LGBTQ+ Population Well-Being: Health Equity Implementation Science in Action.

Abstract

Health equity is actualized when all individuals can attain the highest level of health. Youth who identify as LGBTQ+ experience health disparities and scarce access to culturally congruent mental healthcare. Our nurse-led research team recognized evidence-based practice guidance gaps and prioritized a systematic inquiry into the lived experiences of LGBTQ+ identifying youth who needed emergency care for suicidality. Concurrently, we translated new findings into practice. The purpose of this endeavor is to implement a nimble evidence-based practice adoption process for nursing staff to effectively address LGBTQ+ population health needs. Informed by Purnell's Cultural Competence Theory, qualitative findings from a prospective study and available literature, we developed an LGBTQ+ sensitive care curriculum for nursing staff using the American Nurses Credentialing Center's (ANCC) Nursing Continuing Education Professional Development (NCPD) Framework to address the intersectionality of cultural awareness and care provision. The curriculum was delivered and formally evaluated longitudinally with a focus on communication confidence and knowledge. The curriculum was delivered in one session to nursing staff during a 6-month period. Program evaluations indicated curriculum acceptability and effectiveness. Participants reported improved ability to use appropriate language when communicating with patients who identify as LGBTQ+ and their families and a moderate to high change in confidence when providing care to LGBTQ+ identifying patients. Concurrent, evidence-based efforts to uncover and apply new knowledge relevant to nursing communication with youth who identify as LGBTQ+ is possible and yield effective, positive change in nursing knowledge and confidence in providing care for these youth. Implementation science is essential to advance evidence-based nursing practice or the full positive impact of research on patient outcomes is not likely. When the implementation science program is not incorporated early in the research process, research excellence is at risk. Evolving evidence-based practices that enhance individualized holistic patient care delivery for LGBTQ+ individuals are strengthened when primary research, implementation science, and scaling research co-occurrence is achievable. This implementation strategy demonstrates that early translation of health equity research on culturally congruent care for individuals identifying as LGBTQ+ can be done effectively and replicated across practice settings. Further, this work validates the importance of the relationship between nurse scientists, translational scientists, and clinical practice and education experts in the early dissemination and adoption of new knowledge. Evidence-based practice adoption improves healthcare professionals' propensity to positively impact public health patient care outcomes. Nursing staff are equipped with the knowledge and skills to deliver equitable care. Dissemination of early research findings as an implementation science strategy supports concurrent adoption in clinical practice to advance health equity outcomes with urgency. No patient or public contribution.