Perceptions of Cultural Competence and Utilization of Advanced Practice Providers

Advanced practice providers (APPs) provide preventive services, continuity of care, and bridge health management gaps. Associations between perceptions of shared culture and utilization of APPs are not yet documented in the research literature. Nationally representative data from the 2017 National Health Interview Survey were analyzed using age-adjusted logistic regressions to compare associations between perceptions of cultural competence and utilization of APPs. A total of 11,954 males (mean age 50.0, SD 18.3) and 14,453 females (mean age 51.8, SD 18.8) from the US adult population were included in this study. Perceiving a shared culture with health care providers was significantly associated with utilization of APPs. Among males, perceived respect from providers was associated with an 11.4 percent¬age point increase in the probability of APP utilization (95% CI: 2.7, 27.1). Among females, visiting providers with a shared culture was associated with a 9.4 percentage point increase in the probability of APP utilization (95% CI: 4.4, 14.5). APP utilization decreased among those with less than college education and Hispanic race if providers asked opinions and beliefs about care. This study underscores the need to explore perceptual differences on cultural competence, influences on healthcare utilization, and patient-provider cultural congruence.