Best Practices in Health Services for LGBT Youth

Background: Substantial health risk is often left unaddressed during cllinical encounters between providers and LGBT youth. Research has shown that healthcare providers, and particularly physicians, report being ill-equipped to best serve LGBT youth. Medical schools corroborate this by reporting training on LGBT health is often inadequate. Though best practices are being studied and have been discussed in a variety of reports, e.g., Lamdba Legal's "National Recommendations for Serving LGBT Homeless Youth", the actual implementation of best practices in healthcare services, and how these practices are effecting health outcomes, is not well understood.

Program background: This project, the result of collaboration between the Emerson College Health Communication Program and the Center for Social Innovation, researches the current status of best practices in healthcare services for LGBT youth, studies individual and organizational implementation of best practices, and discusses the development of new strategies for translating research into practice. The project includes a literature review of peer-reviewed scientific literature, an environmental scan, expert interviews, and survey data collection (N=37) from a geographically diverse set of healthcare providers including physicians, registered nurses, nurse practitioners, physician’s assistants, and social workers. Research is being used to inform the development of training tools for a Center of Excellence on care for LGBT youth.

Evaluation Methods and Results: Interview data has been organized by emergent themes. Survey data has been analyzed using descriptive statistics describing frequencies, means, and standard deviations. Data has been compared to a previous survey covering similar ground with physician’s assistants in Kansas. Materials developed are planned for pretesting with healthcare providers and will follow a semi-structured interview protocol to be completed by the end of April 2013.

Conclusions: Preliminary data analysis shows improvement within healthcare providers and organizations regarding use of best practices. These areas of strength include supporting transgender and gender non-conforming youth participants and creating a safe and inclusive environment. Still results show that assessing LGBT identity at intake occurs irregularly, and organizations are not regularly providing LGBT competency training to all agency employees and volunteers. Interviews highlight a clear need for LGBT cultural awareness training. Engagement with youth can shut down after ineffective or absent communication that leaves youth feeling misunderstood. This project shows clear gains in the generation in knowledge around best practices for LGBT youth, but confirms a high need for translation of research into practice.

Implications for research and/or practice: This research will inform the material used in a Center of Excellence for care for LGBT youth. Further, it supports the use of recommended best practices and the need for cultural awareness training. Future research is needed to identify measurable health benefits resulting from the implementation of best practices. Benefits may include improved use of preventive medicine, effective management of HIV/AIDS, and improved use of mental health services and access to housing.