Multilevel cultural competence intervention implementation and evaluation framework

Abstract

As demonstrated in previous chapters, cultural competence is a broad intervention approach that includes diverse practices operating on multiple levels of health systems. Health systems and the cultural competence approaches they take are situated in complex community, social, cultural, political and economic contexts. Because of the inherent complexities, we argue that a multilevel systems approach is necessary for the advancement of cultural competence outcomes in healthcare. Multilevel interventions aim to improve intervention effectiveness by addressing multiple levels of a relevant social system and capitalising on the synergistic effects of interacting intervention components. In this chapter, we present the first evidence-based, peer-reviewed framework for multilevel interventions to improve cultural competence in healthcare systems. We also discuss some key issues in the design and evaluation of multilevel interventions.