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Resources to Implement Cross-Cultural Clinical Practice Guidelines for Medicaid Practitioners: Physician Toolkit and Curriculum


This toolkit will help providers apply the Cross-Cultural Clinical Practice Guidelines, which were written for primary care practitioners serving racially, ethnically, and linguistically diverse Medicaid populations in various outpatient settings. It introduces the fundamentals of cross-cultural practice and offers steps and processes essential to delivering high-quality care to culturally diverse populations.

The toolkit includes the following sections:

  • Introduction and rationale
  • Overview of health disparities
  • Cultural considerations in health care
  • Clinical assessment processes
    • Cross-cultural views on diagnostic and treatment practices
    • Eliciting patient views
    • Patient cultural assessment
    • Sample case study
    • Summary action points
  • Treatment planning and adherence
    • Considerations in treatment planning
    • Factors influencing treatment adherence
    • Negotiating treatment adherence
    • Summary action points
  • Patient communication and education
    • Cultural factors affecting communication
    • Verbal and non-verbal communication styles
    • Working with language barriers
    • Patient education during the medical encounter
    • Summary action points
  • Clinical decisionmaking
    • Factors affecting clinical decisionmaking
    • Sample case study
    • Summary action points
  • Organizational supports and system tools
    • Impacting system change
    • Quality improvement planning
    • Interpreter service arrangements
    • Additional supports
  •  Appendixes
    • Sample patient cultural assessment tool
    • Summary evaluation of case study
    • Sample case examples of cultural competence quality improvement plans
    • Summary of culturally and linguistically appropriate services standards
Links to the Tool:
This tool is available at: (If you don't have the software to open this PDF, download free Adobe Acrobat ReaderĀ® software External Web Site Policy.)


University of Massachusetts Medical School

Funding Sources

Office of Minority Health; U.S. Department of Health and Human Services

QualityTool Topic



  • Release Date: 03/2004
  • Original Summary: 04/2006
Disclaimer: The inclusion of a tool in the Innovations Exchange does not constitute or imply an endorsement by the U.S. Department of Health and Human Services, the Agency for Healthcare Research and Quality or Westat of the tool or of the submitter or developer of the tool. Read more.
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Last updated: October 17, 2012.