The effects of educational curricula and training on LGBT‐specific health issues for healthcare students and professionals: a mixed‐method systematic review

Journal of the International AIDS Society - Tập 20 Số 1 - 2017
Adekemi Sekoni1, Nicola Gale2, Bibiane Manga‐Atangana3, Arjun Bhadhuri3, Kate Jolly3
1Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
2Health Services Management Centre, University of Birmingham, Birmingham, UK
3Institute of Applied Health Research, University of Birmingham, Birmingham, UK

Tóm tắt

AbstractIntroduction: Poor access of lesbian, gay, bisexual and transgender (LGBT) people to healthcare providers with clinical and cultural competency contributes to health inequalities between heterosexual/cisgender and LGBT people. This systematic review assesses the effect of educational curricula and training for healthcare students and professionals on LGBT healthcare issues.Methods: Systematic review; the search terms, strategy and process as well as eligibility criteria were predefined and registered prospectively on PROSPERO. A systematic search of electronic databases was undertaken. Screening for eligible studies and data extraction were done in duplicate. All the eligible studies were assessed for risk of bias. The outcome of interest was a change in participants’ knowledge, attitude and or practice.Results: Out of 1171 papers identified, 16 publications reporting 15 studies were included in the review. Three were non‐randomized controlled studies and 12 had a pre/post‐design; two had qualitative components. Bias was reported in the selection of participants and confounding. Risk reported was moderate/mild. Most studies were from the USA, the topics revolved around key terms and terminology, stigma and discrimination, sexuality and sexual dysfunction, sexual history taking, LGBT‐specific health and health disparities. Time allotted for training ranged from 1 to 42 hours, the involvement of LGBT people was minimal. The only intervention in sub‐Saharan Africa focused exclusively on men who have sex with men. All the studies reported statistically significant improvement in knowledge, attitude and/or practice post‐training. Two main themes were identified from the qualitative studies: the process of changing values and attitudes to be more LGBT inclusive, and the constraints to the application of new values in practice.Conclusions: Training of healthcare providers will provide information and improve skills of healthcare providers which may lead to improved quality of healthcare for LGBT people. This review reports short‐term improvement in knowledge, attitudes and practice of healthcare students and professionals with regards to sexual and LGBT‐specific healthcare. However, a unified conceptual model for training in‐terms of duration, content and training methodology was lacking.

Từ khóa


Tài liệu tham khảo

WilliamsH VarneyJ TaylorJ FishJ DurrP Elan‐CainC. The Lesbian Gay Bisexual and Trans (LGB&T) public health outcomes framework companion 2013. Available from:https://www.london.gov.uk/sites/default/files/LGBT%20Public%20Health%20Outcomes%20Framework%20Companion%20Doc.pdf

Centers for Disease Control and Prevention Lesbian Gay Bisexual and Transgender Health. Available from:http://www.cdc.gov/lgbthealth/about.htm

Graham R, 2011, The health of lesbian, gay, bisexual, and transgender people: building a foundation for better understanding.

Joint United Nations Programme on HIV/AIDS.Agenda for zero discrimination in healthcare. Available from:http://www.unaids.org/en/resources/documents/2016/Agenda‐zero‐discrimination‐healthcare

Joint United Nations Programme on HIV/AIDS.The gap report 2014. Available from:http://www.unaids.org/en/media/unaids/contentassets/documents/unaidspublication/2014/UNAIDS_Gap_report_en.pdf

Joint United Nations Programme on HIV/AIDS 2016‐2021 strategy on the fast‐track to end AIDS. Available from:http://www.unaids.org/en/resources/documents/2015/UNAIDS_PCB37_15‐18

Joint United Nations Programme on HIV/AIDS.Global AIDS update 2016. Available from:http://www.unaids.org/en/resources/documents/2016/Global‐AIDS‐update‐2016

United Nations General Assembly: high level meeting on ending AIDS June 2016. Available from:http://www.unaids.org/en/aboutunaids/unitednationsdeclarationsandgoals/2016highlevelmeetingonaids

Joint United Nations Programme on HIV/AIDS.How AIDS changed everything – MDG 16: 15 years 15 lesson of hope from the AIDS response July 2015. Available from:http://www.unaids.org/sites/default/files/media_asset/MDG6Report_en.pdf

Health Organization. HIV prevention diagnosis treatment and care for key populations: consolidated guidelines. Geneva: WHO;2014. Available from:http://apps.who.int/iris/bitstream/10665/128049/1/WHO_HIV_2014.8_eng.pdf?ua=1

10.1016/S0140-6736(07)61015-0

10.1097/QAD.0000000000000655

World Health Organization.Global strategy for human resources for health: workforce 2030. Draft for the 69th World Health Assembly 2016. Available from:http://www.who.int/hrh/resources/16059_Global_strategyWorkforce2030.pdf?ua=1

10.1111/nyas.12117

10.7326/0003-4819-151-4-200908180-00136

Cochrane library data extraction template for cochrane reviews. Available from: cccrg.cochrane.org/sites/cccrg.cochrane.org/files/…/DET_2013

10.1136/jech.52.6.377

Critical Appraisal Skills Programme (CASP) qualitative research checklist 31.05.13. Available from:http://media.wix.com/ugd/dded87_29c5b002d99342f788c6ac670e49f274.pdf

10.1111/j.1365-2923.1985.tb01355.x

10.1111/j.1365-2923.1977.tb00571.x

10.1111/j.1365-2923.1979.tb01203.x

10.1002/sm2.57

10.1080/10401330802199567

10.1111/j.1365-2923.1980.tb02270.x

10.1080/0142159031000100382

10.3928/01484834-20141228-03

10.3928/01484834-20141224-07

10.1016/j.nedt.2012.05.002

10.1111/j.1743-6109.2010.01883.x

10.1207/S15328015TLM1404_8

10.1111/j.1743-6109.2005.00135.x

2013, Men who have sex with men sensitivity training reduces homo‐prejudice and increases knowledge among Kenyan healthcare providers in coastal Kenya, J Int AIDS Soc., 16, 18748

10.1111/j.1525-1446.1989.tb00596.x

10.7448/IAS.16.4.18741

Hollenbach AD, 2014, Implementing curricular and institutional climate changes to improve health care for individuals who are LGBT, gender nonconforming, or born with DSD: a resource for medical educators.

Fredriksen‐Goldsen KI, 2016, The future of LGBT+ aging: a blueprint for action in services, policies, and research, Generations (San Francisco, Calif)., 40, 6

10.1093/inthealth/ihu101

10.1016/S0027-9684(15)31452-8

10.2105/AJPH.2006.086157

10.1097/00001888-199209000-00013

Parameshwaran V, 2017, Is the lack of specific lesbian, gay, bisexual, transgender and queer/questioning (LGBTQ) healthcare education in medical school a cause for concern?, Evidence from a survey of knowledge and practice amongst UK medical students. J Homosex, 64, 367

10.1186/1472-6920-13-174

Tesar CM, 1998, Survey of curriculum on homosexuality/bisexuality in departments of family medicine, Fam Med‐ Kans City., 30, 283

10.1001/jama.2011.1255

American Medical Association.LGBT health resources. Available from:http://www.ama‐assn.org/ama/pub/about‐ama/our‐people/member‐groups‐sections/glbt‐advisory‐committee/glbt‐resources/lgbt‐health‐resources.page

Royal College of General Practitioners Northern Ireland (RCGPNI) guidelines for the care of Lesbian Gay and Bisexual Patients in Primary Care; Guidelines for the Care of Trans Patients in Primary Care. Available from:http://www.rcgp.org.uk/policy/rcgp‐policy‐areas/lgbt.aspx

The Fenway Institute.National LGBT Health Education Centre. Available from:http://www.lgbthealtheducation.org/

Makadon H, 2015, The fenway guide to lesbian, gay, bisexual, and transgender health.

10.1089/lgbt.2015.0061

AllenM FuS KaneRL.Improving cultural competence to reduce health disparities; comparative effectiveness review no.170. (Prepared by the Minnesota Evidence‐based Practice Center under Contract No. 290‐2012‐00016‐I) AHRQ Publication No. 16‐EHC006‐EF. Rockville (MD): Agency for Healthcare Research and Quality;2016Mar. Available from:www.effectivehealthcare.ahrq.gov/reports/final.cfm

Thông tin
Thông tin xuất bản

Journal of the International AIDS Society

Tập 20 Số 1

Thông tin tác giả