a1 Assistant Clinical Professor, School of Nursing, McMaster University, Hamilton, Canada
a2 Senior Epidemiologist, The Public Health Agency of Canada, Ontario, Canada
a3 Associate Professor, Dorothy C. Hair Chair in Primary Health Care Nursing, School of Nursing, McMaster University, Hamilton, Canada
a4 Director, McMaster Institute of Environment and Health, Professor, School of Geography and Earth Sciences, McMaster University, Hamilton, Canada
a5 Associate Professor, Assistant Dean (retired), School of Nursing, McMaster University, Hamilton, Canada
a6 Director, Centre for Public Health and Zoonoses, Professor, Population Medicine, Ontario Veterinary College, University of Guelph, Ontario, Canada
Aim To explore how an organization's trust in the cultural competency of other service providers (competence trust) can influence the effectiveness of a services network in meeting the needs of recent immigrant families.
Background Primary health care for recent immigrants arriving in Canada is delivered through a network of community-based services. To ensure the functioning of the network and its ability to facilitate access to needed services for new arrivals, network members need to be able to work together collaboratively. A case study involving services for an urban community in Atlantic Canada was undertaken in 2009 to explore how service organizations worked together to address the needs of recent immigrant families with young children. This paper focuses on provider perceptions of cultural competency among local service organizations and how this influenced trust and desire to work together for the benefit of families.
Methods The case study utilized both social network analysis and qualitative inquiry methodology. Twenty-one of 27 selected organizations responded to the online social network survey, and 14 key informant interviews were conducted. Social network measures and network mapping were used to demonstrate trusting relationships and associated interactions, while interview data were used to explain the relationships observed.
Findings Perceived cultural competency affected the degree of trust and collaboration within the services network when addressing the needs of recent immigrant families. Competence trust toward other providers increased the desire and commitment to work together, while lack of competence trust created avoidance. Non-government organizations were identified among the most culturally competent. The perceived positive and negative experiences of families with different providers influenced the level of trust among network members. The development of systemic cultural competences within a services network is needed in order to improve collaborations and access to services for immigrant families.
(Received January 24 2012)
(Revised April 11 2012)
(Accepted April 18 2012)
(Online publication July 13 2012)