Evidence-Based Practice for Counseling the LGBTQI+ Population

Goodrich, Kristopher M.; Ginicola, Misty M.

doi:10.1002/9781119375517.ch9

Cited by 2 publications

(1 citation statement)

References 29 publications

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“…12,13 LGBTQ+-affirming care entails healthcare for LGBTQ+ patients that is culturally responsive and works to alleviate health inequities in this population through strategies such as creating a welcoming environment, addressing provider bias, providing tailored health services, and acknowledging underlying systemic inequality. 13 Despite gains in the availability of LGBTQ+affirming services within VHA, [14][15][16] there is still a complete lack of affirming care interventions at many VHA facilities. 17 In order to address this gap in LGBTQ+-affirming care offerings at VHA facilities, the PRIDE in All Who Served group intervention (PRIDE) was developed and spread by the PRIDE National Diffusion Team.…”

Section: Introductionmentioning

confidence: 99%

Rolling out PRIDE in All Who Served: Barriers and Facilitators for Sites Implementing an LGBTQ+ Health Education Group for Military Veterans

Wilson

Mulcahy

Lange³

et al. 2023

J GEN INTERN MED

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Background/Objective The Veterans Health Administration (VHA) PRIDE in All Who Served health education group (PRIDE) was developed to improve health equity and access to care for military veterans who are lesbian, gay, bisexual, transgender, queer, and/or other sexual/gender-diverse identities (LGBTQ+). This 10-week program rapidly spread to over 30 VHA facilities in 4 years. Veterans receiving PRIDE experience improved LGBTQ+ identity-related resilience and reductions in suicide attempt likelihood. Despite PRIDE’s rapid spread across facilities, information is lacking on implementation determinants. The current study’s goal was to clarify determinants of PRIDE group implementation and sustainment. Methods A purposive sample of VHA staff (N = 19) with experience delivering or implementing PRIDE completed teleconference interviews January–April 2021. The interview guide was informed by the Consolidated Framework for Implementation Research. Rapid qualitative matrix analysis was completed with methods to ensure rigor (e.g., triangulation and investigator reflexivity). Results Key barriers and facilitators of PRIDE implementation were heavily related to facility inner setting (what is happening inside the facility), including implementation readiness (e.g., leadership support for LGBTQ+-affirming programming, access to LGBTQ+-affirming care training) and facility culture (e.g., systemic anti-LGBTQ+ stigma). Several implementation process facilitators enhanced engagement at sites, such as a centrally facilitated PRIDE learning collaborative and a formal process of contracting/training for new PRIDE sites. Discussion/Conclusion Although aspects of the outer setting and larger societal influences were mentioned, the majority of factors impacting implementation success were at the VHA facility level and therefore may be more readily addressable through tailored implementation support. The importance of LGBTQ+ equity at the facility level indicates that implementation facilitation should ideally address institutional equity in addition to implementation logistics. Combining effective interventions with attention to local implementation needs will be required before LGBTQ+ veterans in all areas will benefit from PRIDE and other health equity-focused interventions.

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