March 2013

The primer on Cultural Competency and Health Literacy is the first teaching guide designed for multiple health professions, incorporating both cultural and health literacy competency to improve health equity by improving health literacy and communication satisfaction. The primer aims at reducing health disparities and improving health outcomes by providing students in the health professions and practicing health professionals with resources to implement effective cross-cultural communication skills, have the tools necessary to deliver culturally and linguistically appropriate healthcare services to diverse groups, and develop programs and policies to improve health outcomes and reduce health disparities.

The development of the primer is the result of a combined effort of cultural competency, health literacy, health care communication, minority health and health education professionals from Maryland. Two main workshops took place to discuss cultural competencies in the health care field; the first workshop comprise of 31 participants whom met during a feedback workshop that took place on October 2011 during the 3rd Health Literacy Annual Research Conference in Chicago, Illinois. The participants engaged in a group process to match a set of draft health literacy competencies[1] to the competencies presented in the revised 42-item Tool for Assessing Cultural Competency Training (TACCT) developed by the Association of American Medical Colleges.  The second meeting took place in December 2011, where a group of 29 educators representing 23 different university- and community-college based health profession training programs in Maryland came together in a second workgroup.  Using the results of the October 2011 matching exercise, the second workgroup linked the combined cultural and health literacy competencies to stage of learner (developmental sequencing) and explored approaches to assess learners’ achievement of competencies.

The results of the October 2011 and December 2011 workgroup exercises were analyzed and synthesized by Monica McCann, MA, MPH (Maryland Office of Minority Health and Health Disparities) and discussed and deliberated with Workgroup facilitators Bonnie Braun, PhD (University of Maryland College Park, School of Public Health) and Olivia Carter-Pokras, PhD (University of Maryland College Park, School of Public Health).  The resultant draft core competencies were submitted back to both workgroups for further commentary (see Table 1 for final set). The core competencies that are listed in Table 1 as learning objectives are arranged according to the six domains in the revised Tool for Assessing Cultural Competence Training (TACCT)[2] and are intended to reflect the input provided by participants during the 2011 workgroup meetings.

Thanks to the join collaboration of The University of Maryland School of Public Health in collaboration, the Herschel S. Horowitz Center for Health Literacy and the Maryland Department of Health and Mental Hygiene’s Office of Minority Health & Health Disparities the primer was published on March 2013.

The primer is a free resource and it can be accessed here:


[1] Coleman, Hudson, Maine, Culbert. Health Literacy Competencies for Health Professionals: Preliminary results of a Modified Delphi Consensus Study (Under Review).

[2] Lie DA, Boker J, Crandall S, DeGannes CN, Elliott D, Henderson P, Kodjio C, Seng L. Revising the Tool for Assessing Cultural Competence Training (TACCT) for curriculum evaluation: Findings derived from seven US schools and expert consensus. Med Educ Online [serial online] 2008;13:11 doi;10.3885/meo.2008.Res00272 Available from