Improving Health Outcomes for Sexual Minorities Through Access
Authors: Van Der Wege Michelle , Gubitoso Mary Jo , null null , null null , null null , null null 
Published: August 2023

Introduction: Lesbian, gay, bisexual, transgender and questioning (LGBTQ) individuals are often reluctant to access healthcare services due to previous experiences both within and outside of healthcare (Hafeez, Zeshan, Tahir, Jahan, &amp; Naveed, 2017; Macapagal, Bhatia, &amp; Green, 2016). Healthy People 2020 (2018) has identified LGBTQ people as a vulnerable population susceptible to poor health outcomes. Cultural competence is defined by a healthcare provider’s desire and ability to work with a client within a cultural context (Garneau &amp; Pepin, 2015). Cultural competence not only includes knowledge and skills of staff, but also applies to the physical environment of the clinic. The Gay and Lesbian Medical Alliance (GLMA) (n.d.) recommends displaying posters from LGBTQ non-profit organizations in the clinic lobby to convey a welcoming environment. Furthermore, all forms should be reviewed to ensure inclusive language is used throughout. The purpose of this project was to address barriers to care for sexual minorities at a student health clinic on a Midwestern university campus. Methods: To complete this project, a quasi-experimental, longitudinal approach was used. The primary instrument used in this project is the Inventory for Assessing the Process of Cultural Competence Among Healthcare Professionals-Revised (IAPCC-R©) tool. The IAPCC-R© is designed to measure the cultural competence of health care providers; the tool measures five areas of cultural competence including desire, awareness, knowledge, skills, and encounters using a four-point Likert scale. This survey was conducted immediately prior to the first, and immediately after the last educational session. Staff training regarding the disparities that exist among LGBTQ clients as well as research-driven methods to overcome them was provided. Meanwhile, posters and magazines that reflect the diverse patients of the clinic were added to the lobby and exam rooms. The EMR was reviewed to include multiple gender options and sexual orientations. Results: Statistically significant increases were seen in the overall mean, as well as the constructs of cultural knowledge and cultural awareness. While all other areas showed higher post-intervention mean scores, none were statistically significant The effects of the project go beyond the original goals identified by researchers. Through the collaboration with the GSA, students asked the clinic administration to consider offering Human Immunodeficiency Virus (HIV) pre-exposure prophylaxis (PrEP). In addition, a LGBTQ representative was added to the Health Advisory Board. This project does have limitations due to a small sample size and single site of implementation.Conclusion: This project highlights the importance of being open to considering a problem exists even if one is unaware or unaffected by it. While many initially denied there was a pressing issue regarding care of the LGBTQ client, this project opened a conversation that led to many opportunities to increase care provided to LGBTQ individuals. Methods used within this project could be implemented in clinics of any size. Keywords: LGBTQ, healthcare, access, cultural competence, health disparities, rural