An online LGBT (lesbian, gay, bisexual, transgender) cultural competency training program for oncologists may significantly improve knowledge and clinical practices surrounding LGBT cancer care, according to the results of a new pilot study.
“LGBT people experience substantial health disparities in various cancer survivorship and quality of life outcomes, including reporting more distress, more relationship difficulties, and less satisfaction with their cancer treatment and care than their heterosexual and cisgender counterparts,” said Julia Seay, Ph.D., research assistant professor at the Sylvester Comprehensive Cancer Center in Florida.
“As part of a broader effort to address disparities and improve cancer care and survivorship among LGBT people, we are working to improve LGBT cultural competency among oncologists.”
LGBT competency involves having the knowledge and ability to work effectively with LGBT patients, says Seay. It is an evolving skill set that requires not only knowledge about the unique care needs of sexual and gender minority individuals, but also the communication skills to effectively provide high-quality, personalized care for LGBT patients.
The new findings were recently presented at the 11th AACR Conference on The Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved.
The training program was developed via an interdisciplinary collaboration among researchers at the Sylvester Comprehensive Cancer Center in Miami; the H. Lee Moffitt Cancer Center and Research Institute in Tampa; and the University of Florida (UF) Cancer Center in Gainesville.
Seay’s colleagues previously conducted a national survey of oncologists and found that the overwhelming majority would be willing to receive training on the unique care needs of LGBT patients. This led the team to design the interactive online LGBT cultural competency training program.
The program includes four 30-minute modules. Two of the modules cover general topics, such as sexual orientation and gender identity terminology. The other two are oncology-focused; they include topics such as hormone therapy considerations for transgender patients undergoing cancer treatment and discussions of fertility with LGBT patients within the context of cancer care.
To date, the researchers have recruited 20 oncologists from Sylvester Comprehensive Cancer Center, Moffitt Cancer Center, and UF Health Cancer Center to participate in the online training and provide feedback via self-administered questionnaires. Among the participating oncologists, 75 percent were heterosexual and cisgender.
The findings show that oncologists’ LGBT-related knowledge increased considerably after completion of the training: The proportion of participants who correctly answered more than 90 percent of LGBT-related knowledge items was 33 percent before training and 85 percent after training.
LGBT-related attitudes and clinical practices also improved after completing the training: 70 percent of participants reported an increase in favorable perspectives toward LGBT people and 80 percent reported increasing their endorsement of LGBT-serving clinical practices.
In addition, after completing the training, 90 percent of the oncologists rated the training as either “excellent” or “very good,” and 95 percent stated that they would refer another oncologist to the training.
“These descriptive data from our pilot study show that this training program is both feasible and acceptable for oncologists,” said Seay. “The preliminary analyses also showed positive pre-post changes in LGBT-related knowledge and clinical practices. We hope to have the formal significance testing analysis completed in advance of the conference.”
The main limitation of the research is that it was a pilot study involving a relatively small sample of oncologists from three institutions in the state of Florida, according to Seay.