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Fam Med. 2009 Mar;41(3):167-74.

Teaching culturally effective diabetes care: results of a randomized controlled trial.

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Department of Family and Community Medicine, University of Arizona, USA.



Increased cultural competence is a tool in the fight to eliminate health disparities in people with diabetes. However, questions remain regarding the best cultural competence teaching, evaluation, and dissemination methods. An Internet-based approach requires less facilitator time and provides greater ease of dissemination. We developed and tested a skills-focused, Internet-based course on cultural competence in the context of type 2 diabetes.


To test the effectiveness of the course, a randomized controlled trial was conducted on a national sample of 122 family medicine residents. The primary outcome was measured by changes in score on the Cultural Competence Assessment Tool (CCAT), a new self-assessment tool developed for this study.


Total CCAT score increased significantly after the completion of the Internet course for 58 residents in the experimental group (83.55 before the course, 192.09 after the course) but did not change for the 64 residents in the control group (177.58 at baseline, 177.84 at end of study). On multivariate analysis, the only significant predictor of total CCAT score change was having taken the online course.


A skills-based course on cultural competence, delivered via the Internet, is an effective educational strategy. It has potential for dissemination of standardized content.

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