Three hundred four students participated in the study, with 184 from UFL and 120 from FAMU (response rates of 62.2% and 90.9%, respectively), for an overall response rate of 70.2%. The majority of the students in both schools were female, most respondents were between 20 and 24 years of age, and 84.2% from each college were born in the United States (). More students had lived in or visited another country outside the United States than had not. At FAMU, the respondents were predominantly African-American/black (60.8%), approximately a third (29.2%) spoke a language in addition to English. About 86% of the FAMU respondents reported having been previously exposed to cultural-competency instruction in their school's curriculum. In contrast, respondents at UFL were mostly Caucasian (69.4%) and more UFL students (38%), spoke a language(s) in addition to English, compared with students from FAMU. Only about 27% of respondents at UFL reported having had some previous exposure to cultural-competency instruction in the school curriculum, and 13% reported having had some previous exposure outside the school curriculum.
Demographic Characteristics of Pharmacy Students Participating in a Survey About Clinical Cultural Competency and Knowledge About Health Disparities
The health-disparities knowledge subscale assessed participants’ knowledge of health disparities by subject area, including programs, policies, and sources of information. With a potential maximum score of 40 and midscore of 24 (score if a respondent indicated the option “somewhat” about knowledge on all 8 areas listed), the overall mean score was 22.4 (median score, 22) ().
Summary Statistics of Student Responses to a Survey About Clinical Cultural Competency and Knowledge of Health Disparities
The sociocultural-skills subscale had a list of common sociocultural issues that a pharmacist as a healthcare provider would likely encounter in patient care. With a potential maximum score of 60 and a midscore of 36 (score if a respondent indicated the option “somewhat” for all the 12 sociocultural issues listed), the overall mean score was 37.5 (median score, 38).
The cross-cultural subscale was comprised of a list of 12 common cross-cultural encounters or situations in which pharmacists might find themselves while providing patient care. Self-assessment of how comfortable the respondents thought they might feel in these situations yielded an overall mean score of 36.6 (median score, 36). The potential maximum score was 60, indicating a consistent score of 5 (“very comfortable”) for each item.
The attitude subscale had a list of 12 factors known to contribute to health disparities, such as genetics, the environment, lifestyle, racism, ableism, and ageism. Respondents were asked to rate the importance of each factor. A sixth option of “don't know” was included on the scale and assigned a value of zero (0) to allow participants to provide an appropriate response to factors about which they had no knowledge. The potential maximum score, therefore, was 60; with a midscore of 36. The mean score for all participants was 45.7 (median score, 46).
Each item on the self-awareness subscale was assessed independently. There were 3 items addressing self-awareness of racial, ethnic, or cultural identity; self-awareness of racial, ethnic, or cultural stereotypes; and self-awareness of biases and prejudices. Each item had a potential maximum score of 5. Overall mean scores were generally high for these items (mostly ≥ 4.0 on a scale of 5). The importance of training in cultural competence for health professionals was generally rated highly; with an overall mean score of 8.2 (median score of 8) out of a potential maximum of 10.
Regression analyses were performed to determine the variables that were significantly associated with cultural competency and knowledge of health-disparities constructs (). After controlling for relevant covariates, students who had formal training on cultural competence outside the school curriculum and those attending FAMU had significantly more knowledge of relevant subject areas related to health disparities. Respondents who were not born in the US, those who spoke a language other than English, and those exposed to formal training reported better skills in dealing with sociocultural issues (p < 0.05). Respondents older than 24 years, male students, and those who spoke a language other than English reported feeling more comfortable with cross-cultural encounters. Speaking a language other than English was associated with more favorable attitudes toward factors contributing to health disparities and higher self-awareness of racial, ethnic, or cultural identity, and biases and prejudices (p < 0.05). Students from minority groups and females tended to place more value on training in cultural competence for health professionals (p < 0.05). Generally, students at FAMU had more favorable attitudes toward factors contributing to health disparities and higher self-awareness of biases and prejudices (p < 0.05).
Demographic Correlates of Cultural Competency and Knowledge of Health Disparities