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Open Access 01-12-2022 | Study protocol

Assessing the effectiveness of a LGBT cultural competency training for oncologists: study protocol for a randomized pragmatic trial

Authors: Julia Seay, Eryk N. Hernandez, Jaileene Pérez-Morales, Gwendolyn P. Quinn, Matthew B. Schabath

Published in: Trials | Issue 1/2022

Abstract

Background

LGBT patients may have unique psychosocial cancer care needs, and healthcare providers should have knowledge and understanding of these unique needs to effectively address disparities through the delivery of personalized healthcare. As such, our group developed and piloted a web-based LGBT cultural competency training designed specifically for oncologists called the Curriculum for Oncologists on LGBT populations to Optimize Relevance and Skills (COLORS). We designed a randomized pragmatic trial for oncologists to compare the effectiveness of the COLORS training versus a general online LGBT cultural competency training in improving LGBT-related knowledge, attitudes, and clinical practices.

Methods/design

Study procedures include an 8-step approach for recruitment, randomization, retention, and completion of the interventions. Oncologists of any subspecialty who are currently practicing physicians will be identified from the American Medical Association Masterfile. Approximately 5000 oncologists will be sent a FedEx envelope with an invitation letter and study timeline. Electronic consent is obtained using a secure REDCap (Research Electronic Data Capture) portal hosted at the Moffitt Cancer Center (Tampa, FL) where the oncologists will complete the eligibility questionnaire, pre-training assessments, and then will be randomized to complete the COLORS training or an online general healthcare training offered by the National LGBT Health Education Center. Effectiveness of both trainings will be assessed utilizing self-reported measures of LGBT-related knowledge, attitudes, and affirming clinical practices. The measures will be collected before and directly after training completion, as well as 3-month post-training completion. The primary outcomes are changes in knowledge, attitudes, and practice behaviors regarding LGBT cancer patients from pre-test to post-test training in the COLORS training vs. the comparison training.

Discussion

The overarching premise of this trial is to assess the effectiveness of the COLORS cultural competency training program. If successful, among oncologists who completed the COLORS training should yield statistically significantly improvements in knowledge, attitudes, and affirming practice.

Blank TO, Descartes L, Asencio M. Cancer screening in gay and bisexual men and transgender people. In: Boehmer U, Elk R, editors. Cancer and the LGBT Community: Unique Perspectives from Risk to Survivorship. Cham: Springer International Publishing; 2015. p. 99–114. https://doi.org/10.1007/978-3-319-15057-4_7.CrossRef

Jabson JM, Farmer GW, Bowen DJ. Health behaviors and self-reported health among cancer survivors by sexual orientation. Lgbt Health. 2015;2(1):41–7. https://doi.org/10.1089/lgbt.2014.0038.CrossRefPubMedPubMedCentral

Jabson JM, Bowen DJ. Perceived stress and sexual orientation among breast cancer survivors. J Homosex. 2014;61(6):889–98. https://doi.org/10.1080/00918369.2014.870814.CrossRefPubMed

Jabson JM, Farmer GW, Bowen DJ. Stress mediates the relationship between sexual orientation and behavioral risk disparities. BMC Public Health. 2014;14(1). https://doi.org/10.1186/1471-2458-14-401.

Jabson JM, Farmer GW, Bowen D. Does stress mediate the relationship between sexual orientation and behavioral risk disparities? Ann Behav Med. 2014;47(1):S47. https://doi.org/10.1186/1471-2458-14-401.CrossRef

Jabson JM, Donatelle RJ, Bowen DJ. Relationship between sexual orientation and quality of life in female breast cancer survivors. J Womens Health. 2011;20(12):1819–24. https://doi.org/10.1089/jwh.2011.2921.CrossRef

Jabson JM, Donatelle RJ, Bowen D. Breast cancer survivorship: the role of perceived discrimination and sexual orientation. J Cancer Surviv. 2011;5(1):92–101. https://doi.org/10.1007/s11764-010-0161-7.CrossRefPubMed

Quinn GP, Schabath MB, Sanchez JA, Sutton SK, Green BL. The importance of disclosure: lesbian, gay, bisexual, transgender/transsexual, queer/questioning, and intersex individuals and the cancer continuum. Cancer. 2015;121(8):1160–3. https://doi.org/10.1002/cncr.29203.CrossRefPubMed

Kamen C, Mustian K, Johnson MO, Boehmer U. Same-sex couples matter in cancer care. J Oncol Pract. 2015;11(2):E212–5. https://doi.org/10.1200/JOP.2014.000877.CrossRefPubMedPubMedCentral

10.

Kamen CS, Smith-Stoner M, Heckler CE, Flannery M, Margolies L. Social support, self-rated health, and lesbian, gay, bisexual, and transgender identity disclosure to cancer care providers. Oncol Nurs Forum. 2015;42(1):44–51. https://doi.org/10.1188/15.ONF.44-51.CrossRefPubMedPubMedCentral

11.

Kamen C, Palesh O, Gerry AA, Andrykowski MA, Heckler C, Mohile S, et al. Disparities in health risk behavior and psychological distress among gay versus heterosexual male cancer survivors. Lgbt Health. 2014;1(2):86–U103. https://doi.org/10.1089/lgbt.2013.0022.CrossRefPubMed

12.

Kamen CS, Blosnich J, Trevio L, et al. Cigarette smoking disparities among sexual minority cancer survivors. Ann Behav Med. 2013;45:S251.

13.

Griggs J, Maingi S, Blinder V, Denduluri N, Khorana AA, Norton L, et al. American Society of Clinical Oncology position statement: strategies for reducing cancer health disparities among sexual and gender minority populations. J Clin Oncol. 2017;35(19):2203–8. https://doi.org/10.1200/JCO.2016.72.0441.CrossRefPubMed

14.

Banerjee SC, Staley JM, Alexander K, Walters CB, Parker PA. Encouraging patients to disclose their lesbian, gay, bisexual, or transgender (LGBT) status: oncology health care providers' perspectives. Transl Behav Med. 2020;10(4):918–27. https://doi.org/10.1093/tbm/iby105.CrossRefPubMed

15.

Schabath MB, Blackburn CA, Sutter ME, Kanetsky PA, Vadaparampil ST, Simmons VN, et al. National survey of oncologists at National Cancer Institute-designated comprehensive cancer centers: attitudes, knowledge, and practice behaviors about LGBTQ patients with cancer. J Clin Oncol. 2019;37(7):547–58. https://doi.org/10.1200/JCO.18.00551.CrossRefPubMedPubMedCentral

16.

Institute of Medicine (U.S.). Committee on lesbian gay bisexual and transgender health issues and research gaps and opportunities. The health of lesbian, gay, bisexual, and transgender people : building a foundation for better understanding. Washington, DC: National Academies Press; 2011.

17.

Gates GJ: How many people are lesbian, gay, bisexual, and transgender? The Williams Institute, UCLA School of Law https://williamsinstitute.law.ucla.edu/wp-content/uploads/Gates-How-Many-People-LGBT-Apr-2011.pdf.

18.

Gates GJ, Newport F: Special Report: 3.4% of U.S. Adults identify as LGBT. Gallup. http://news.gallup.com/poll/158066/special-report-adults-identify-lgbt.aspx.

19.

Miller KD, Nogueira L, Mariotto AB, Rowland JH, Yabroff KR, Alfano CM, et al. Cancer treatment and survivorship statistics, 2019. CA Cancer J Clin. 2019;69(5):363–85. https://doi.org/10.3322/caac.21565.CrossRefPubMed

20.

Seay J, Hicks A, Markham MJ, Schlumbrecht M, Bowman M, Woodard J, et al. Developing a web-based LGBT cultural competency training for oncologists: The COLORS training. Patient Educ Couns. 2019;102(5):984–9. https://doi.org/10.1016/j.pec.2019.01.006.CrossRefPubMed

21.

Seay J, Hicks A, Markham MJ, Schlumbrecht M, Bowman-Curci M, Woodard J, et al. Web-based LGBT cultural competency training intervention for oncologists: Pilot study results. Cancer. 2020;126(1):112–20. https://doi.org/10.1002/cncr.32491.CrossRefPubMed

22.

National LGBT Health Education Center. Learning resources — learning module. URL at: https://www.lgbtqiahealtheducation.org/resources/type/learning-module/

23.

United States Census Bureau. Census Regions and Divisions of the United States. URL at: https://www2.census.gov/geo/pdfs/maps-data/maps/reference/us_regdiv.pdf.

24.

Hoddinott SN, Bass MJ. The dillman total design survey method. Can Fam Physician. 1986;32:2366–8.PubMedPubMedCentral

25.

Schabath MB, Sutter M, Simmons VN, et al. National survey of oncologists at National Cancer Institute-designated comprehensive cancer centers: attitudes, knowledge, and practice behaviors about LGBTQ cancer patients. J Clin Oncol (under revision Sept 2018). 2018.

26.

Tamargo CL, Quinn GP, Sanchez JA, et al. Cancer and the LGBTQ population: quantitative and qualitative results from an oncology providers’ survey on knowledge, attitudes, and practice behaviors. J Clin Med. 2017;6(10).

27.

Shetty G, Sanchez JA, Lancaster JM, Wilson LE, Quinn GP, Schabath MB. Oncology healthcare providers' knowledge, attitudes, and practice behaviors regarding LGBT health. Patient Educ Couns. 2016;99(10):1676–84. https://doi.org/10.1016/j.pec.2016.05.004.CrossRefPubMedPubMedCentral

28.

Campinha-Bacote J. The process of cultural competence in the delivery of healthcare services : a culturally competent model of care. Cincinnati: Transcultural C.A.R.E. Associates; 2003.

29.

Romero DH, Morera OF, Wiebe JS. Assessing the gender invariance of the Modern Homonegativity Scale. J Homosex. 2015;62(11):1539–59. https://doi.org/10.1080/00918369.2015.1073034.CrossRefPubMed

30.

Wilson CK, West L, Stepleman L, Villarosa M, Ange B, Decker M, et al. Attitudes toward LGBT patients among students in the health professions: influence of demographics and discipline. LGBT Health. 2014;1(3):204–11. https://doi.org/10.1089/lgbt.2013.0016.CrossRefPubMed

31.

Crisp C. The Gay Affirmative Practice Scale (GAP): a new measure for assessing cultural competence with gay and lesbian clients. Soc Work. 2006;51(2):115–26. https://doi.org/10.1093/sw/51.2.115.CrossRefPubMed

32.

Ambrose AJH, Lin SY, Chun MB. Cultural competency training requirements in graduate medical education. J Graduate Med Educ. 2013;5(2):227–31. https://doi.org/10.4300/JGME-D-12-00085.1.CrossRef

33.

Jabson JM, Mitchell JW, Doty SB. Associations between non-discrimination and training policies and physicians’ attitudes and knowledge about sexual and gender minority patients: a comparison of physicians from two hospitals. BMC Public Health. 2016;16(1):256. https://doi.org/10.1186/s12889-016-2927-y.CrossRefPubMedPubMedCentral

34.

Leyva VL, Breshears, E.M. and Ringstad, R. Assessing the efficacy of LGBT cultural competency training for aging services providers in California’s Central Valley. J Gerontol Soc Work 2014;57(2-4):335-348, DOI: https://doi.org/10.1080/01634372.2013.872215.

35.

Porter KEaK, L. Do LGBT aging trainings effectuate positive change in mainstream elder service providers? J Homosex. 2014;61(1):197–216. https://doi.org/10.1080/00918369.2013.835618.CrossRef

Title: Assessing the effectiveness of a LGBT cultural competency training for oncologists: study protocol for a randomized pragmatic trial
Authors: Julia Seay
Eryk N. Hernandez
Jaileene Pérez-Morales
Gwendolyn P. Quinn
Matthew B. Schabath
Publication date: 01-12-2022
Publisher: BioMed Central
Published in: Trials / Issue 1/2022
Electronic ISSN: 1745-6215
DOI: https://doi.org/10.1186/s13063-022-06274-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Assessing the effectiveness of a LGBT cultural competency training for oncologists: study protocol for a randomized pragmatic trial

Abstract

Background

Methods/design

Discussion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods/design

Discussion

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