Introduction: Failure to address cultural diversity has been identified as the single biggest barrier to equitable health outcomes. Righting this wrong can only be achieved by researchers generating, and therapists seeking and being receptive to, evidence developed with and for diverse populations. Yet the evidence-based practice (EBP) process occupational therapists are taught emphasises making practice decisions based on ‘best’ evidence; that is, evidence appraised to be the most scientifically rigorous.
Objectives: To propose and explain a modified EBP process that supports culturally valid practice.
Approach: Delivery of EBP typically involves five steps; formulating an answerable question, retrieving best evidence, critiquing the evidence, integrating the evidence with therapist and client expertise to reach a decision, and reviewing the process. We critiqued each step, identifying shortcomings and proposing how each might be addressed.
Results: A culturally valid EBP process was developed, comprising: 1) specifying the cultural affiliation of healthcare seekers in EBP questions, 2) prioritising retrieval of culturally valid evidence, 3) critiquing evidence for its cultural validity, including cultural consultation in relation to research design, theoretical constructs, participants, data collection and analysis, acceptability, and cultural views represented in the findings, 4) integrating culturally valid evidence with client/therapist expertise, and 5) evaluating the integration of cultural perspectives into practice decisions.
Conclusion: Research evidence must be applied discerningly, to ensure the cultural worldview and characteristics of the population being served drive all aspects of the occupational therapy process. Using culturally valid evidence supports transformational change that will benefit all sectors of society.