Study recommends that future system-wide programs of sexual and
gender minority health care education invest in more rigorous
program evaluations

BOSTON, April 14,
2022 /PRNewswire-PRWeb/ — A paper published in
Academic Medicine documents lessons learned from a pilot sexual and
gender minority (SGM) health curriculum offered to clinicians
working at NYC Health + Hospitals from 2017-2020. The program is
believed to be the largest and most comprehensive
single-institution sexual and gender minority health education
program to engage professionally diverse employees across multiple
practice facilities. It contributed important new knowledge to
efforts to provide professional development and training to
clinicians in how to meet the healthcare needs of LGBTQIA+
people.

“LGBTQIA+ people experience disparities in health outcomes,
including mental health, substance use, preventive care, and HIV
and sexually transmitted infections,” said study co-author
Hilary Goldhammer, SM. “A
contributing factor to these disparities is a lack of comprehensive
education about LGBTQIA+ people during formative clinician
training. Consequently, there is a dearth of clinicians with
expertise in the healthcare needs of LGBTQIA+ people.”

“The Joint Commission recommends that practicing clinicians and
other staff receive sexual and gender minority health education,”
added study senior author Dr. Alex S.
Keuroghlian, who directs the National LGBTQIA+ Health
Education Center at The Fenway Institute and the Massachusetts
General Hospital Psychiatry Gender Identity Program. “Optional
training of some clinicians may be helpful for reducing health
disparities, but this may be insufficient to ensure adequate
knowledge and skill among all clinicians. System-wide training may
be what is needed to make significant progress.”

NYC Health + Hospitals is the largest public health care system
in the United States, employing
approximately 6,000 clinicians at 11 acute care hospitals, over 70
neighborhood clinics, and other health care facilities that serve
more than 1 million people in New York
City. In this pilot study, NYC Health + Hospitals engaged
the National LGBTQIA+ Health Education Center at The Fenway
Institute at Fenway Health to design and implement a SGM health
care curriculum for clinicians. The pilot program featured a
90-minute live introductory session, a pre-test, a post-test, and
six 45-minute online learning modules focusing on a range of topics
in SGM health care. Modules include video of LGBTQIA+ patients
sharing their experiences in clinical settings.

NYC Health + Hospitals encouraged participation by clinicians in
the pilot program by promoting it in emails, posters, and screen
saver messages. Clinicians who completed the curriculum earned the
Certificate of Advanced Training in LGBTQ Healthcare for promotion
to patients as SGM-affirming providers.

Of the 6,000 clinicians eligible to participate at NYC Health +
Hospitals, 792 enrolled in the program, with a majority of
participants employed at acute care hospitals. Of the 792
participants, 372 (47%) completed all of the training modules. With
a mean pre-program test score of 60.9 and a mean post-program test
score of 81.9, those who completed the program demonstrated
significantly higher knowledge of SMG health care.

The study’s authors recommend that future system-wide programs
of SGM health care education invest in more rigorous program
evaluations. In addition to a post-program test, evaluators could
solicit feedback from participants about how likely they believe
that the training will alter their practice. But the most rigorous
evaluation would involve measuring changes in process and clinical
outcomes.

“SGM health outcomes can be measured by examining data in
electronic health records,” said lead author Dr. Kevin Ard, Medical Director of the National
LGBTQIA+ Health Education Center at The Fenway Institute and
Director of the Sexual Health Clinic at Massachusetts General
Hospital. “As an example, it would be meaningful to examine the
proportion of LGBTQIA+ patients in the electronic health record and
the proportion receiving appropriate preventive health screenings.
Measuring these outcomes prior to launching a training program
would set a baseline for evaluation while also providing
information about areas of need that the training program should
focus on.”

Study authors also recommend that institutions investing in SGM
health education training for clinicians allocate resources to
encouraging clinicians to participate and assessing the reasons for
non-participation.

“Reasons for lack of participation could have ranged from lack
of awareness that the program was available, a self-perception of
pre-existing expertise, limited interest in SGM health, time
constraints or other factors,” added Ard. “Without a good
understanding of why clinicians opted not to participate, it’s hard
to develop meaningful recruitment strategies going forward.”

“A Pilot Sexual and Gender Minority Health Curriculum for the
Largest Public Health Care System in the
United States,” is available online.

Media Contact

Christopher A Viveiros, Fenway Health, 617.927.6342,
cviveiros@fenwayhealth.org

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SOURCE Fenway Health