Cultural competence: a critical factor in nursing research.

By the year 2000, one in every third American will represent an ethnic minority. This statistic presents various challenges for healthcare providers. While cultural competence is examined in educational and practical nursing areas, nursing research is only beginning to view cultural competence as essential. This article explores various cultural issues embedded in the research process and provides readers with a conceptual model to enhance cultural competence in nursing research.

Ideological shifts needed in primary care delivery: removing barriers through reform.

Black Americans is one of the fastest growing segments of the population, yet the incidence of illness and mortality are higher and survival from the leading causes of death is poorer than for White Americans (Jaynes & Williams, 1989; U.S. Department of Health and Human Services [DHHS], 1990). In achieving the Year 2000 national health promotion and disease prevention objectives, health care systems must provide universal access to high quality, affordable, comprehensive, and coordinated primary health care services. It is crucial to initiate new approaches to health care delivery, including linking primary care providers (PCPs) in communities where people live and work to eliminate barriers and improve access to culturally-sensitive primary health care in Black communities. Nursing can play an important leadership role in redirecting the education of PCPs and shaping public policy to reflect the primary health care philosophy.

Health policy reform initiatives to improve the health of black Americans.

Black Americans comprise 12.4 percent of the United States (U.S.) population and is one of the fastest growing minority groups (U.S. Bureau of the Census, 1992). Recent health statistics indicate, however, that the life expectancy for Black Americans has lagged dramatically behind other minorities and White Americans throughout the century (DHHS, 1990). Economic, legislative and social factors hinder access to care and the provision of services within the current structure of health care in the U.S. Under health care reform, these three factors must be redefined to promote access to comprehensive health care services for Black Americans. Nursing is being challenged to provide the vision and leadership that will influence the key players to support a reform in health policy.