LGBTQ Cultural Competency in a Rural Setting

Abstract

Background: The lesbian, gay, bisexual, transgender, and queer (LGBTQ) population is a diverse community of gender and sexual minorities that experiences mental health disparities such as increased prevalence of anxiety, depression, suicide, drug and alcohol abuse and dependence (Healthy People 2020, 2018). In rural America, mental health disparities among LGBTQ individuals can be attributed to geographic barriers, limited healthcare providers (HCP), stigma, and limited culturally competent HCPs (Rosenkrantz, Black, Abreu, Aleshire, & Fallin-Bennett, 2017). LGBTQ cultural competency (CC) programs are a response to LGBTQ health disparities and attempt to improve knowledge, beliefs, behaviors, and effect organizational policies. Methods: This quality improvement project used a descriptive quantitative design to address the knowledge, beliefs, and behaviors towards the LGBTQ population among rural HCPs employed at an organization with a mandatory LBGTQ cultural competency program. A convenience sample of staff (n= 51) at a behavioral health center were emailed surveys including demographic information, the Gay Affirmative Practice (GAP) scale, and a basic knowledge survey. Results: Response rate of fully completed surveys was 13.7%. Registered nurses (RN) accounted for 45% of respondents however response rate per profession was highest among social workers (75%). GAP results provided a mean belief score of 67.2 (SD 6.32) and behavior score of 58.5 (SD 7.29). The mean score for the knowledge survey was 56% overall with a range of 50. Conclusion: Those that attended CC101 had higher GAP and knowledge scores compared to those that did not attend. Overall respondents reported higher GAP belief scores than behavior scores and relatively low knowledge scores. Future cultural competency training should focus on how HCPs can display affirmative behaviors towards LGBTQ and increase general LGBTQ knowledge.