Cross-Cultural Competence Interventions Have Potential to Improve Oncology Care

Interventions based on cross-cultural competence (CCC) and knowledge may be helpful for oncology patients, but more research is needed to support the claim, according to a study in the European Journal of Oncology Nursing.

A team of researchers conducted a meta-analysis and quantitative review of the available literature about the effectiveness of interventions based on cross-cultural competence in oncology. They determined that 15 studies met their inclusion criteria. All of the studies were published between 2000 and 2020, and two-thirds were carried out in the United States. The mean sample size of providers in the studies was 63.8 (SD, 52.4). Four of the studies included only nurses, and nurses were the largest occupational group in 4 other studies.

The researchers assessed study quality with the Design and Implementation Assessment Device (DIAD), but they discovered that “many of the 35 individual items of DIAD could not be answered with certainty due to nonreported information.”

Of the 15 studies, only 9 provided sufficient statistical information so the researchers could obtain an effect size.

The researchers determined that behavior changes seemed to generate the highest effects, despite the fact that the effect sizes were considered small and there was a low number of included studies.

Ultimately, the findings suggest that interventions based on cross-cultural knowledge and behavior have positive effects, but beyond that, the effects are unknown. Many of the studies were published after 2016, which could indicate that gaps in knowledge could be the result of interest in this matter seeming to develop only relatively recently.

“Given the lack of studies examining the effectiveness of CCC interventions in oncology and the insufficient methodological rigor of the available studies, more thorough research is urgently needed to support the claim that interventions actually improve CCC in oncology and to better understand which cross-cultural dimensions can be most effectively improved,” the research team concluded. “However, building a stronger evidence base requires not losing sight of patient-reported outcomes and putting their experiences at the centre of future research.”

Disclosure: This research was supported by the Swiss Cancer League. Please see the original reference for a full list of disclosures.


Rost M, de Clerq E, Arnold, L, et al. Interventions to enhance cross-cultural competence in oncology: a meta-analysis of effectiveness studies and a qualitative review. Eur J Oncol Nurs. 2023;64:102277. doi:10.1016/j.ejon.2023.102277

This article originally appeared on Oncology Nurse Advisor