Measuring Health Care Provider Cultural Competency with Appalachian Populations: Validation of a Modified Cultural Self Efficacy Scale

While researchers have identified major health determinants for Appalachian populations as well as chronic diseases common to those in the region, less known is the cultural competency of health care providers who serve in Appalachia. Furthermore, current measures of health providers’ self-rated cultural competence in the provision of care do not include Appalachian cultures. This presentation focuses on the results of a validation study of a cultural self-efficacy scale modified to consider work with people from Appalachia. The Cultural Self-Efficacy Scale or CSES is a self-report measure of an individual\u27s confidence working with various ethnic groups. Previous researchers have applied and validated this measure with Asian Americans, Hispanics, and African Americans. The researchers administered the CSES via an online survey to a nationally representative sample of 113 health care workers from various disciplines including social work, nursing, and medicine. Results of an exploratory factor analysis showed that the underlying factor structure for those rating their comfort working with Appalachian populations was different than in previous studies that focused on cultural self-efficacy with African-Americans, Asian-Americans, and Hispanics. Furthermore, the average level of provider comfort working with Appalachian populations was lower than the average level of comfort previously reported with African-Americans, Asian-Americans, and Hispanics. This study points to the importance of including Appalachians as a distinct cultural group in measures of cultural competency. The results of this study also point to the need to acknowledge Appalachian cultures in the preparation of health care providers who endeavor to practice in the region