Clinicians' Cultural Sensitivity Survey

What is Cultural Sensitivity? 

We conceptualize the meaning of culture in the medical encounter as multidimensional, based on our qualitative research with African American, Latino (English and Spanish speaking), and White adults from community settings (community health centers, senior centers).  Based on analysis of data from 19 focus groups, we identified several domains of culture affecting the medical encounter.  The relevance of each domain varies by subgroup.

  • Sensitivity to complementary/alternative medicine
  • Language and language-based discrimination
  • Discrimination due to health insurance, social class, ethnicity, and age
  • Ethnic concordance of physician and patient
  • Role of spirituality 
  • Role of family
  • Modesty
  • Immigration
  • Nutrition
  • Patient submissiveness
  • Doctor culture

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. Download publication.

What is the Clinicians’ Cultural Sensitivity Survey?

The Clinicians’ Cultural Sensitivity Survey (CCSS-29) is a 29-item questionnaire designed to assess the multiple domains identified in our qualitative research (above).  Analysis of data of over 500 English- and Spanish-speaking Latinos from primary care practices identified 14 domains: 11 are relevant for all patients, two for those with limited English proficiency, and one for immigrants (# of items in parantheses).  

All respondents

  • 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)
  • Physician discrimination due to education (2)
  • Physician discrimination due to race/ethnicity (2)
  • Staff discrimination due to race/ethnicity (2)

Persons with limited English proficiency

  • Discrimination due to language needs (3)
  • Sensitivity to language needs (3)

Immigrants

  • Sensitivity to immigration status (3)

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.  PMC3570254. Download publication.

  • A supplement to this article contains the final 29-item survey, descriptive statistics including reliability, factor loadings, and inter-factor correlations. Download supplemental material. 

Copyright and Permission

Although the CCSS-29 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). To view a copy of this license, visit https://creativecommons.org/licenses/by-nc-sa/4.0/

Download the CCSS-29 Surveys and Scoring Instructions

One file contains a packet that includes a description, method of administration, copyright information, publication, scoring instructions, and the English and Spanish surveys.

CCSS English and Spanish Surveys and Scoring Instructions

Funding

The CCSS 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, the Division of Intramural Research of the National Institute on Minority Health and Health Disparities; and grant no. U01-CA86117 from the National Cancer Institute; National Institutes of Health.