CAHPS Cultural Competence Item Set

The CAHPS Cultural Competence Item Set is designed to capture the patient's perspective on the cultural competence of health care providers. Culturally competent care is defined as care that is responsive to diversity in the patient population and cultural factors that can affect health and health care, such as language, communication styles, beliefs, attitudes, and behaviors.

The Cultural Competence Item Set was developed for use with the CAHPS Clinician & Group Survey 2.0. It is available in the Supplemental Items for the Adult Survey (PDF, 531 KB; PDF Help), which also includes instructions for placing the items into the core questionnaire. The items are currently available in English only.

Learn About the CAHPS Cultural Competence Item Set (PDF, 302 KB; PDF Help).

To download both the supplemental items and the descriptive document, go to Get Clinician & Group Surveys and Instructions.

Topics Covered by the Cultural Competence Item Set

The Cultural Competence Item Set covers the following topics:

  • Patient-provider communication
  • Complementary and alternative medicine
  • Experiences of discrimination due to race/ethnicity, insurance, or language
  • Experiences leading to trust or distrust, including level of trust, caring and truth-telling
  • Linguistic competency (Access to language services)

Quality Measures from the Cultural Competence Item Set

Users of this item set can calculate and report two composite measures:

  • Providers (Doctors) are polite and considerate*
  • Providers (Doctors) are caring and inspire trust

*Note: This composite measure is intended to supplement the existing composite measure for provider communication (How well providers communicate with patients), which can be calculated from the core items in the Clinician & Group Survey.

The remaining questions in the item set cannot be rolled up into composite measures.

Users can also report two rating items:

  • Overall rating of trust in provider (on a scale of 0 to 10)
  • Overall rating of interpreter (on a scale of 0 to 10)

Please note that the labels for these measures are provisional because they have not yet been tested with consumers.

Learn more about these measures in About the CAHPS Cultural Competence Item Set (PDF, 302 KB; PDF Help).

Brief History

The impetus for this item set was research by members of the CAHPS team on strategies for increasing response rates for non-English speakers and issues missing from the CAHPS surveys that overwhelmingly affect non-English speakers.

See: 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. (Available by selecting here.)

Learn about the development of the CAHPS Cultural Competence Item Set.

Page last reviewed September 2016
Page originally created June 2012
Internet Citation: CAHPS Cultural Competence Item Set. Content last reviewed September 2016. Agency for Healthcare Research and Quality, Rockville, MD.