Background/aim: Systematic reviews demonstrate cultural barriers to diabetes service uptake across international multi-ethnic populations and effective interventions to reduce these barriers. The aim of this study was to present workforce cultural competence evidence, specifically, the ethnicity and linguistic skillset of General Practice teams, their access to diabetes training, and assess the practices’ overall cultural competence.
Design and setting: Cross-sectional survey of all 66 general practices in Coventry, a typical multicultural UK city with 4.9% diabetes prevalence.
Methods: Semi-structured survey comprising 35 questions completed by a practice nurse or another designated practice staff. Data analysed using descriptive statistics and interpreted with reference to the Culturally-Competent Assessment Tool.
Results: Thirty-two practices (52%) responded betwteen November 2011 and January 2012. Six important findings emerged across the responding practices: (1) One in five practice staff was from a minority group in contrast with one in ten of Coventry’s population, (2) 94% of practices reported the ethnicity of their populations, (3) Nine (26%) practices reported over 50% diabetes prevalence in ethnic minorities; the highest practice had 96%, (4) Ten practices (29%) reported higher attendance of diabetes annual checks in the white British population compared to ethnic minorities, (5) The most frequently stated barriers to culturally-competent service delivery were language and knowledge of nutritional habits, and (6) 56% of practices were highly culturally-competent and 26% moderately culturally-competent.
Conclusions:Ethnicity reporting in primary care is improving and some degree of culturally-competent health services in diabetes is widespread across the city. Language barriers are being addressed but could be improved further. Cultural knowledge around diabetes-related nutrition is low.
Funding sources: NHS West Midlands through a research fellowship.