Abstract PO-014: Assessment of training needs for clinicians who provide reproductive health counseling for sexual and gender minority adolescents and young adults with cancer
Authors: Toldeo Rhyan J. , Sampson Amani , Lake Paige W. , Sutter Megan E. , Alpert Ash B. , Schabath Matthew B. , Vadaparampil Susan T. , Quinn Gwendolyn P. 
Published: December 2020

Background: Adolescent and young adults (AYA) with cancer have distinct psychosocial needs, with reproductive health being a chief concern. Reproductive health includes fertility, contraception, romantic relationships, body image, sexuality and disease prevention. Along with the unique needs of AYAs with cancer, health disparities exist among sexual and gender minority (SGM) AYAs, and there is a gap in clinician training. Our NCI-funded R25 Enriching Communication skills for Health professionals in Oncofertility (ECHO) provides reproductive health communication training to psychologists, social workers, nurses, and physician assistants who provide care for AYA people diagnosed with cancer. To refine our curriculum to address the unique needs of SGM AYAs with cancer, we conducted a survey of prior ECHO trainees to evaluate knowledge and comfort in obtaining sexual orientation and gender identity (SOGI) information from patients and providing reproductive health counseling. Methods: A 28-item electronic survey was distributed to 601 prior ECHO trainees. Quantitative items assessed: SOGI data collection at their institution; SGM AYA cancer-related health knowledge; adequacy of ECHO training for SGM AYAs; desire for additional training; comfort discussing reproductive health with SGMs; and confidence in knowledge of SGM health needs (pre- and post-survey).

Response options ranged from 1=strongly agree to 5=strongly disagree, or ‘prefer not to answer. Total knowledge score was computed and ranged from 0=no correct responses to 7=all correct. Self-perceived comfort and confidence were assessed with regard to specific patient subgroups (i.e., gay/lesbian; bisexual/queer; and trans/nonbinary patients). Four open-ended items invited respondents to describe personal experiences, reservations, and suggestions for improving SGM AYA cancer care. Quantitative responses were summarized with descriptive statistics. Paired t- tests were used to analyze changes in confidence. Content analysis was applied to qualitative responses. Results: Of the 346 who completed the survey (58% response rate), only 7.4% correctly answered all knowledge questions (M=3.76, SD=1.72). One- third thought ECHO training adequately addresses SGM needs, and the majority (89%) wanted additional training in SGM reproductive health. Confidence in knowledge of SGM health was neutral in all subgroups prior to survey completion (M=3.05, SD=1.02), but reduced significantly for bisexual/queer (M=-0.21 t(307)=4.70, p&lt;.001) and transgender/nonbinary health(M=-0.12 t(307)=2.66, p=.008). Open-ended responses focused on experiences caring for SGM AYAs with cancer; training needs; and appreciation for the survey. Conclusions: Our findings demonstrate a need to expand our ECHO curriculum to include SGM reproductive health concerns and strong desire for SGM content among trainees. We are developing a module to improve reproductive health communication for the care of SGM AYAs with cancer and survivors.

Citation Format: Rhyan J. Toldeo, Amani Sampson, Paige W. Lake, Megan E. Sutter, Ash B. Alpert, Matthew B. Schabath, Susan T. Vadaparampil, Gwendolyn P. Quinn. Assessment of training needs for clinicians who provide reproductive health counseling for sexual and gender minority adolescents and young adults with cancer [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-014.