Supporting cultural competence: Practices of managers and line workers in a health service

This paper examines approaches and practices of managers and line-workers to support and delivery culturally competent health services. The aim is to explore the connections between managerial and professional practices that sustain or hinder cultural competence. We conducted a case-study of a large health service, located in a central Italian Region, with diversity initiatives underway. We involved four managers and six family planning counselling providers. Data came from interviews with managers and one focus group with the staff. Findings showed organizational commitment toward cultural competence and the perception of mutual support at multiple levels. Also, an evolution toward participation and community-based approaches of cultural competence was found. Data revealed the importance of intra-and inter-organizational communication in order to sustain cultural competence implementation. The main perceived barriers concern the risk of precariousness and resistances, while evidence of ineq-uities, innovative and patient-centered culture emerged as facilitators.