Comparative Effectiveness Research to Improve the Health of Sexual and Gender Minority Patients Through Cultural Competence and Skill Training of Community Health Center Providers and Non-clinical Staff
Comparative Effectiveness Research to Improve the Health of Sexual and Gender Minority Patients Through Cultural Competence and Skill Training of Community Health Center Providers and Non-clinical Staff
The primary goal of this PCORI proposal is to evaluate the impact of enhanced provider and
 clinical staff training to address the health disparities of SGM CHC patients to ultimately
 improve their health outcomes because CHCs are a key part of the U.S. health care delivery
 system for underserved populations. The current application proposes to test an intervention
 designed to understand how CHCs, including front line staff and safety net clinical
 providers, can identify and provide optimal care for their SGM patients, and will determine
 whether enhanced training of CHC staff in best practices for the provision of primary care
 for SGM patients will improve their clinical outcomes. The time is right for routinization of
 SOGI measures in EHRs and evaluation of the optimal methods to train primary care providers
 in the best practices for the care of SGM patients.
This project will work with 12 community health centers across the country that are part of
 and extended from the HRSA-established Community Health Applied Research Network (CHARN) to
 determine the optimal way to train CHC staff in the collection of SOGI data, and will
 evaluate the impact of enhanced SOGI data collection on health outcomes for LGBT patients.
 The project will build on more than six years of collaborations of a network of safety-net
 CHCs, including patient investigators from the inception of the project, with a plan for
 ongoing local patient engagement. Aim 1: Conduct interviews with patient and clinical
 stakeholders regarding how SOGI data are being used to inform patient care, and how they feel
 SOGI data should best be collected and utilized. Aim 2: Educate providers in culturally
 competent patient-centered care with sexual and gender minority populations. Aim 3: Compare
 the effect of a SOGI educational training program to usual practice on SOGI documentation
 rates and appropriate screening rates for LGBT patients.

 The project will determine the optimal way to train CHC staff in the collection of SOGI data,
 and will evaluate the impact of enhanced SOGI data collection on health outcomes for LGBT
 patients. The project team proposes a study design that is commonly employed to examine
 changes in outcomes (e.g., screening rates) across time, comparing rates prior to and after
 the educational training intervention. The project will measure the impact of changes to
 practice and to patient outcomes (e.g., depression screening, appropriate use of mammography
 and HPV screening for lesbians and transgender women), as well as patient satisfaction.

 Results of this study would be the first of their kind to evaluate the impact of a series of
 educational programs on the healthcare outcomes of LGBT patients and could provide a
 replicable patient-centered model for routinely collecting and documenting sexual and gender
 minority information at CHCs and improving provider competence in care. Ultimately, the study
 has strong potential for improving the quality of care for sexual and gender minorities and
 reducing health disparities.
Inclusion Criteria:

 -  18 years or older

 -  Clinical staff or patient at participating clinical site (for staff interviews and web
 surveys)

 -  English speakers

 Exclusion Criteria:

 -  Does not meeting the inclusion criteria above