{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T11:27:40Z","timestamp":1770895660007,"version":"3.50.1"},"reference-count":39,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,5,17]],"date-time":"2022-05-17T00:00:00Z","timestamp":1652745600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100013274","name":"Asylum, Migration and Integration Fund","doi-asserted-by":"publisher","award":["PT\/2019\/FAMI\/439"],"award-info":[{"award-number":["PT\/2019\/FAMI\/439"]}],"id":[{"id":"10.13039\/100013274","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Societies"],"abstract":"<jats:p>Health professionals play an essential role in the protection and promotion of health rights without distinction of sex, sexual orientation, gender identity and expression, ethnicity\/race, nationality and migration status, age, functional diversity, or any other individual and\/or cultural positions. With the growing diversity of patient populations, health professionals must be able to identify and be responsive to individual and cultural diversity, ensuring equity in access to high-quality individually-centered care. For this, it is fundamental to promote training in cultural competence, understood as responsivity and the ability to work the valorization of multiple and intersectional identities throughout life. The paper aims to describe the experience of the implementation of the program \u201cHealth in Equality\u201d, aimed at training the primary healthcare workforce in Portugal, which was based on Sue and Sue\u2019s (2008) three-dimensional model of multicultural skills, which champions cultural best practices in an intersectional perspective. Based on the trainees\u2019 and trainers\u2019 evaluation of four completed editions developed online between March and July 2021, this study discusses ways to improve the impact of the training program and amplify the number of leaders and role models for other health care providers towards culturally competent healthcare systems and organizations.<\/jats:p>","DOI":"10.3390\/soc12030080","type":"journal-article","created":{"date-parts":[[2022,5,17]],"date-time":"2022-05-17T08:34:29Z","timestamp":1652776469000},"page":"80","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Standing Up for Culturally Competent Care in Portugal: The Experience of a \u201cHealth in Equality\u201d Online Training Program on Individual and Cultural Diversity"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4807-5904","authenticated-orcid":false,"given":"Violeta","family":"Alarc\u00e3o","sequence":"first","affiliation":[{"name":"Centro de Investiga\u00e7\u00e3o e Estudos de Sociologia (CIES-Iscte), Iscte\u2014Instituto Universit\u00e1rio de Lisboa, Avenida das For\u00e7as Armadas, 1649-026 Lisboa, Portugal"}]},{"given":"Sandra","family":"Roberto","sequence":"additional","affiliation":[{"name":"Centro de Investiga\u00e7\u00e3o e de Interven\u00e7\u00e3o Social (CIS-Iscte), Iscte\u2014Instituto Universit\u00e1rio de Lisboa, Avenida das For\u00e7as Armadas, 1649-026 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1279-412X","authenticated-orcid":false,"given":"Thais","family":"Fran\u00e7a","sequence":"additional","affiliation":[{"name":"Centro de Investiga\u00e7\u00e3o e Estudos de Sociologia (CIES-Iscte), Iscte\u2014Instituto Universit\u00e1rio de Lisboa, Avenida das For\u00e7as Armadas, 1649-026 Lisboa, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6722-5472","authenticated-orcid":false,"given":"Carla","family":"Moleiro","sequence":"additional","affiliation":[{"name":"Centro de Investiga\u00e7\u00e3o e de Interven\u00e7\u00e3o Social (CIS-Iscte), Iscte\u2014Instituto Universit\u00e1rio de Lisboa, Avenida das For\u00e7as Armadas, 1649-026 Lisboa, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1002\/j.1556-6676.1992.tb01642.x","article-title":"Multicultural Counseling Competencies and Standards: A Call to the Profession","volume":"70","author":"Sue","year":"1992","journal-title":"J. Couns. Dev."},{"key":"ref_2","unstructured":"Leong, F.T.L. (2014). The evolution of the revolution: The successful establishment of multicultural psychology. APA Handbook of Multicultural Psychology Vol. 1: Theory and Research, American Psychological Association."},{"key":"ref_3","unstructured":"Sue, D.W., and Sue, D. (2008). Counseling the Culturally Diverse, John Wiley & Sons Inc.. [5th ed.]."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1111\/j.1751-9004.2011.00350.x","article-title":"The Quest for Multicultural Competence: Challenges and Lessons Learned from Clinical and Organizational Research","volume":"5","author":"Chao","year":"2011","journal-title":"Soc. Pers. Psychol. Compass"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1177\/0011000008319986","article-title":"Multicultural Competence and Social Justice Training in Counseling Psychology and Counselor Education","volume":"37","author":"Pieterse","year":"2008","journal-title":"Couns. Psychol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1177\/0022022110396864","article-title":"The Structure of Human Values at the Culture Level: A Meta-Analytical Replication of Schwartz\u2019s Value Orientations Using the Rokeach Value Survey","volume":"42","author":"Vauclair","year":"2011","journal-title":"J. Cross Cult. Psychol."},{"key":"ref_7","unstructured":"Brown, S.D., and Lent, R.W. (2009). Conceptual and measurement issues in multicultural psychology research. Handbook of Counseling Psychology, Wiley. [4th ed.]."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1080\/15210960.2016.1125742","article-title":"Developing Multicultural Awareness, Knowledge, and Skills: Diversity Training Makes a Difference?","volume":"18","author":"Hall","year":"2016","journal-title":"Multicult. Perspect."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1177\/0011000082102008","article-title":"Position Paper: Cross-Cultural Counseling Competencies","volume":"10","author":"Sue","year":"1982","journal-title":"Couns. Psychol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1177\/0011000001296002","article-title":"Multidimensional Facets of Cultural Competence","volume":"29","author":"Sue","year":"2001","journal-title":"Couns. Psychol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1177\/1363461512444673","article-title":"Rethinking cultural competence","volume":"49","author":"Kirmayer","year":"2012","journal-title":"Transcult. Psychiatry"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"690","DOI":"10.4040\/jkan.2013.43.5.690","article-title":"Effects of a Multicultural Education Program on the Cultural Competence, Empathy and Self-efficacy of Nursing Students","volume":"43","author":"Peek","year":"2013","journal-title":"J. Korean Acad. Nurs."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1037\/a0032595","article-title":"Cultural humility: Measuring openness to culturally diverse clients","volume":"60","author":"Hook","year":"2013","journal-title":"J. Couns. Psychol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1037\/0003-066X.53.4.440","article-title":"In search of cultural competence in psychotherapy and counseling","volume":"53","author":"Sue","year":"1998","journal-title":"Am. Psychol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1002\/capr.12157","article-title":"Integrating diversity into therapy processes: The role of individual and cultural diversity competences in promoting equality of care","volume":"18","author":"Moleiro","year":"2018","journal-title":"Couns. Psychother. Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1037\/0022-0167.53.1.132","article-title":"Multicultural Education in the Mental Health Professions: A Meta-Analytic Review","volume":"53","author":"Smith","year":"2006","journal-title":"J. Couns. Psychol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1037\/0022-0167.47.2.155","article-title":"Self-report multicultural counseling competence scales: Their relation to social desirability attitudes and multicultural case conceptualization ability","volume":"47","author":"Constantine","year":"2000","journal-title":"J. Couns. Psychol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1037\/0735-7028.26.3.322","article-title":"Examining multicultural counseling competencies of graduate students in psychology","volume":"26","author":"Reynolds","year":"1995","journal-title":"Prof. Psychol. Res. Pract."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1037\/0022-0167.45.3.256","article-title":"Correlates of self-reported multicultural competencies: Counselor multicultural social desirability, race, social inadequacy, locus of control racial ideology, and multicultural training","volume":"45","author":"Sodowsky","year":"1998","journal-title":"J. Couns. Psychol."},{"key":"ref_20","unstructured":"Constantine, M.G., and Sue, D.W. (2005). Strategies for Building Multicultural Competence in Mental Health and Educational Settings, John Wiley & Sons Inc."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1017\/S1742058X13000349","article-title":"Intersectionality: Mapping the Movements of a Theory","volume":"10","author":"Carbado","year":"2013","journal-title":"Du Bois Rev. Soc. Sci. Res. Race"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1771","DOI":"10.1086\/426800","article-title":"The Complexity of Intersectionality","volume":"30","author":"McCall","year":"2005","journal-title":"Signs J. Women Cult. Soc."},{"key":"ref_23","first-page":"8","article-title":"Demarginalizing the intersection of race and sex: A black feminist critique of antidiscrimination doctrine, feminist theory and antiracist politics","volume":"1989","author":"Crenshaw","year":"1989","journal-title":"Univ. Chic. Leg. Forum"},{"key":"ref_24","first-page":"75","article-title":"Ain\u2019t I a woman? Revisiting intersectionality","volume":"5","author":"Brah","year":"2004","journal-title":"J. Int. Womens Stud."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1016\/j.childyouth.2010.11.022","article-title":"Cultural Diversity Competencies in Child and Youth Care Services in Portugal: Development of two measures and a brief training program","volume":"33","author":"Moleiro","year":"2011","journal-title":"Child. Youth Serv. Rev."},{"key":"ref_26","first-page":"87","article-title":"Development and Evaluation of a Brief LGBT Competence Training for Psychotherapists","volume":"6","author":"Moleiro","year":"2014","journal-title":"Transcultural"},{"key":"ref_27","first-page":"681","article-title":"Calling for Awareness and Knowledge Perspectives on Religiosity, Spirituality and Mental Health in a Religious Sample from Portugal (a Mixed-Methods Study)","volume":"2","author":"Freire","year":"2016","journal-title":"Open Theol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"656454","DOI":"10.3389\/fpubh.2021.656454","article-title":"Reducing Sexual and Reproductive Health Inequities Between Natives and Migrants: A Delphi Consensus for Sustainable Cross-Cultural Healthcare Pathways","volume":"9","author":"Candeias","year":"2021","journal-title":"Front. Public Health"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1037\/0735-7028.39.3.313","article-title":"Approaches to multicultural training for professionals: A guide for choosing an appropriate program","volume":"39","year":"2008","journal-title":"Prof. Psychol. Res. Pract."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"103161","DOI":"10.1016\/j.midw.2021.103161","article-title":"A SWOT analysis of the opinions of midwifery students about distance education during the COVID-19 pandemic a qualitative study","volume":"103","author":"Topuz","year":"2021","journal-title":"Midwifery"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Wang, J., and Wang, Z. (2020). Strengths, Weaknesses, Opportunities and Threats (SWOT) Analysis of China\u2019s Prevention and Control Strategy for the COVID-19 Epidemic. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17072235"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1111\/wvn.12176","article-title":"How Effective is Cultural Competence Training of Healthcare Providers on Improving Patient Satisfaction of Minority Groups? A Systematic Review of Literature","volume":"13","author":"Govere","year":"2016","journal-title":"Worldviews Evid. Based Nurs."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"359","DOI":"10.18865\/ed.29.S2.359","article-title":"Improving Behavioral Health Equity through Cultural Competence Training of Health Care Providers","volume":"29","author":"McGregor","year":"2019","journal-title":"Ethn. Dis."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1177\/0022487104266746","article-title":"What Precipitates Change in Cultural Diversity Awareness during a Multicultural Course: The Message or the Method?","volume":"55","author":"Brown","year":"2004","journal-title":"J. Teach. Educ."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1177\/1470595820938412","article-title":"Workforce diversity, diversity training and ethnic minorities: The case of the UK National Health Service","volume":"20","author":"Hussain","year":"2020","journal-title":"Int. J. Cross Cult. Manag."},{"key":"ref_36","first-page":"1","article-title":"COVID-19 pandemic and online learning: The challenges and opportunities","volume":"2","author":"Adedoyin","year":"2020","journal-title":"Interact. Learn. Environ."},{"key":"ref_37","first-page":"222","article-title":"Developing Workforce Diversity in the Health Professions: A Social Justice Perspective","volume":"6","author":"Wilbur","year":"2020","journal-title":"Health Prof. Educ."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1016\/j.chb.2012.01.011","article-title":"Exploring the use of video podcasts in education: A comprehensive review of the literature","volume":"28","author":"Kay","year":"2012","journal-title":"Comput. Hum. Behav."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"16","DOI":"10.5688\/aj710116","article-title":"Asynchronous Video Streaming vs. Synchronous Videoconferencing for Teaching a Pharmacogenetic Pharmacotherapy Course","volume":"71","author":"Moridani","year":"2007","journal-title":"Am. J. Pharm. Educ."}],"container-title":["Societies"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4698\/12\/3\/80\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:11:44Z","timestamp":1760137904000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4698\/12\/3\/80"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,17]]},"references-count":39,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,6]]}},"alternative-id":["soc12030080"],"URL":"https:\/\/doi.org\/10.3390\/soc12030080","relation":{},"ISSN":["2075-4698"],"issn-type":[{"value":"2075-4698","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,17]]}}}