Diversity Awareness and Documentation Practices Among Oncology Advanced Practice Providers

Advanced practice providers (APPs) care for widely diverse populations. The Institute of Medicine (IOM) states that bias, prejudice, and stereotyping by a health-care provider may contribute to disparities, which are associated with worse outcomes. The IOM called for efforts to increase awareness among health-care providers. The objective of this study is to assess the cultural self-awareness of oncology APPs who practice in a community-based outpatient cancer center and investigate the extent to which APPs include cultural care into patient assessments and document this data. Oncology APPs completed a questionnaire evaluating cultural self-awareness. A prospective, quality improvement chart review was performed to analyze the extent to which cultural themes were addressed during oncology clinic visits. A list of cultural keywords was used as a guide. About 10% of the 2015 cancer population at the institution was examined, which included a stratified sample of the top six disease groups. Responses were analyzed. All APPs demonstrated average or above-average cultural awareness. Documentation of cultural assessment was low. Of the 28 cultural keyword items, an average of 4.88 items were addressed during each visit. Multiple cultural items, including literacy, language, insurance status, and belief about the disease were addressed less than 5% of the time.