Pilot Project 1: Testing the effectiveness of an intervention to foster cervical cancer screening promotion for Latinx trans men among medical students

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ABSTRACT | PILOT RESEARCH PROJECT Transmen (TM) and non-binary individuals (NB; individuals assigned female sex at birth who identify as a man, male, or another diverse non-binary gender identity on the masculine spectrum) are at higher risk of screening- detectable cancers. The incidence of cervical cancer among Latinx (a gender-neutral term designating Hispanics/Latinos (H/L)) is the highest among all ethnic groups in the US. Thus, Latinx TM and NB (LTM-NB) are at a higher risk for cervical cancer as they lie at the intersection (i.e., gender and ethnic minorities) of two populations that experience health disparities for this disease. Individual and interpersonal level factors in interactions with health care providers such as the gendered nature of testing, “misgendering” or use of incorrect pronouns, and avoidance to discuss issues about body parts associated with their assigned at birth gender have been identified as some of the key aspects driving cervical cancer disparities among LTM-NB. In addition, healthcare providers’ negative attitudes and insensitivity can contribute to emotional discomfort for testing, adding another screening barrier. Our previous studies among LTM-NB in Puerto Rico and Florida show that providers lack knowledge about specific healthcare needs, have negative stigmatizing attitudes, and manifest discriminatory behaviors in clinical interactions with LTM-NB. However, although there are existing guidelines to foster cancer early detection and prevention among TM, no guidelines or interventions address the increased disparities encountered by ethnic minority LTM-NB. We developed a brief online intervention to improve medical students’ competencies for cervical cancer education and screening promotion among LTM- NB. The efficacy of this intervention has already been tested and exhibited medium to large effect sizes. The Aims of this proposed study are: Aim 1) Test the effectiveness of the intervention in increasing medical students’ knowledge, attitudes, and skills for providing healthcare to LTM-NB. This will be achieved by conducting a randomized controlled trial with participants from Ponce Health Science University and from Moffitt Cancer Center-University of South Florida. Quantitative measures (knowledge and attitudes) and SPS direct observations (behaviors) will be collected to examine the intervention’s effectiveness. The rationale for this aim is to determine the additional effect of the measure. Aim 2) Determine the acceptability, appropriateness, and feasibility of implementing the interventions in real-world medical educational settings. We will implement quantitative self-report measures and individual interviews with a sub-sample of participants from the experimental condition (n=10) to examine implementation outcomes (acceptability, appropriateness, and feasibility). The impact of this study will reveal new effective interventions and implementation strategies. The translational implications of this work will result in providing medical schools with a cross-cultural tool to train students on cervical cancer prevention for LTM- NB.