| Summary: | Healthcare providers are called upon to increasingly care for and communicate with patients of varying backgrounds, preferences, and cultures that are often different from their own. Culturally competent interventions are recognized as effective strategies for healthcare professionals to utilize during these cross-cultural encounters. The ability to utilize culturally appropriate strategies is already necessary and will continue to grow in importance as the population of the United States continues to diversify, especially given that healthcare encounters can dramatically impact and influence patient outcomes (Giger & Davidhizar, 2007; IOM, 2003). The purpose of this study was to evaluate the impacts of a culturally competent educational intervention with African American patients with chronic low-back pain.A quantitative, quasi-experimental research design was utilized. African American chronic-pain patients (patients of a University based pain-management center for chronic low-back pain severe enough to have been referred to the pain-management center) were randomly assigned to either the control group (standard patient education) or to the experimental group (culturally competent patient education). The convenience sample consisted of 26 subjects (13 in the control group and 13 in the experimental group). The intervention was a culturally competent patient education session that informed the experimental-group subjects of the cultural differences that can be associated with chronic pain in the African American patient. The patient education session that was provided to the experimental group was based on the standard-care guidelines for low-back pain with the addition of evidence-based cultural information pertinent to African Americans. Content validity was determined by an extensive literature review and the expertise of the dissertation committee members in the areas of chronic pain management and cultural competency of the African American population. The educational intervention was provided to the experimental-group sessions during 20-minute, one-on-one sessions. Evaluation of the study outcomes was focused on pain scale (Visual Analog Scale), functional status (Roland-Morris Questionnaire), and quality-of-life indicators (World Health Organization Quality Of Life -100). These results were compared to the outcomes of subjects who received only the standardized patient education. Results were analyzed utilizing SPSS-18. Descriptive statistics (means, standard deviations, and ranges) were conducted to compare sociodemographic characteristics and outcome measures at the pretest and posttest stages. Inferential statistics were conducted to test the three study hypotheses.The first hypothesis, that the culturally competent educational intervention would decrease patients' self-reported pain levels (as evidenced by a lower score on VAS), was not supported to a statistically significant level. Clinical significance, however, was achieved for this relationship. The second hypothesis, that functional status would be improved (as evidenced by the Roland-Morris disability questionnaire) was supported (p = .005). The third hypothesis, that quality of life would be improved (as evidenced by the WHOQOL-100) was supported for one of the quality-of-life domains (spirituality p = .05). There are several limitations to the study, such as low statistical power, potential Type II errors, reliance on a convenience sample, and the use of a quasi-experimental research design. These limitations constrain the generalizability of the study findings. Replication of this study is recommended.
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