The practice and operationalisation of “Cultural Humility” across disciplines: A scoping review protocol

Zahra Tayer Farahani; Yukti Arora; Ethel Matarutse; Frédérique Vallières; Rebecca Murphy

doi:10.12688/hrbopenres.14073.1

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Study Protocol

The practice and operationalisation of “Cultural Humility” across disciplines: A scoping review protocol

[version 1; peer review: 1 approved]

Zahra Tayer Farahani¹, Yukti Arora¹, Ethel Matarutse¹, Frédérique Vallières², Rebecca Murphy¹

Zahra Tayer Farahani¹, Yukti Arora¹, [...] Ethel Matarutse¹, Frédérique Vallières², Rebecca Murphy¹

PUBLISHED 04 Mar 2025

Author details Author details

¹ Dublin City University School of Nursing Psychotherapy and Community Health, Dublin, Leinster, Ireland
² Trinity Centre for Global Health, Trinity College Dublin, Dublin, Leinster, Ireland

Zahra Tayer Farahani
Roles: Conceptualization, Methodology, Writing – Original Draft Preparation

Yukti Arora
Roles: Methodology, Project Administration

Ethel Matarutse
Roles: Conceptualization, Methodology

Frédérique Vallières
Roles: Methodology, Writing – Review & Editing

Rebecca Murphy
Roles: Conceptualization, Funding Acquisition, Writing – Review & Editing

OPEN PEER REVIEW

REVIEWER STATUS

Abstract

Introduction

Cultural humility has gained increased traction in recent years to promote inclusion and equity and improve health, mental health, and human services for minoritised groups. Cultural humility acknowledges the dynamic nature of cultural identity, focuses on life-long learning of the self in relation to others, and challenges individuals and organisations to address systemic inequalities. While the literature has been focused greatly on theoretically describing cultural humility, its definition, and conceptualisation, there exists a knowledge gap regarding its systemic operationalisation and practice.

Objective

As part of this scoping review, a comprehensive knowledge synthesis will be carried out to map the current knowledge landscape on cultural humility, as an evolving and emerging topic, and to identify existing knowledge gaps. The aim is to identify and synthesise the available literature regarding measures and indicators of cultural humility across different disciplines and its Practice and operationalisation at individual, interpersonal, and collective.

Methods

Literature search will be conducted across multi-disciplinary databases, Scopus, Web of Science, and discipline specific databases, PsycINFO, Education Research Complete, ERIC, Business Source Complete, Medline, CINAHL Complete, Embase, Applied Social Sciences Index & Abstracts (ASSIA) and ProQuest Social Science Premium Collection.

Analysis

Published literature on measures, indicators, and practice of cultural humility across disciplines will be included. Two independent reviewers will conduct title, abstract, and full-text review of the search results on Covidence. Data will be analysed thematically and mapped to the individual, interpersonal, and collective levels.

Conclusion

This review will address the gap within the current evidence synthesis by describing the existing knowledge on measurement and operationalisation of cultural humility. The wide scope of this review in considering a range of disciplines as sources of knowledge will expand the current literature of cultural humility within the health and mental health fields and facilitate more innovative approaches towards its operationalisation.

Keywords

Cultural Humility, Cultural Responsiveness, Scoping Review, Human Services, Mental Health Service, Ethnic Minority, CHUMS Study

Corresponding author: Rebecca Murphy

Competing interests: No competing interests were disclosed.

Grant information: Health Research Board [EIA-2022-007].
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Copyright: © 2025 Farahani ZT et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

How to cite: Farahani ZT, Arora Y, Matarutse E et al. The practice and operationalisation of “Cultural Humility” across disciplines: A scoping review protocol [version 1; peer review: 1 approved]. HRB Open Res 2025, 8:38 (https://doi.org/10.12688/hrbopenres.14073.1) First published: 04 Mar 2025, 8:38 (https://doi.org/10.12688/hrbopenres.14073.1) Latest published: 04 Mar 2025, 8:38 (https://doi.org/10.12688/hrbopenres.14073.1)

Introduction

In the last decade, cultural humility has gained increased traction as an approach to promote inclusion, equity, and sense of belonging (Barnes et al., 2023; Schiavo, 2023). In the field of human services (e.g., social, health, and mental health services), systemic implementation of cultural humility is proposed as a solution to improve service delivery through connecting more effectively with service users (Schiavo, 2023; Tham & Solomon, 2024). Within the context of health and mental healthcare more specifically, embracing cultural humility is considered essential for cultivating a sense of belonging, tackling systemic inequities and biases, building trust, and enhancing service users’ positive experiences and outcomes(Jonas et al., 2021; Schiavo, 2015; Schiavo, 2023).

The body of literature on cultural humility, however, remains relatively recent, with much of extant literature focusing on theoretically describing cultural humility, its definition, and conceptualisation. Theoretically, cultural humility is understood as a practice that acknowledges the dynamic nature of cultural identity, focuses on life-long learning of the self in relation to others, and challenges individuals and organisations to address systemic inequalities (Fisher-Borne et al., 2015; Foronda, 2020). Importantly, there appears to be a consensus across definitions that cultural humility goes beyond a sole focus on the accrual of knowledge about ‘the other’ and a decontextualized and static view of cultural identity to address the integral interconnected role of organisational climate and the need for whole system approaches to cultural responsiveness (Beagan, 2018; Jongen et al., 2018; Kirmayer, 2012). In other words, cultural humility shifts the focus from learning about ‘the other’ to self-reflection and action on how our cultural identity and the organisational culture we work in can perpetuate societal patterns of inequity and reinforce structurally embedded injustice and exclusion experienced by minoritized populations. More recent work on the conceptualisation of cultural humility has further teased out these theoretical definitions. For example, according to Foronda and colleagues’ (2016) concept analysis of 62 articles discussing cultural humility, five common attributes of cultural humility are: openness, self-awareness, egoless[ness], supportive interactions, and self-reflection and self-critique. Aligned with Foronda’s conceptualisation, Abe (2020)’s use of a liberation psychology framework conceptualized cultural humility across multiple levels: developing a critical consciousness (individual level), seeing the other (interpersonal level), and psychosocial accompaniment (collective level). According to this framework, cultural humility is a social practice which involves a commitment to working with communities; respect for their experiences, culture and perspectives; building relationships with them; learning from them; and paying attention to the structural forces, power imbalances, and social inequities that shape lived experience (Abe, 2020).

A common thematic thread running across many of the theoretical definitions and conceptualisations of cultural humility is the focus on systemic change. Yet, to date, the discourse surrounding cultural humility has strongly focused on its operationalisation within the individual practitioner and/or the therapeutic relationship. Commensurate amplification and discussion on the systemic and social aspects of cultural humility and its manifestation at institutional and organisational levels is therefore required to ensure that, as Abe (2020) argues, cultural humility is not reduced to a list of individual characteristics at personal and interpersonal level.

Present study

The CHUMS Study (Cultural HUmility in Mental health Services) is a four-year research program with an overall goal of strengthening cultural humility for Irish mental health services. Epistemologically informed by Community Based Participatory Research (CBPR), The CHUMS Study aims to progress the operationalisation of cultural humility from its current, abstract nature into distilled principles of practice and concretised strategies that can be feasibly implemented and measured within existing mental health systems.

To inform the work of The CHUMS Study, a comprehensive knowledge synthesis will be carried out to map the current knowledge landscape on cultural humility, as an evolving and emerging topic, and to identify existing knowledge gaps. According to a preliminary search of several databases including PsycINFO, Scopus, Web of Science, the Cochrane Database of Systematic Reviews and JBI Evidence Synthesis, no scoping or systematic reviews have been published on cultural humility to date.

As such, the specific aims of the planned scoping review are to identify and synthesise the available literature regarding 1) Measures and indicators of “Cultural Humility” across different disciplines and 2) Practice and operationalisation of cultural humility at individual, interpersonal, and collective levels (Abe, 2020).

This review will extend beyond the health and mental health literature to cover humanity, social, and other health sciences with the aim of learning about different approaches to this newly emerged concept and consequently consider its application in the field of mental health.

Methods

This protocol and the subsequent scoping review will be guided by the methodological frameworks proposed by the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis guidelines (Peters et al., 2020). In addition, the reporting guidelines from the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (Tricco et al., 2018) will be adhered to. This review will begin in the first quarter of 2025 and completion anticipated within 6 months.

According to Arksey and O’Malley (2005), scoping reviews consist of six stages: (1) identifying the research question, (2) identifying relevant studies, (3) selecting studies, (4) charting the data, (5) collating, summarising, and reporting results and (6) consultation. The proposed methodological approaches across each of these stages is further outlined below.

Stage 1: identifying the research question

In order to provide a comprehensive understanding of the concept of “Cultural Humility” this scoping review aims to identify and present the available literature regarding: 1) Measures and indicators of “Cultural Humility” across different disciplines and 2) Practice and operationalisation of cultural humility at individual, interpersonal, and collective levels. Aligned with these aims, the following review questions were identified:

What indicators and assessment tools are used to measure cultural humility at individual, interpersonal, and collective levels across disciplines?
How is cultural humility being practiced and operationalised at individual, interpersonal, and collective levels across disciplines?

Stage 2: identifying relevant studies

Eligibility criteria

In line with the PRISMA-ScR guidelines, the Population, Concept, Context (PCC) framework was used to define the eligibility criteria for this scoping review (Table 1).

Table 1. Inclusion and Exclusion Criteria.

Criteria	Include	Exclude
Population	▪ No specification or restriction in terms of age, gender, ethnicity or other conditions are required.
Concept	▪ Measures of cultural humility developed or used as part of empirical studies. ▪ Indicators of cultural humility outlined in empirical studies or theoretical commentaries. ▪ Papers that describe the practice of cultural humility.	▪ Studies and pieces that focus on importance and benefits of cultural humility without using or proposing any measures, indicators, or interview guides to explore it. ▪ Theoretical and commentary papers that just describe cultural humility without focusing on its practice
Context	▪ Literature across all disciplines	▪ Grey literature ▪ Unpublished pieces
Literature characteristics	▪ All study designs (qualitative, quantitative, mixed methods). ▪ Peer-reviewed literature. ▪ Literature across academic databases	▪ Grey Literature that is not published across academic databases ▪ Unpublished literature
Other	▪ Studies published in English.	▪ Studies not available in English.

Types of evidence sources

Evidence sources will include any available academic literature including peer reviewed articles, books, book chapters, thesis, reports, toolkits, guidelines, and policies. Studies will be confined to English language only due to resource limitations.

Key search terms

The key search terms for this review are Cultur* NEAR Humility OR Cultur* NEAR Humble. The specific focus of this review on cultural humility means that the included studies must clearly mention one of the two key words as part of their title, abstract, or keywords.

Reflecting on the emergence of cultural humility within the literature in 1998 (Tervalon & Murray-Garcia, 1998), the search is limited to the previous 30 years.

Search strategy

In line with the aim of the review to map the existing knowledge on cultural humility across different disciplines, it is planned to conduct the literature search across both multi-disciplinary databases and discipline specific databases (Education, Psychology, Business, Medicine, Nursing and Social Sciences). One of the objectives of this review is to identify various disciplines which practise and operationalise cultural humility. Therefore, if, during the search, relevant literature is encountered within disciplines that are not listed above, databases specific to those disciplines will be added to the search strategy to make it inclusive.

The three-step process recommended by JBI Manual for Evidence Synthesis (Peters et al., 2020) calls for a primary search for relevant articles. This was thus conducted on two databases: Scopus among multidisciplinary databases and PsycINFO among discipline specific databases in order to obtain an overall understanding of the depth and breadth of the review and identify relevant key terms and phrases. The next steps will involve the search across all the identified databases, and manual search of reference list of selected sources to identify relevant studies.

The search will be conducted within the following databases:

Multi-disciplinary databases: Scopus, Web of Science
Discipline Specific databases: PsycINFO, Education Research Complete, ERIC, Business Source Complete, Medline, CINAHL Complete, Embase, Applied Social Sciences Index & Abstracts (ASSIA) and ProQuest Social Science Premium Collection.

Stage 3: study selection

Upon conducting the search, all identified citations will be collated and uploaded into the open-source bibliographic software management system Zotero, and any duplicates will be removed. Two independent reviewers will screen the titles and abstracts based on the eligibility criteria of the review. Evidence sources that are potentially relevant will be retrieved in full and their citation details will be imported into the Covidence evidence synthesis software tool to enhance the management and review of the evidence sources. Free tools like Rayyan can also be used as an alternative. The two independent reviewers will continue with the assessment of the full text of selected evidence according to the eligibility criteria. If required, authors of evidence sources will be contacted to request missing or additional data. If an evidence source in full text did not meet the inclusion criteria, reasons for exclusion will be recorded and reported in the scoping review. Any disagreements between the two reviewers at each stage of the selection process will be managed through a third member of the research team. The results of the search and the study selection process will be reported fully in the final scoping review paper and presented according to Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping review (PRISMA-ScR) in form of a flow diagram (Tricco et al., 2018).

Stage 4: data extraction and charting

A three-step process will be followed for extraction and charting of the data. First an extraction and charting tool (Peters et al., 2020) will be developed and piloted on a small sample of evidence sources by the reviewers. Then the reviewers will meet to discuss any discrepancies and ensure accuracy and consistency. Since data charting is an iterative and reflexive process, several refinement and modifications of the extraction tool is likely. Changes to the extraction tool will be detailed in the subsequent scoping review paper. Table 2 is a provisional demonstration of type of information that will be extracted.

Table 2. Extracted Information.

Source of evidence	Author(s)	Year of publication	Country/ origin	Discipline	Context	Measurement tool	Indicators	Operationalisation

Stage 5: collating, summarising, and reporting the data

The findings of the review including the details of the screening and study selection will be reported according to PRISMA-ScR guidelines (Tricco et al., 2018) along with a PRISMA flow diagram. Descriptive statistical analysis will be used to report on the characteristics of the evidence sources included in the review. Using the Abe’s (2020) multilevel approach (individual, interpersonal, and collective levels) as our theoretical framework, collated data will be analysed thematically, and summarised and presented in the form of descriptive and narrative texts as well as tables, graphs, or maps where appropriate. Findings will directly respond to the review questions by describing the existing literature on measures, practice, and operationalisation of cultural humility across different disciplines and mapping the data based on the multi-level approach to cultural humility.

Stage 6: consultation

Engagement and consultation with knowledge users as part of the scoping review process has been considered by Arksey and O’Malley (2005) as an optional step that could add value to the work. However, methodologists recently began to acknowledge its importance and offered guidelines on how to engage with knowledge users throughout each stage of the scoping review, including the topic prioritization, planning, conducting, and dissemination (Levac et al., 2010; Peters et al., 2020). The JBI scoping review methodology group recently suggested moving from consultation to co-creation with knowledge users (Pollock et al., 2022).

The proposed scoping review will be informed by these recent guidelines (Levac et al., 2010; Peters et al., 2020; Pollock et al., 2022) as well as the principles of CBPR (Balazs & Morello-Frosch, 2013; Wallerstein, 2021) as the overarching methodology for The CHUMS Study. At the core of CBPR is entrenched respect for the value of diverse knowledge systems and their integration into the research process. Therefore, collaboration with and equitable partnerships among the research team, community members and other knowledge users is ongoing throughout all phases of this review and will happen through involvement of The CHUMS Study community advisory board (CAB) members and peer researchers. This process was initiated by seeking views and opinions of CAB members on different aspects of this review protocol, including the scope of the review, its objectives, review questions and their alignment with the review objectives.

As part of the review process, peer researchers or interested CAB members will be involved in the process of data screening, selecting and extraction as well as analysis and write up of the findings. CAB members will be asked to review the findings of the scoping review and its implications for the design and conduct of The CHUMS Study as well as research and practice at large. CAB members will also contribute to dissemination of the findings to academic and public audiences.

Conclusion

The proposed scoping review will address the gap within the current evidence synthesis by describing the existing knowledge on cultural humility, its operationalisation, and measurement across different disciplines. Findings of this review will map the current literature to the multilevel approach to cultural humility and allow for further exploration of its systemic operationalisation. The wide scope of this review in considering a wide range of disciplines as sources of knowledge will inform and further expand the current literature of cultural humility within the health and mental health fields and facilitates more innovative approaches towards its operationalisation. Furthermore, this review will provide an example of applying CBPR principles and methods in conducting scoping reviews.

Ethics and consent

Ethical approval and consent were not required.

Data availability

Underlying data

No data are associated with this article.

Faculty Opinions recommended

References

Abe J: Beyond cultural competence, toward social transformation: liberation psychologies and the practice of cultural humility. J Soc Work Educ. 2020; 56(4): 696–707. Publisher Full Text
Arksey H, O’Malley L: Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005; 8(1): 19–32. Publisher Full Text
Balazs CL, Morello-Frosch R: The three R's: how community-based participatory research strengthens the rigor, relevance, and reach of science. Environ Justice. 2013; 6(1): 9–16. PubMed Abstract | Publisher Full Text | Free Full Text
Barnes J, Hall JB, Grubb B: Cultural humility and inclusion: transformation to a culture of belonging. In: J. Barnes, M. J. Stevens, B. Z. Ekelund, & K. Perham-Lippman (Eds.), Inclusive leadership: equity and belonging in our communities. Emerald Publishing Limited, 2023; 9. : 25–38. Publisher Full Text
Beagan BL: A critique of cultural competence: assumptions, limitations, and alternatives. In: C. L. Frisby & W. T. O’Donohue (Eds.), Cultural Competence in Applied Psychology: An Evaluation of Current Status and Future Directions. Springer International Publishing, 2018; 123–138. Publisher Full Text
Fisher-Borne M, Cain JM, Martin SL: From mastery to accountability: cultural humility as an alternative to cultural competence. Soc Work Educ. 2015; 34(2): 165–181. Publisher Full Text
Foronda C: A theory of cultural humility. J Transcult Nurs. 2020; 31(1): 7–12. PubMed Abstract | Publisher Full Text
Foronda C, Baptiste DL, Reinholdt MM, et al.: Cultural humility: a concept analysis. J Transcult Nurs. 2016; 27(3): 210–217. Publisher Full Text
Jonas D, Morvant A, Munoz-Blanco S: Cultural humility, social determinants, and disparities in pediatric palliative care. In: Wolfe, J., Hinds, P. S., & Sourkes, B. M. (Eds). Interdisciplinary pediatric palliative care. Oxford University Press, 2021; 53–65. Publisher Full Text
Jongen C, McCalman J, Bainbridge R: Health workforce cultural competency interventions: a systematic scoping review. BMC Health Serv Res. 2018; 18(1): 232. PubMed Abstract | Publisher Full Text | Free Full Text
Kirmayer LJ: Cultural competence and evidence-based practice in mental health: epistemic communities and the politics of pluralism. Soc Sci Med. 2012; 75(2): 249–256. PubMed Abstract | Publisher Full Text
Levac D, Colquhoun H, O’Brien KK: Scoping studies: advancing the methodology. Implement Sci. 2010; 5(1): 69. PubMed Abstract | Publisher Full Text | Free Full Text
Peters MDJ, Marnie C, Tricco AC, et al.: Updated methodological guidance for the conduct of scoping reviews. JBI Evid Synth. 2020; 18(10): 2119–2126. PubMed Abstract | Publisher Full Text
Pollock D, Alexander L, Munn Z, et al.: Moving from consultation to co-creation with knowledge users in scoping reviews: guidance from the JBI scoping review methodology group. JBI Evid Synth. 2022; 20(4): 96–979. PubMed Abstract | Publisher Full Text
Schiavo R: Addressing health disparities in clinical settings: population health, quality of care, and communication. J Commun Healthc. 2015; 8(3): 163–166. Publisher Full Text
Schiavo R: Embracing 'cultural humility' in clinical and public health settings: a prescription to bridge inequities. J Commun Healthc. 2023; 16(2): 123–125. PubMed Abstract | Publisher Full Text
Tervalon M, Murray-García J: Cultural humility versus cultural competence: a critical distinction in defining physician training outcomes in multicultural education. J Health Care Poor Underserved. 1998; 9(2): 117–125. PubMed Abstract | Publisher Full Text
Tham SS, Solomon P: Practicing cultural humility will achieve recovery-oriented mental health practice and service delivery. Adm Policy Ment Health. 2024; 51(1): 10–13. PubMed Abstract | Publisher Full Text
Tricco AC, Lillie E, Zarin W, et al.: PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018; 169(7): 467–473. PubMed Abstract | Publisher Full Text
Wallerstein N: Engage for equity: advancing the fields of community‐based participatory research and community‐engaged research in community psychology and the social sciences. Am J Community Psychol. 2021; 67(3–4): 251–255. PubMed Abstract | Publisher Full Text

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Version 1

VERSION 1 PUBLISHED 04 Mar 2025

Author details Author details

¹ Dublin City University School of Nursing Psychotherapy and Community Health, Dublin, Leinster, Ireland
² Trinity Centre for Global Health, Trinity College Dublin, Dublin, Leinster, Ireland

Zahra Tayer Farahani
Roles: Conceptualization, Methodology, Writing – Original Draft Preparation

Yukti Arora
Roles: Methodology, Project Administration

Ethel Matarutse
Roles: Conceptualization, Methodology

Frédérique Vallières
Roles: Methodology, Writing – Review & Editing

Rebecca Murphy
Roles: Conceptualization, Funding Acquisition, Writing – Review & Editing

Competing interests

No competing interests were disclosed.

Grant information

Health Research Board [EIA-2022-007].
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Article Versions (1)

version 1

Published: 04 Mar 2025, 8:38

https://doi.org/10.12688/hrbopenres.14073.1

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© 2025 Farahani ZT et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Farahani ZT, Arora Y, Matarutse E et al. The practice and operationalisation of “Cultural Humility” across disciplines: A scoping review protocol [version 1; peer review: 1 approved]. HRB Open Res 2025, 8:38 (https://doi.org/10.12688/hrbopenres.14073.1)

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Reviewer Report 04 Apr 2025

Jacopo Villani, Health Service Executive, National Office of Mental Health Engagement and Recovery, St Loman’s Hospital, Dublin, Ireland

Approved

https://doi.org/10.21956/hrbopenres.15457.r46465

This study protocol represents a positive step towards transparency in research, it can also inform researchers that ‘cultural humility’ is being investigated. It is a very timely publication as the health system in Ireland is creating a more integrated healthcare ... Continue reading

This study protocol represents a positive step towards transparency in research, it can also inform researchers that ‘cultural humility’ is being investigated. It is a very timely publication as the health system in Ireland is creating a more integrated healthcare provision developed around the specific needs of service users. Operationalising cultural humility can contribute to develop person-centred approaches.

Rationale and objectives are clearly described and the study design is appropriate. Methodologically is very sound and there are sufficient details for replication. The emphasis on community-based participatory approaches is a strength as it ensures the study is relevant and aligns with the priorities of communities. The involvement of knowledge users at each stage of the review, through the participation of peer researchers and advisory board, is a very positive element.

One limitation is the focus on studies published in English language only, which may exclude important work on cultural humility practices in non-Anglophone contexts and restrict the inclusivity of the review.
The methodology also excludes grey literature. While this helps maintain quality by focusing on peer-reviewed sources, it limits the comprehensiveness of the review. Grey literature could offer important, though unpublished, insights, especially in areas where research is emerging. These limitations can be stated in a ‘Study limitation’ section.

The Introduction would benefit from a sentence on how cultural humility can also help to build recovery-oriented mental healthcare practice, and therefore promote the recovery of service users from minoritized communities. This may further encourage practitioners to adopt a cultural humility approach in day-to-day practice. The article discusses building trust, enhancing service users' positive experience and outcomes, cultivating a sense of belonging, creating partnership and connections between service users and providers; these are all elements that can support service users in their mental health recovery journey. These references may be helpful to explore this:

Levy-Fenner E, (2022). [Ref-1].
Jacobson, N, Farah, D (2012). [Ref-2].

Since the CHUMS study aims at strengthening cultural humility in Irish mental health services it might be worth mentioning how this study will help shaping current and future Irish national policy frameworks, such as for example Sharing the Vision and its future implementation plans. This will further contextualise the study and provide an example of operationalising cultural humility in the Irish setting. It can also encourage Sharing the Vision implementation team to adopt a language more attuned to cultural humility, as Sharing the Vision still refers to ‘cultural competency’ in mental healthcare.

Congratulations to all researchers for advancing such an interesting and very important research project.

Is the rationale for, and objectives of, the study clearly described?

Yes
Is the study design appropriate for the research question?

Yes
Are sufficient details of the methods provided to allow replication by others?

Yes
Are the datasets clearly presented in a useable and accessible format?

Not applicable

References

1. Levy-Fenner E, Colucci E, McDonough S: Lived Experiences of Mental Health Recovery in Persons of Culturally and Linguistically Diverse (CALD) Backgrounds within the Australian Context.J Psychosoc Rehabil Ment Health. 2022. 1-26 PubMed Abstract | Publisher Full Text
2. Jacobson N, Farah D: Recovery through the Lens of Cultural Diversity.Psychiatr Rehabil J. 2012; 35 (4): 333-5 PubMed Abstract | Publisher Full Text

Competing Interests: No competing interests were disclosed.

Reviewer Expertise: Mental Health Promotion, Health Inequalities, Culturally appropriate care, Mental health recovery, Social determinants of Mental Health, Irish Travellers

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard.

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Jacopo Villani, Health Service Executive, National Office of Mental Health Engagement and Recovery, St Loman’s Hospital, Dublin, Ireland

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Jacopo Villani, Health Service Executive, National Office of Mental Health Engagement and Recovery, St Loman’s Hospital, Dublin, Ireland

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Approved

This study protocol represents a positive step towards transparency in research, it can also inform researchers that ‘cultural humility’ is being investigated. It is a very timely publication as the health system in Ireland is creating a more integrated healthcare provision developed around the specific needs of service users. Operationalising cultural humility can contribute to develop person-centred approaches.

Rationale and objectives are clearly described and the study design is appropriate. Methodologically is very sound and there are sufficient details for replication. The emphasis on community-based participatory approaches is a strength as it ensures the study is relevant and aligns with the priorities of communities. The involvement of knowledge users at each stage of the review, through the participation of peer researchers and advisory board, is a very positive element.

One limitation is the focus on studies published in English language only, which may exclude important work on cultural humility practices in non-Anglophone contexts and restrict the inclusivity of the review.
The methodology also excludes grey literature. While this helps maintain quality by focusing on peer-reviewed sources, it limits the comprehensiveness of the review. Grey literature could offer important, though unpublished, insights, especially in areas where research is emerging. These limitations can be stated in a ‘Study limitation’ section.

The Introduction would benefit from a sentence on how cultural humility can also help to build recovery-oriented mental healthcare practice, and therefore promote the recovery of service users from minoritized communities. This may further encourage practitioners to adopt a cultural humility approach in day-to-day practice. The article discusses building trust, enhancing service users' positive experience and outcomes, cultivating a sense of belonging, creating partnership and connections between service users and providers; these are all elements that can support service users in their mental health recovery journey. These references may be helpful to explore this:

Levy-Fenner E, (2022). [Ref-1].
Jacobson, N, Farah, D (2012). [Ref-2].

Since the CHUMS study aims at strengthening cultural humility in Irish mental health services it might be worth mentioning how this study will help shaping current and future Irish national policy frameworks, such as for example Sharing the Vision and its future implementation plans. This will further contextualise the study and provide an example of operationalising cultural humility in the Irish setting. It can also encourage Sharing the Vision implementation team to adopt a language more attuned to cultural humility, as Sharing the Vision still refers to ‘cultural competency’ in mental healthcare.

Congratulations to all researchers for advancing such an interesting and very important research project.

Is the rationale for, and objectives of, the study clearly described?

Yes
Is the study design appropriate for the research question?

Yes
Are sufficient details of the methods provided to allow replication by others?

Yes
Are the datasets clearly presented in a useable and accessible format?

Not applicable

References

1. Levy-Fenner E, Colucci E, McDonough S: Lived Experiences of Mental Health Recovery in Persons of Culturally and Linguistically Diverse (CALD) Backgrounds within the Australian Context.J Psychosoc Rehabil Ment Health. 2022. 1-26 PubMed Abstract | Publisher Full Text
2. Jacobson N, Farah D: Recovery through the Lens of Cultural Diversity.Psychiatr Rehabil J. 2012; 35 (4): 333-5 PubMed Abstract | Publisher Full Text

Competing Interests

No competing interests were disclosed.

Reviewer Expertise

Mental Health Promotion, Health Inequalities, Culturally appropriate care, Mental health recovery, Social determinants of Mental Health, Irish Travellers

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard.

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[1] Abe J: Beyond cultural competence, toward social transformation: liberation psychologies and the practice of cultural humility. J Soc Work Educ. 2020; 56(4): 696–707. Publisher Full Text

[2] Arksey H, O’Malley L: Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005; 8(1): 19–32. Publisher Full Text

[3] Balazs CL, Morello-Frosch R: The three R's: how community-based participatory research strengthens the rigor, relevance, and reach of science. Environ Justice. 2013; 6(1): 9–16. PubMed Abstract | Publisher Full Text | Free Full Text

[4] Barnes J, Hall JB, Grubb B: Cultural humility and inclusion: transformation to a culture of belonging. In: J. Barnes, M. J. Stevens, B. Z. Ekelund, & K. Perham-Lippman (Eds.), Inclusive leadership: equity and belonging in our communities. Emerald Publishing Limited, 2023; 9. : 25–38. Publisher Full Text

[5] Beagan BL: A critique of cultural competence: assumptions, limitations, and alternatives. In: C. L. Frisby & W. T. O’Donohue (Eds.), Cultural Competence in Applied Psychology: An Evaluation of Current Status and Future Directions. Springer International Publishing, 2018; 123–138. Publisher Full Text

[6] Fisher-Borne M, Cain JM, Martin SL: From mastery to accountability: cultural humility as an alternative to cultural competence. Soc Work Educ. 2015; 34(2): 165–181. Publisher Full Text

[7] Foronda C: A theory of cultural humility. J Transcult Nurs. 2020; 31(1): 7–12. PubMed Abstract | Publisher Full Text

[8] Foronda C, Baptiste DL, Reinholdt MM, et al.: Cultural humility: a concept analysis. J Transcult Nurs. 2016; 27(3): 210–217. Publisher Full Text

[9] Jonas D, Morvant A, Munoz-Blanco S: Cultural humility, social determinants, and disparities in pediatric palliative care. In: Wolfe, J., Hinds, P. S., & Sourkes, B. M. (Eds). Interdisciplinary pediatric palliative care. Oxford University Press, 2021; 53–65. Publisher Full Text

[10] Jongen C, McCalman J, Bainbridge R: Health workforce cultural competency interventions: a systematic scoping review. BMC Health Serv Res. 2018; 18(1): 232. PubMed Abstract | Publisher Full Text | Free Full Text

[11] Kirmayer LJ: Cultural competence and evidence-based practice in mental health: epistemic communities and the politics of pluralism. Soc Sci Med. 2012; 75(2): 249–256. PubMed Abstract | Publisher Full Text

[12] Levac D, Colquhoun H, O’Brien KK: Scoping studies: advancing the methodology. Implement Sci. 2010; 5(1): 69. PubMed Abstract | Publisher Full Text | Free Full Text

[13] Peters MDJ, Marnie C, Tricco AC, et al.: Updated methodological guidance for the conduct of scoping reviews. JBI Evid Synth. 2020; 18(10): 2119–2126. PubMed Abstract | Publisher Full Text

[14] Pollock D, Alexander L, Munn Z, et al.: Moving from consultation to co-creation with knowledge users in scoping reviews: guidance from the JBI scoping review methodology group. JBI Evid Synth. 2022; 20(4): 96–979. PubMed Abstract | Publisher Full Text

[15] Schiavo R: Addressing health disparities in clinical settings: population health, quality of care, and communication. J Commun Healthc. 2015; 8(3): 163–166. Publisher Full Text

[16] Schiavo R: Embracing 'cultural humility' in clinical and public health settings: a prescription to bridge inequities. J Commun Healthc. 2023; 16(2): 123–125. PubMed Abstract | Publisher Full Text

[17] Tervalon M, Murray-García J: Cultural humility versus cultural competence: a critical distinction in defining physician training outcomes in multicultural education. J Health Care Poor Underserved. 1998; 9(2): 117–125. PubMed Abstract | Publisher Full Text

[18] Tham SS, Solomon P: Practicing cultural humility will achieve recovery-oriented mental health practice and service delivery. Adm Policy Ment Health. 2024; 51(1): 10–13. PubMed Abstract | Publisher Full Text

[19] Tricco AC, Lillie E, Zarin W, et al.: PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018; 169(7): 467–473. PubMed Abstract | Publisher Full Text

[20] Wallerstein N: Engage for equity: advancing the fields of community‐based participatory research and community‐engaged research in community psychology and the social sciences. Am J Community Psychol. 2021; 67(3–4): 251–255. PubMed Abstract | Publisher Full Text

The practice and operationalisation of “Cultural Humility” across disciplines: A scoping review protocol

Abstract

Introduction

Objective

Methods

Analysis

Conclusion

Keywords

Introduction

Present study

Methods

Stage 1: identifying the research question

Stage 2: identifying relevant studies

Table 1. Inclusion and Exclusion Criteria.

Stage 3: study selection

Stage 4: data extraction and charting

Table 2. Extracted Information.

Stage 5: collating, summarising, and reporting the data

Stage 6: consultation

Conclusion

Ethics and consent

Data availability

Underlying data

References

Comments on this article Comments (0)

Open Peer Review

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Open Peer Review

Reviewer Status

Reviewer Reports

Comments on this article

Are you a HRB-funded researcher?

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The practice and operationalisation of “Cultural Humility” across disciplines: A scoping review protocol

Abstract

Introduction

Objective

Methods

Analysis

Conclusion

Keywords

Introduction

Present study

Methods

Stage 1: identifying the research question

Stage 2: identifying relevant studies

Table 1. Inclusion and Exclusion Criteria.

Stage 3: study selection

Stage 4: data extraction and charting

Table 2. Extracted Information.

Stage 5: collating, summarising, and reporting the data

Stage 6: consultation

Conclusion

Ethics and consent

Data availability

Underlying data

References

Comments on this article Comments (0)

Open Peer Review

Comments on this article Comments (0)

Open Peer Review

Reviewer Status

Reviewer Reports

Comments on this article

Competing Interests Policy

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Are you a HRB-funded researcher?

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