Web‐based LGBT cultural competency training intervention for oncologists: Pilot study results

Abstract

Background Lesbian, gay, bisexual, and transgender (LGBT) cancer patients experience substantial health disparities, including poorer overall health and lower satisfaction with their cancer care than their heterosexual and cisgender counterparts, which may be due in part to a lack of culturally competent providers. To address these disparities, a web‐based LGBT cultural competency training tailored to oncologists was developed by an interdisciplinary team of scientists, LGBT cancer survivors, cultural competency experts, oncologists, a web designer, and an instructional designer. Methods Oncologists (n = 44) were recruited from 3 academic cancer centers in Florida. Participants were administered the LGBT cultural competency training Curriculum for Oncologists on LGBT populations to Optimize Relevance and Skills (COLORS) and completed pre‐ and posttraining measures regarding LGBT‐related knowledge, attitudes (including general negative attitudes and health care–related attitudes), and clinical practices. After the training, participants completed training acceptability measures. Results Of the 44 participants, 33 (75%) completed the COLORS training. Participants were 55% non‐Hispanic white, 63% male, and had a mean age of 47 years. Participants demonstrated significant improvements in LGBT‐related knowledge (t = −4.9, P < .001), attitudes (Z = −3.0, P = .002; t = −2.5, P = .019), and clinical practices (Z = −3.5, P < .001) after completing the COLORS training (Wilcoxon signed rank tests were used for nonnormally distributed variables). Moreover, training acceptability was high, with 82% of participants rating the training as high quality, and 97% being willing to recommend the training to a colleague. Conclusion The COLORS training is both feasible to administer and acceptable for use with oncologists, and may improve oncologists' LGBT‐related knowledge, attitudes, and clinical practices. Larger trials are needed to examine the training's effectiveness in reducing LGBT cancer disparities, as well as its applicability to other types of care providers.

Health‐related quality of life among colorectal cancer survivors of diverse sexual orientations

“…43 However, culturally tailoring interventions to sexual minority individuals is a known practice and can complement ongoing efforts to train health care professionals to deliver culturally competent care to sexual minority patients. [44][45][46] Findings for all survivors show that 3 domains (personal factors, health condition characteristics, and body function) explained CRC survivors' poor health and 46% of the variance in PCS, whereas 56% of the variance in MCS was explained by personal factors, body function, and environmental factors. Focusing on the modifiable factors identified in each model, these findings suggest that survivors' PCS might be improved by guiding survivors to a healthy body weight.…”

Reproductive health risks and clinician practices with gender diverse adolescents and young adults

“…88,89 Web-based training in reproductive health with other populations (eg oncology) demonstrates efficacy for improving communication skills and confidence in counseling, and for reaching clinicians in rural or under-resourced areas who may have difficulty accessing desired reproductive health training. 88,[90][91][92] Enhancing reproductive health counseling with TGD AYAs would improve the quality and sensitivity of care, reduce mistrust, increase satisfaction with health services and safety for youth, and optimize TGD AYA reproductive health outcomes. These programs should be geared toward a heterogeneous group of clinicians, as both medical (eg physicians, nurse practitioners) and mental health (eg psychologists, social workers) clinicians, play important roles in the reproductive health care of all AYAs.…”

What Exactly Are We Measuring? Evaluating Sexual and Gender Minority Cultural Humility Training for Oncology Care Clinicians

“…36 New measures are needed that capture facets of cultural humility specific to care of SGM patients, correlate with clinical practice changes, and lead to improvements in SGM patient outcomes. 37 Communication theory can serve as a guide for evaluation of SGM cultural humility training. Effective communication in medical interactions is "the ability to gather information to facilitate accurate diagnosis, counsel appropriately, give therapeutic instructions, and establish caring relationships with patients."…”