The Together, Equitable, Accessible, Meaningful (TEAM) cancer care for sexual and gender minority (SGM) patients: A pilot training evaluation.

Abstract

366 Background: SGM persons face barriers to health care which may contribute to disparities in cancer outcomes. SGM-specific health coverage in healthcare professional schools is minimal and inconsistent. The TEAM SGM Training aimed to address the unique health care needs of SGM people diagnosed with cancer by improving healthcare professional knowledge and clinical preparedness and changing in-clinic behaviors as well as organizational policies. Methods: Seven teams of healthcare professionals (n = 28) were invited to participate in the pilot. Each team participated in a 13-week, 17.5-hour training curriculum and developed an action plan and progress was assessed at three- and six-months post-training. Change in provider confidence, attitudes, knowledge, and behaviors were measured using an investigator-created and validated survey. Paired sample t-tests were used to examine differences from baseline to post-training learner assessment. Teams participated in entrance and exit interviews to identify drivers and barriers to implementation. Independent samples t-tests were used to examine differences in patient experiences at baseline in each organization and at 26 weeks post baseline data collection. Results: Of the 28 learners who started the training, 27 learners completed the training. All learners (n = 28) completed baseline assessments, and n = 22 completed post-intervention assessments. Statistically significant improvements were found in four of five factors: Environmental Cues ( t(21) = 2.56, p =.018), Knowledge ( t(21) = 2.15, p =.043), Clinical Preparedness ( t(7) = 3.89, p =.006), and Clinical Behaviors (t(21) = 2.48, p =.022). For patient experience, n = 90 baseline surveys and n = 187 post-intervention surveys were collected across two healthcare settings. Results were null. All teams made progress at six months on action plans. Facilitators and barriers included; resources and buy-in from leadership and limited staff engagement respectively. Conclusions: Synchronized standardized training can improve knowledge, clinical preparedness, and clinical behaviors for SGM-affirming care. While realistic goals are critical to early success, ongoing technical assistance and supportive institutional structures are important for successful organizational change.