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Development of the CAHPS Cultural Competence Item Set

The development of the Cultural Competence Item Set was completed by the CAHPS II grantees. This work included initial development of the items, cognitive testing, and translation of the items into Spanish. The Commonwealth Fund also provided funding to support the development and testing of this item set.

Initial research. The intergrantee Cultural Comparability team conducted a literature review and preliminary research to investigate the usefulness of a CAHPS survey to gather information on patients’ assessments of the cultural competence of health care providers. This research was published by the Commonwealth Fund in: Ngo-Metzger Q, Telfair J, Sorkin DH, Weidmer B, Weech-Maldonado R, Hurtado M, Hays RD. Cultural Competence and Quality of Care: Obtaining the Patient's Perspective. New York: The Commonwealth Fund; October 2006.

Item inventory. Based on their research, the grantees identified the domains that this item set would need to address and started gathering appropriate items. They produced a preliminary set of items that combined existing CAHPS survey items and adapted items from other measures, which were collected through a call for measures in the Federal Register. The grantees also developed new items to fill gaps as needed.

Cognitive testing. The grantees conducted cognitive interviews in three locations to ensure that patients can accurately understand and interpret the questions and response options. Both the English and Spanish versions were tested. The team incorporated their findings into the item set that was used for the field test.

Field testing. The item set was tested with a sample of Medicaid managed care enrollees of two health plan partners, Affinity and CareFirst, in California and New York.

Learn more about the development of this item set in a set of slides discussed at a Breakfast Roundtable at the April 2010 CAHPS User Group Meeting. ( PDF [103.2 KB] )

Release of updated items. In May 2012, the CAHPS team released a revised version of the Cultural Competence Item Set. The revision reflects an effort to align this item set with recent updates to the Clinician & Group Surveys and related supplemental items.

Page last reviewed March 2016
Page originally created June 2012
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