Abstract
Objectives: Training/education is increasingly used to improve healthcare professionals’ knowledge, attitudes and clinical skills about lesbian, gay, bisexual and transgender (LGBT) health but few reviews have assessed their effectiveness. This review describes the impact of training about LGBT healthcare for healthcare professionals on participants’ knowledge, attitudes and clinical practice.
Design: Systematic review of intervention studies with contemporaneous comparators.
Data sources: Medline, CINAHL, PsycINFO, SSCI, ERIC, Cochrane Library, University of York CRD, PROSPERO and Ethos e-thesis database were searched from 15/12/2015 to 29/11/2023 to update a review published in 2017.
Eligibility criteria: Interventional studies of training/education for healthcare professionals or students about LGBT-specific health issues, compared to standard or no training/education. Outcomes were changes in participants’ knowledge, attitudes or clinical practice regarding LGBT health.
Data extraction and synthesis: Reviewer pairs independently screened titles/abstracts and full texts. Data were extracted by one reviewer and checked by a second (population, training content, development, delivery, duration/intensity and outcomes). The NIH tool for controlled intervention studies assessed study quality. Synthesis was descriptive.
Results: 11,734 citations were screened and 10 studies included. 8/10 were published since 2019. Study quality was poor (8/10) or fair (2/10) and all were conducted in high income countries. Four focused on transgender care. All studies used multi-component approaches, with topics covering terminology, lived experience, LGBT-specific health, sexuality and sexual history taking. Training duration ranged from 40 minutes to 50+ hours. Five studies included LGBT individuals in training development and/or delivery. 7/7 studies assessing attitudes, 2/4 studies assessing knowledge and 4/6 studies assessing skills/practice (actual or intended) reported statistically significant improvements.
Conclusions: Multi-component healthcare professional training on LGBT health can significantly improve participants’ knowledge, attitudes and skills. However, there was substantial heterogeneity in training content, delivery and duration and most studies were poor quality.
PROSPERO registration: CRD42023414431 (26/06/2023).
Design: Systematic review of intervention studies with contemporaneous comparators.
Data sources: Medline, CINAHL, PsycINFO, SSCI, ERIC, Cochrane Library, University of York CRD, PROSPERO and Ethos e-thesis database were searched from 15/12/2015 to 29/11/2023 to update a review published in 2017.
Eligibility criteria: Interventional studies of training/education for healthcare professionals or students about LGBT-specific health issues, compared to standard or no training/education. Outcomes were changes in participants’ knowledge, attitudes or clinical practice regarding LGBT health.
Data extraction and synthesis: Reviewer pairs independently screened titles/abstracts and full texts. Data were extracted by one reviewer and checked by a second (population, training content, development, delivery, duration/intensity and outcomes). The NIH tool for controlled intervention studies assessed study quality. Synthesis was descriptive.
Results: 11,734 citations were screened and 10 studies included. 8/10 were published since 2019. Study quality was poor (8/10) or fair (2/10) and all were conducted in high income countries. Four focused on transgender care. All studies used multi-component approaches, with topics covering terminology, lived experience, LGBT-specific health, sexuality and sexual history taking. Training duration ranged from 40 minutes to 50+ hours. Five studies included LGBT individuals in training development and/or delivery. 7/7 studies assessing attitudes, 2/4 studies assessing knowledge and 4/6 studies assessing skills/practice (actual or intended) reported statistically significant improvements.
Conclusions: Multi-component healthcare professional training on LGBT health can significantly improve participants’ knowledge, attitudes and skills. However, there was substantial heterogeneity in training content, delivery and duration and most studies were poor quality.
PROSPERO registration: CRD42023414431 (26/06/2023).
Original language | English |
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Article number | e090005 |
Number of pages | 9 |
Journal | BMJ open |
Volume | 15 |
Issue number | 1 |
DOIs | |
Publication status | Published - 7 Jan 2025 |
Bibliographical note
© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.Keywords
- Humans
- Sexual and Gender Minorities
- Health Personnel/education
- Health Knowledge, Attitudes, Practice
- Attitude of Health Personnel
- Clinical Competence