Fenway Gets $2M for Culturally Competent LGBT Healthcare

The Fenway Institute has been approved for a $2,075,915 funding award by the Patient-Centered Outcomes Research Institute (PCORI) to determine the best way to train community health center staff in the collection of sexual orientation and gender identity (SOGI) data. The project will then evaluate the impact of that enhanced data collection on health outcomes for lesbian, gay, bisexual, and transgender (LGBT) patients.

Sexual and gender minorities in the U.S. experience significant health disparities. For example, LGBT populations experience a greater burden of depression and other problems such as substance use disorders, including nicotine and alcohol abuse. Gay and bisexual men and transgender women are at increased risk of HIV infection and lesbians and bisexual women are impacted by breast and cervical cancer at higher rates than the general population. Transgender people often do not receive appropriate cancer screenings.

Many healthcare providers lack proper training to ask questions about sexual orientation, sexual behavior and gender identity and social stigma prevent many patients from volunteering this information. In addition, electronic health record (EHR) systems do not currently include standard ways to collect SOGI information. Without this knowledge, providers cannot properly identify and address health disparities affecting their LGBT patients.

"The federal government and organizations like the AMA and the American College of Physicians have recognized that the provision of optimal health care for LGBT patients requires training all providers and other healthcare personnel to routinely ask patients about their sexual orientation and gender identity, and providing them with correct information so providers understand what is entailed in culturally competent care for sexual and gender minority persons," said Kenneth H. Mayer, MD, Co-Chair and Medical Research Director of The Fenway Institute, who will serve as Principal Investigator on the project.

Results of this study would be the first of their kind to evaluate the impact of a series of educational programs on the healthcare outcomes of LGBT patients and could provide a replicable patient-centered model for routinely collecting and documenting sexual and gender minority information and improving provider competence in care. The ultimate goal of the study is to improve the quality of care for sexual and gender minorities and reduce health disparities.

"This new PCORI award will allow staff at The Fenway Institute to evaluate health outcomes before and after community health center personnel receive trainings about LGBT health from Fenway's National LGBT Health Education Center. The study could help transform LGBT clinical care nationally by demonstrating the importance of providers receiving specialized training," said Mayer.

"This project was selected for PCORI funding not only for its scientific merit and commitment to engaging patients and other stakeholders but also for its potential to fill an important gap in the delivery of healthcare to sexual and gender minority populations," said PCORI Executive Director Joe Selby, MD, MPH. "We look forward to following the study's progress and working with The Fenway Institute to share the results."

The Fenway Institute's project was selected for PCORI funding through a highly competitive review process in which patients, clinicians and other stakeholders joined clinical scientists to evaluate the proposals. Applications were assessed for scientific merit, how well they will engage patients and other stakeholders and their methodological rigor among other criteria.

The award has been approved pending completion of a business and programmatic review by PCORI staff and issuance of a formal award contract.

PCORI is an independent, nonprofit organization authorized by Congress in 2010. Its mission is to fund research that will provide patients, their caregivers and clinicians with the evidence-based information needed to make better-informed healthcare decisions.