Degree Name
Nursing Practice, DNP
Publication Date
2-24-2026
First Advisor
Lisa Drake
Second Advisor
Kristie Givens
Abstract
Health disparities among culturally and linguistically diverse populations continue to negatively affect access to and quality of behavioral health care. Limited provider education on the National Culturally and Linguistically Appropriate Services (CLAS) Standards contributes to communication barriers, reduced therapeutic engagement, and lower provider confidence. The purpose of this quality improvement project was to evaluate the impact of evidence-based CLAS Standards education on behavioral health providers’ self-efficacy in delivering culturally and linguistically appropriate care. Guided by Lewin’s Change Theory and the Health Equity Implementation Framework, a quantitative pre-test–post-test quasi-experimental design was used. A convenience sample of three behavioral health nurse practitioners from a private outpatient clinic in South Urban Texas participated in a structured, four-module CLAS educational intervention over two months. Provider self-efficacy was measured using the 17-item Evidence-Based Nursing Practice Self-Efficacy Scale (0–100 scale). Paired t-tests and Wilcoxon signed-rank tests were used based on item-level distributional characteristics. Post-intervention scores increased on 16 of 17 items, with mean change scores ranging from −10 to +100 points. Statistically significant improvements were seen on six items, including identifying clinical questions, applying evidence to practice, adapting care to patient values, evaluating outcomes, and integrating evidence into decision-making (p < .05). Uniformly positive directional change across domains was noted on the Wilcoxon signed-rank test. Findings indicate that CLAS Standards education meaningfully improves provider self-efficacy and supports culturally responsive behavioral health practice, offering a feasible and sustainable strategy for advancing equity in care delivery.
Rights Management
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
Recommended Citation
Anigbou, Zita, "Quality Improvement Project: Impact of National Culturally and Linguistically Appropriate Services (CLAS) Standards Education on Behavioral Health Providers’ Self-Efficacy" (2026). Doctor of Nursing Practice Projects. 285.
https://arch.astate.edu/dnp-projects/285
