Medical educators can play a critical role in decreasing LGBT healthcare disparities. The University of Louisville LGBT Health Certificate Program played an important first step in increasing medical students' knowledge and improving certain attitudes about LGBT patients.
Introduction:The eQuality project at the University of Louisville aims to train future physicians to deliver equitable quality care for all people by creating an integrated educational model utilizing the competencies identified in the AAMC's Implementing Curricular and Institutional Climate Changes to Improve Health Care for Individuals Who Are LGBT, Gender Nonconforming, or Born With DSD. This foundational interprofessional health equity session for early learners addresses knowledge and attitude milestones relating to interprofessional collaboration, professionalism, and systems-based practice competencies for lesbian, gay, bisexual, and transgender (LGBT) populations. Methods: First-year medical students were assigned to interprofessional teams of approximately 10 health sciences students each. Students participated in a 75-minute session utilizing a group case study activity, including a systems lecture exploring social determinants and community resources related to LGBT health. Students collaboratively discussed the case and recorded strategies for optimal patient care. The Readiness for Interprofessional Learning Scale and health disparities attitudes and knowledge scales were administered pre-/postsession. Results: One hundred fifty-eight first-year medical students participated in the session. Posttest scores reflected an improvement for all disparities knowledge items (p < .001), and an increased interest in working with other health professions students on future projects (p < .001). Changes in attitudes toward systemic and social factors affecting health were also observed. However, content analysis of worksheets revealed that only 36% of teams identified specific action steps for the case scenarios. Discussion: This session was effective in improving knowledge and attitudes related to LGBT health equity and interprofessional education.
The Kentucky Teen Institute trains youth throughout the state to advocate for policies that promote health in their communities. By evaluating two program summits held at universities, regularly scheduled community meetings, ongoing technical support, and an advocacy day at the state Capitol, the aims of this study were to assess the impact of the intervention on correlates of youths' advocacy intentions and behaviors and to assess youth participants' and other key stakeholders' perceptions of the intervention. An ecological model approach and the theory of planned behavior served as theoretical frameworks from which pre-post, one-group survey and qualitative data were collected (June 2013-June 2014). An equal number of low-income and non-low-income youth representing five counties participated in the Summer Summit pretest (n = 24) and Children's Advocacy Day at the Capitol posttest (n = 14). Survey data revealed that youths' attitude toward advocacy, intentions to advocate, and advocacy behaviors all improved over the intervention. Observations, interviews, a focus group, and other written evaluations identified that the youths', as well as their mentors' and advocacy coaches', confidence, communities' capacity, and mutually beneficial mentorship strengthened. Stronger public speaking skills, communication among the teams, and other recommendations for future advocacy interventions are described.
WHAT IS THE PURPOSE OF THE eQUALITY TOOLKIT? is manual will help providers build a foundation of inclusive clinical skills to competently care for lesbian, gay, bisexual, transgender, and queer-identi ed (LGBTQ) patients and individuals born with di erences of sex development (DSD, sometimes called intersex). Although this toolkit was designed for medical students, any healthcare provider who wants to learn inclusive clinical skills can bene t from this manual. Other published resources address LGBTQ/DSD health and clinical skills comprehensively (see Appendix A). e purpose of this manual is to provide a brief primer that is accessible to all medical students with actionable steps to improve clinical care. It was speci cally written for use at the University of Louisville School of Medicine; therefore, some resources or laws may be region/city speci c. However, most of the content is applicable to any provider caring for LGBTQ/DSD patients. WHY IS THIS MANUAL NEEDED? Simply, this manual addresses gaps in healthcare provider training in caring for LGBTQ/DSD communities. ese populations experience repeated instances of stigma and discrimination related to their identities, with consequent health and healthcare disparities that knowledgeable 1 The number of people who identify as LGBTQ is growing, including 7.3% of millennials. 1 DSD is estimated to a ect 1.7% of births. 2,3 These individuals are our patients, and it is our responsibility to learn how to provide quality care for them. eQuality Toolkit how other considerations, such as insurance coverage, may in uence these decisions (see Part IV). Finally, LGBTQ/DSD health is an evolving eld, and the authors will make e orts to periodically update this manual with current information. e information in the following sections represents best practice as of the time of this writing.
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