Intercultural Public Health: A Qualitative Investigation of Gaps in Knowledge, Skills and Attitudes of Public Health Professionals

Student thesis: Master of Philosophy


Culture is much broader than race and ethnicity. Intercultural issues of public health professionals working in culturally diverse contexts are relatively unexplored. Identifying competency gaps is urgently required to inform training to help tackle health disparities through a preventative, intercultural public health approach. A qualitative systematic literature review was conducted to identify gaps in competences, prior to or post an intercultural competence training intervention. Themes were extracted and coded into an emerging framework. Key findings of 15 studies from the US, Canada, Taiwan and Switzerland, included: knowledge gaps of health disparities linking a local and global perspective; skills gaps applying theory into practice using flexible and diverse methods and cultural models and tools, and a non judgemental attitude gap, focusing on population-based patterns and root causes, rather than stereotypes and repair. A qualitative study was then conducted with five focus groups with public health professionals and the Wider Public Health Workforce, to identify intercultural competence gaps in real-world practice. Positive and negative intercultural issues were identified to highlight competence gaps and examples of good practice. Focus group data was analysed using the analytic framework developed in the systematic review, based on three overarching themes in relation to the three competencies. Key findings aligned with the framework included intercultural knowledge gaps linking the local population to a global picture; skills gaps applying theory into practice through flexible and diverse methods, and intercultural attitude gaps linked to a population-approach and a non judgemental attitude. Key deviating themes included the definition of culture, interconnected competencies and training issues. Examples of good practice included, demographic knowledge informing targeted work, flexible approaches meeting the needs of diverse groups and non judgemental attitudes supporting the root causes of health issues. Identifying competency gaps is key in order to inform the design and delivery of training that aligns with intercultural competency gaps and good practice, in order to build capacity within an interculturally competent public health workforce.
Date of Award31 Aug 2021
Original languageEnglish
Awarding Institution
  • The University of Manchester
SupervisorArpana Verma (Supervisor) & Christine Greenhalgh (Supervisor)


  • Public Health
  • Health Disparities
  • Cultural Diversity
  • Cultural Competence
  • Training
  • Health Inequities
  • Competence
  • Intercultural
  • Public Health Professionals

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