Making a Difference: Increasing Provider Comfort Addressing Sexual Orientation and Gender Identity in Primary Care

Abstract

Purpose. This quality improvement (QI) project aims to increase provider knowledge and comfort in appropriately addressing sexual orientation and gender identity (SOGI) in the primary care setting. Background. LGBTQIA+ people are twice as likely to suffer depression, substance abuse, and other health disparities. LGBTQIA+ people suffer from minority stress as an underrepresented population. The consequence of this pervasive stress increases levels of depression and anxiety, leading to destructive coping mechanisms like substance and alcohol abuse, suicidal behaviors, and self-harming behaviors. Health care providers receive minimal education about specific health needs of LGBTQIA+ people in their training, which may lead to unintended discriminatory practices. Methods. The QI occurred at a Federally Qualified Health Center (FQHC) in East Central Wisconsin. The educational material from the National LGBTQIA+ Health Education Center’s Foundations of LGBTQIA+ Health Parts 1 and 2 was used for staff education. The participants were convenience sampled from 39 medical clinic staff members. The PC administered a pretest and posttest using the Lesbian, Gay, Bisexual, Transgender Development of Clinical Skills Scale (LGBT-DOCSS). Results. Participant responses were N=7 for the pretest and N=5 for the posttest. The score for the pretest was 603, and the posttest was 455. The highest scoring subsection was “attitude” for pretest and posttest. And “clinical preparedness” and “knowledge” scored lower in both pretest and posttest.