Abstract
Introduction: 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 lesbian, gay, bisexual and transgender people. This systematic review assesses the effect of educational curricula and training for healthcare students and professionals on LGBT healthcare issues.
Methods: Systematic review. Search terms, strategy and process as well as eligibility criteria were pre-defined 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-randomised controlled studies and twelve 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.
Conclusion: Training of healthcare providers will provide information and improve skills of healthcare providers which may lead to improved quality of health care 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.
Methods: Systematic review. Search terms, strategy and process as well as eligibility criteria were pre-defined 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-randomised controlled studies and twelve 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.
Conclusion: Training of healthcare providers will provide information and improve skills of healthcare providers which may lead to improved quality of health care 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.
| Original language | English |
|---|---|
| Article number | 21624 |
| Journal | Journal of the International AIDS Society |
| Volume | 20 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 19 Jul 2017 |
Keywords
- Systematic review
- LGBT health
- Education
- healthcare students
- Healthcare professionals