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Patient-centered approaches to collect sexual orientation/gender identity information in the emergency department (ED)
Investigator (PI): Haider, Adil
Performing Organization (PO): (Current): Brigham and Women's Hospital, Center for Surgery and Public Health / (410) 614-3831
(Past): John Hopkins Medicine, Department of Surgery, Division of Acute Care Surgery / (410) 614-3831
Supporting Agency (SA): Patient-Centered Outcomes Research Institute (PCORI)
Initial Year: 2014
Final Year: 2018
Record Source/Award ID: PCORI/AD-110114-IC ; PCORI/AD-1306-03980
Funding: Total Award Amount: $1,378,194
Award Type: Contract
Award Information: PCORI: More information and project results (when completed)
Abstract: Background: Approximately nine million individuals identify as lesbian, gay, bisexual, or transgender (LGBT) in the United States. Few hospitals routinely collect sexual orientation and gender identity (SO/GI) patient information, despite its impact on the quality and patient-centeredness of care. Researchers have documented extensive health disparities among LGBT people, including higher risk of suicide, substance abuse, and HIV. While there is a growing body of evidence on collecting SO/GI information in primary care health settings, very little research has been conducted among patients presenting to the hospital emergency department (ED). Given that there are nearly 130 million annual ED visits in the U.S., it is essential that patient-centered strategies for collecting SO/GI information in this context are developed and tested. Objectives: The specific aims of this proposal are to (1) gather patient and provider input on barriers, facilitators, and preferred strategies for the collection of SO/GI information in the hospital ED; (2) develop two approaches for the patient-centered collection of SO/GI information; and (3) evaluate the feasibility and effectiveness of these approaches. The long-term objective is to develop best practices for patient-centered approaches to routinely collect SO/GI information in the hospital ED. Methods: We propose a three-year, three-phase study to develop ways to ask hospital ED patients about their sexual orientation and gender identity. This research will be conducted through the Johns Hopkins Clinical Research Network (a collaboration of teaching hospitals and community medical centers). We will focus on the experience of LGBT patients in this research. Phase 1 will involve individual interviews with 50 patients and 40 health care providers to gather feedback on strategies for collecting SO/GI information in the hospital ED. We will also supplement these findings with a nationwide survey of 1,200 patients and 400 health care providers. In phase 2, we will use the phase 1 results to work together with stakeholders to develop two approaches for routinely collecting SO/GI information in the ED. In phase 3, we will implement and test these two approaches at four JHCRN hospitals. We will review 4,060 patient medical records to determine how many provided their SO/GI information. We will conduct surveys with 426 patients, focusing on those who are LGBT or didn't provide their SO/GI information, and 196 health care providers to determine the feasibility and effectiveness of these strategies. A stakeholder advisory board of LGBT patients, clinicians, advocates, and hospital administrators will inform study design, conduct, and dissemination. Patient outcomes: Patient outcomes are (1) percentage providing SO/GI information, (2) Communication Climate Assessment Toolkit (CCAT) scores, (3) patient satisfaction, and (4) patient perceived levels of stigma/discrimination.
MeSH Terms:
  • Data Collection
  • Emergency Service, Hospital /*organization & administration
  • /*statistics & numerical data
  • Female
  • Gender Identity
  • Health Status Disparities
  • Healthcare Disparities
  • Humans
  • Male
  • Medical Records
  • * Patient-Centered Care
  • Sexual Behavior
  • Social Stigma
  • United States
Country: United States || United States
State: Massachusetts || Maryland
Zip Code: 02120 / 21287
UI: 20143409
CTgovId: NCT02701049
Project Status: Completed
Record History: ('2018: Project extended to 2018. CHANGED PO, 7/30/15. ',)