Refinement of a Training Module to Improve Discussions of Sexual Orientation and Gender Identity in Cancer Clinics

PROJECT SUMMARY/ABSTRACT Sexual and gender minority (SGM) individuals comprise a growing population of over 20 million people in the United States. SGM individuals experience cancer care-related disparities with comparatively more frequent late-stage cancer diagnoses and more premature cancer deaths. Although these disparities are stark, the

cancer-specific needs of SGM patients are under-reported and under-studied. Our preliminary data reveals that fewer than half of oncology practices nationwide collect SOGI data, because oncology clinicians lack training in how to discuss SOGI information in an affirming and culturally appropriate manner. Invisibility of

SGM people further exacerbates cancer-related disparities; clinicians and researchers cannot even begin to discuss ways to improve these patients’ cancer care without first identifying them and their cancer-specific needs. We propose to remedy this by refining a training module for oncology clinicians, which will teach

clinicians why and how to ask patients about their SOGI status in cancer clinics. In the first aim, we propose to pilot this training module among oncology clinicians at three clinical sites nationwide. We will learn oncology clinicians’ views and attitudes of this module and feelings of competence in caring for SGM people after

participating in this module, using qualitative interviews. Interview questions will be derived from a model highlighting five fundamental constructs to provide culturally responsive healthcare to diverse groups of patients, developed by Campinha-Bacote and colleagues. We will use an iterative process to improve the

module content, based upon this qualitative data. In the second aim, we propose to learn the views and attitudes of SGM patients about the training module content using qualitative interviews, and, based on this data, further refine the module so that it is as patient-centric and SGM-affirming as possible. Upon completion

of these aims, the final training module will be: 1) concise and thereby easily implementable into clinical practice – it will take 45 minutes or less to complete, 2) specifically targeted to both patient and clinician concerns and needs, 3) applicable to a wide and diverse audience. With the completion of these two aims, the

finalized module will be ready for further development within the context of a national clinical trial and ready for broad dissemination among oncology practices.