Background: Health disparities result from a variety of factors, both societal and institutional. One root is the dearth of attention paid to illnesses with health disparities in formal medical curricula as well as the lack of training of physicians with skills and knowledge that would improve cultural competence. Hypothesis: Curricular reform that includes assessment and revision of current curricular content and training for improved skills and knowledge in cultural competence will result in improved knowledge and attitudes for health care providers regarding cardiovascular disease, stroke, sickle cell disease, asthma, and sleep disorders in populations with health disparities. Intervention/Process: Funding for this grant will provide resources to: 1. identify curricular opportunities and gaps to integrate cultural competency and health disparities education 2. develop curricular objectives linked to training level (from preclinical student to physician level) highlighting cross-cultural competency knowledge, attitudes, skills, unique population specific issues and different clinical manifestations or health disparities associated with the disease topics under study. 3. modify curriculum and develop new instructional strategies to address gaps 4. implement new and modified instructional strategies 5. evaluate new and modified curriculum 6. develop a dissemination plan 7. disseminate curriculum to medical education groups (medical schools, graduate medical education and continuing education groups) 8. evaluate dissemination plan and analyze program effectiveness. Evaluation: Results will be measured by evaluating pre and post test performance knowledge about the health disparities associated with target illnesses, learners' ability to develop concept maps outlining a comprehensive strategy to delineate the intercalations between illnesses and cultural context; skills in health care delivery using standardized patient exercises; faculty and student attitudes regarding the cultural competence curriculum and qualitative feedback from learners and educators.
