Cancer Center Support Grant Supplement: “Asking and Telling”: Education and Process around the Implementation of SOGI assessment within the UPMC Hillman Cancer Center network.

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Abstract In the United States, disparities exist for adults who identify as lesbian, gay, bisexual, transgender, queer/questioning, intersex and other sexual and gender minorities (LGBTQI+) across the cancer care continuum, from prevention and screening through survivorship and end of life care. A major factor contributing to this dearth of research is the lack of systematically collected standardized data on sexual orientation and gender identity (SOGI) status. The purpose of this proposal is to institute the standardized collection of SOGI data at a sample of clinical sites of the UPMC Hillman Cancer Center (HCC). The six HCC sites chosen exhibit demographic and geographical diversity. This program will include cultural competency training of health care providers to promote their effective collection of these data. In addition, we will monitor barriers to effective collection of SOGI data at the patient, provider, and health system level. These barrier data will be used to modify and improve the program to remove barriers before launching our standardized program for collecting SOGI data across all clinical and research sites of HCC. To implement SOGI data collection, we propose five aims directed at clinical staff, patients, and information technology: 1. Assess all levels of HCC professional and administrative staff regarding barriers, knowledge, confidence, concerns and learning needs necessary to implement SOGI assessment tools. a. Will ensure participation across age, gender, race and geographic perspectives. 2. Assess HCC patients regarding factors facilitating disclosure of SOGI information, focusing on preferred mode of disclosure including (a) modality – paper forms, kiosk/iPad, in person, etc.; (b) location – at home, front desk, exam room, etc.; and (c) personal – when during intake, maintaining confidentiality if there with family. Will ensure participation across age, gender, race and geographic perspectives 3. Develop tailored assessment process and educational programs informed by Aims 1 and 2. 4. Provide education and sensitivity training around the patient disclosure of SOGI responses for the HCC staff at selected sites. 5. Concurrently implement SOGI questionnaires into the HCC electronic medical record, ARIA. Successful completion of this study will help us to begin the process of systemically collecting SOGI data, a critical first step in addressing cancer-related disparities in the LGBTQI+ community. It will also provide education and training to sensitize staff to the importance of this information as well as to help LGBTQI+ individuals feel recognized and accepted at HCC.