What is Cultural Sensitivity?
We conceptualize the meaning of culture in the medical encounter as multidimensional. Based on qualitative research with African American, Latino (English and Spanish speaking), and White patients from community settings, we identified 11 domains of culture affecting the medical encounter.
- Complementary and alternative medicine
- Discrimination
- Doctor culture
- Ethnic concordance of physician and patient
- Family
- Immigration
- Language
- Modesty
- Nutrition
- Patient submissiveness
- Spirituality
This research is described in the following publication.
Citation: Nápoles-Springer AM, Santoyo J, Houston K, Pérez-Stable EJ, Stewart AL. Patients’ perceptions of cultural factors affecting the quality of their medical encounters. Health Expectations, 2005:8(1):4-17. PMCID: PMC5060265
What is the Clinicians’ Cultural Sensitivity Survey?
The Clinicians’ Cultural Sensitivity Survey (CCSS-29) is a 29-item multidimensional questionnaire to assess one aspect of quality of care of Latino patients. It was developed to measure the domains identified in the qualitative research (above). Psychometric evaluation was based on a survey administered to over 500 English- and Spanish-speaking Latino patients. Information on its development and testing are described in this publication:
Nápoles AM, Santoyo-Olsson J, Farren G, Olmstead J, Cabral R, Ross B, Gregorich SE, Stewart AL. The patient-reported Clinicians' Cultural Sensitivity Survey: a field test among older Latino primary care patients. Health Expectations, 2012; 15(1):63-77. PMC3570254
- A supplement to this article contains the final 29-item survey (including instructions), descriptive statistics including reliability, factor loadings, and inter-factor correlations. Download supplemental material.
The final survey assesses 14 domains of cultural sensitivity. It is designed to be interviewer-administered because of the need to administer several items only to patients with limited English proficiency or immigrants. The CCSS assesses 14 domains of cultural sensitivity. Eleven are relevant for all patients, two for those with limited English proficiency, and one for immigrants (# items in parentheses).
All Patients
- Complementary and alternative medicine (2)
- Mind-body connections (2)
- Causal attributions of health problem (2)
- Preventive care (2)
- Family involvement (2)
- Modesty (2)
- Prescription medications (1)
- Spirituality (1)
- MD discrimination due to education (2)
- MD discrimination due to race/ethnicity (2)
- Staff discrimination due to race/ethnicity (2)
Limited English proficient
- Discrimination due to language needs (3)
- Sensitivity to language needs (3)
Immigrants
- Sensitivity to immigration status (3)
The CCSS can be used to assess the quality of care of older Latino patients. Its development and testing can be found in the following publication:
Citation: Nápoles AM, Santoyo-Olsson J, Farren G, Olmstead J, Cabral R, Ross B, Gregorich SE, Stewart AL. The patient-reported Clinicians' Cultural Sensitivity Survey: a field test among older Latino primary care patients. Health Expectations, 2012; 15(1):63-77. PMCID: PMC3570254.
Permission and Copyright
Although the CCSS is copyrighted, it is available without charge and no written permission is required for use. It is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License (CC-BY-NC-SA).
Click here for conditions for using the CCSS
Download the CCSS and Scoring Instructions
The CCSS survey was designed to be interviewer-administered.
Funding
The CCS measurement development was supported by grant no. R21CA121176 from the National Cancer Institute; grant no. P30-AG15272 from the Resource Centers for Minority Aging Research program of the National Institute on Aging, the National Institute of Nursing Research, and the National Center on Minority Health and Health Disparities; and grant no. U01-CA86117 from the National Cancer Institute; National Institutes of Health.