Oncologists: LGBT-related Knowledge and Clinical Practices Improved After Cultural Competency Training

NEW ORLEANS – An interactive online LGBT cultural competency training program for oncologists may be acceptable, feasible, and improve LGBT-related knowledge and clinical practices, according to preliminary results of a pilot study of oncologists in Florida to be presented at the 11th AACR Conference on The Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved, held here Nov. 2-5.

The training program was developed via an interdisciplinary collaboration between investigators at the Sylvester Comprehensive Cancer Center in Miami; the H. Lee Moffitt Cancer Center and Research Institute in Tampa; and the University of Florida Cancer Center in Gainesville.

“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, PhD, research assistant professor at the Sylvester Comprehensive Cancer Center. “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, explained Seay. It is an evolving skill set that involves 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.

Seay’s colleagues, Matthew Schabath, PhD, associate member in the Department of Cancer Epidemiology at the H. Lee Moffitt Cancer Center and Research Institute, and Gwendolyn Quinn, PhD, the Livia S. Wan, MD, Professor of Obstetrics and Gynecology in the Department of Obstetrics and Gynecology at New York University Langone Medical Center, 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 them to design the interactive online LGBT cultural competency training program.

The training program comprises 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, Seay and colleagues 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 questionnaire. Among the participating oncologists, 75 percent were heterosexual and cisgender.

Oncologists’ LGBT-related knowledge increased 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 were 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.”

According to Seay, the main limitation of the study is that it is a pilot study that involved a relatively small sample of oncologists from three institutions in the state of Florida. “This limits our ability to draw conclusions regarding the effectiveness of the training and the findings may not be broadly applicable to oncologists across the United States. However, we are hoping to soon be able to examine the effectiveness of our training among oncologists nationally,” said Seay.

This study was supported by a grant from the Florida Academic Cancer Center Alliance. Seay declares no conflicts of interest.