Cultural Competence in the Public Health System: A Cross-Sectional Study in the Northern Metropolitan Area of Barcelona

Abstract

The increasing migration to Catalonia—where migrants represent 17.24% of the population—underscores the importance of strengthening healthcare professionals’ cultural competence. This study evaluates healthcare workers’ self-perceived knowledge, skills, attitudes, training, and comfort in this area. A cross-sectional, multicenter study was carried out in 93 primary care centers and 1 hospital located in the northern metropolitan area of Barcelona. The CCCTQ-pre questionnaire, consisting of 67 items distributed across 5 dimensions, was employed. A total of 750 responses were obtained from an estimated population of 5400 healthcare professionals. Data were analyzed using R software, with results disaggregated by sex. Results indicate that the majority of respondents were female (79.9%), with Spanish nationality (94.9%), and held a permanent position (55.5%). Positive correlations were observed between knowledge, skills, and comfort, with attitudes being the highest-rated dimension. Younger, newly incorporated, or migrant professionals scored higher in attitudes and training. No significant differences were found between centers with high or low migration rates. The findings highlight the need to enhance healthcare professionals cultural training and to adapt institutional policies to the evolving social context. Strengthening education on the social determinants of health and the axes of inequality is essential for promoting culturally competent healthcare services. Given that 17.24% of the population in Catalonia is of migrant origin, improving the cultural competence of healthcare personnel is increasingly necessary. This study assesses healthcare professionals’ self-perceived knowledge, skills, attitudes, training, and comfort in this area.