Health Professional Cultural Competence Reduces the Psychological and Behavioral Impact of Negative Healthcare Encounters

Objectives: Negative health care encounters have psychological and behavioral consequences for patients, particularly for minority and low socioeconomic populations. Guided by an integrative model of culture, psychological processes, and health behavior, this study examined whether provider cultural competence reduces the emotional and behavioral consequences of negative health care encounters among Latina and non-Latino White American women in the United States. Method: A total of 335 women participated in the study, of which 236 (Latina = 112; non-Latino White = 124) reported at least one negative health care encounter during a preventive medical screening exam. Structural equation causal modeling was used to examine whether provider cultural competence, as perceived by the patient, influenced emotions associated with negative health care encounters and subsequent medical avoidance. Results: When both Latina and non-Latino White American patients perceived their provider to be higher in cultural competence, they experienced less shame and embarrassment related to the negative encounter. Lower levels of shame and embarrassment in turn, predicted less medical avoidance for Latina, but not non-Latino White American women. Conclusions: Findings revealed that provider cultural competence reduces some of the consequences of negative health care encounters that are relevant to health behavior. These findings shed light on the complexity of how providers' cultural competence impacts patient behavior, highlighting the importance of including psychological variables when investigating the role of cultural competence in health behavior and outcome. Public Significance Statement This study revealed that when Latina and non-Latina White American patients believe their health care provider is culturally competent (possesses the knowledge, awareness, and skills relevant to their cultural background), they are less likely to feel ashamed and embarrassed in response to a negative health care encounter. This is particularly important for Latina patients considering that feeling less shame and embarrassment resulted in less avoidance of future medical care. Our findings suggest that training health care providers in cultural competence could have beneficial effects on patients' feelings towards their providers and on the likelihood that they will seek timely medical care.