Curricular Competencies Related to Cultural Competence for the Education and Training of Registered Dietitians

Increasing demographic diversity, persistent health disparities, and ongoing efforts to reduce health care costs have made cultural and linguistic competence in the United States health care system a premier concern. Integral to improving cultural competence in health care is providing health professionals with adequate education and training in cultural competence. For this reason, there has been increasing attention paid by academia across health-related disciplines and by national organizations and governmental health agencies to delineating what cultural competence in education and training entails. Though a multidisciplinary body of literature on developing curricula related to cultural competence for health professionals exists, still lacking from this literature is sufficient input from the dietetic profession. The purpose of this cross-sectional internet-based research was to create a curricular model of core curricular competencies related to cultural competence for the education and training of registered dietitians. A random sample of registered dietitians rated 73 proposed curricular competencies for essentiality on a 7-point Likert-like scale (1 = Not a priority; 7 = Essential). Exploratory principal components analysis (PCA) with Varimax rotation condensed the proposed competencies with similar variances of responses into factors (model domains) and eliminated competencies which accounted for too little or ambiguous variance. Factors were assigned unique labels based on the prevailing themes of their respective competencies and further interpreted in terms of respondent characteristics via multivariate general analysis of variance (MANOVA). Results based on a 17.9% (n=1,090) rate of response produced a model with 69 competencies and 7 domains: Communication and Relationships; Community Collaboration; Disparities and Diversity in Health Care; Information Access, Analysis, and Use; Bias Management; Food Environments; and Models and Definitions. Significant differences in mean factor ratings were detected between respondents who differed by race and by experience working with diverse individuals and groups. This model is representative of existing research on cultural competence, but it is the first unique to dietetics. It may be used by dietetic education and training programs to systematically plan, implement, and evaluate curricula for cultural competence.