Factors associated with the provision of cultural sensitivity training in hospice agencies: Evidence from national home health and hospice survey

Cultural sensitivity is vital in the healthcare setting because it helps healthcare providers better understand the needs of their patients and communicate effectively with them. Organizational characteristics associated with the provision of cultural sensitivity training to healthcare staff are not well understood, especially in long term care. By focusing on the hospice setting, this study attempts to identify the organizational characteristics associated with the provision of mandatory cultural training to direct care workers in US hospice agencies. A retrospective cross-sectional study design was used to analyze data from the 2007 National Home and Hospice Care Survey (NHCS). The dependent variable was the provision of mandatory cultural training to all direct service providers. Facility level variables included location, ownership type, chain affiliation, agency type (hospice-home health mixed agency/hospice only), JCAHO accreditation, number of patients admitted, and the type of hospice agency (freestanding hospice/other). Chi Square test and weighted logistic regression were used for the analyses. Bivariate analysis provided evidence of a relationship between cultural training and ownership type, chain affiliation, agency type, JCAHO accreditation, training status, number of patients admitted, and type of hospice agency. In multivariate logistic regression analysis, the following factors were associated with a higher likelihood of providing cultural sensitivity training: private ownership (OR= 6.2, CI =3.67-10.5), JCAHO accreditation (OR= 1.7, CI =1.2-2.6), urban location (OR=3.04, CI =2.17-4.26), and smaller facilities (OR= 1.8, CI=1.4-2.1). In order to reduce racial and ethnic disparity in healthcare, attention to cultural sensitivity in the healthcare setting is required.