receiving medical care; therefore, the need for community support for women is a concern
where analysing and reporting data should be individualistic including both genders (Purnell
et al., 2016).
Another outcome is benefit of rural underprivileged people. The cost of
healthcare services will be reduced, and equity among high and low-income families will be
maintained in giving culturally competent healthcare. The population-based concept can be
applied by nurses to initiate timely access to medical services, reduce susceptibility to chronic
diseases in rural areas such as Appalachia in US (Baciu et al.,2017).
IV. Summary
Therefore it can be stated that Purnell's model is the best cultural competency model
used in a multidisciplinary healthcare system by professionals for assessing and
implementing interventions for public health. By providing individual care; health promotion,
disease prevention and health improvement occur. To implement patient care, the healthcare
provider should have cultural knowledge that is specific for the individual as well as general.
Therefore by applying the knowledge and skills of diverse culture, the healthcare provider
can become culturally competent.

CONCEPTS OF CULTURAL COMPETENCY MODEL 6
References
Abitz, T.L., 2016. Cultural congruence and infusion nursing practice. Journal of Infusion
Nursing, 39(2), pp.75-79.
Baciu, A., Negussie, Y., Geller, A., Weinstein, J. N., & National Academies of Sciences,
Engineering, and Medicine. (2017). The state of health disparities in the United States.
In Communities in Action: Pathways to Health Equity. National Academies Press (US).
Campinha-Bacote, J. (2019). Cultural compatibility: A paradigm shift in the cultural
competence versus cultural humility debate—Part I. Online Journal of Issues in
Nursing, 24(1).
Countyhealthrankings.org. (2020). County Health Rankings & Roadmaps.
Countyhealthrankings.org. Retrieved 14 February 2020, from
https://www.countyhealthrankings.org/.
Golden, S. H., Purnell, T., Halbert, M. J. P., & Matens, M. R. (2014). A community-engaged
cardiovascular health disparities research training curriculum: implementation and
preliminary outcomes. Academic medicine: journal of the Association of American
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Isaacson, M., 2014. Clarifying concepts: Cultural humility or competency. Journal of
Professional Nursing, 30(3), pp.251-258.
Napier, A. D., Ancarno, C., Butler, B., Calabrese, J., Chater, A., Chatterjee, H., ... &
Macdonald, A. (2014). Culture and health. The Lancet, 384(9954), 1607-1639.

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National Center for Health Statistics (US. (2016). Health, United States, 2015: with special
feature on racial and ethnic health disparities.
Purnell, L. D., & Fenkl, E. A. (2019). The purnell model for cultural competence.
In Handbook for Culturally Competent Care (pp. 7-18). Springer, Cham.
Purnell, T. S., Luo, X., Kucirka, L. M., Cooper, L. A., Crews, D. C., Massie, A. B., ... &
Segev, D. L. (2016). Reduced racial disparity in kidney transplant outcomes in the
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Purnell, T.S., Calhoun, E.A., Golden, S.H., Halladay, J.R., Krok-Schoen, J.L., Appelhans,
B.M. and Cooper, L.A., 2016. Achieving health equity: closing the gaps in health care
disparities, interventions, and research. Health Affairs, 35(8), pp.1410-1415.