Dataset Information

Patient Acceptance of Sexual Orientation and Gender Identity Questions on Intake Forms in Outpatient Clinics: A Pragmatic Randomized Multisite Trial.

ABSTRACT: OBJECTIVES:To (1) test whether patient attitudes toward intake forms at three Midwestern outpatient clinics are significantly more negative among those who are asked to complete SOGI questions versus those who are not; and (2) gain an in-depth understanding of patient concerns about SOGI questions. STUDY SETTING:Data were collected between 6/29/2015 and 2/29/2016 from new patients (N = 491) who presented at three outpatient clinics in a large academic medical center. This study was originally a quality improvement project, and later, institutional review board approval was obtained for secondary data analysis. STUDY DESIGN:Two-stage mixed-methods study. (1) Experimental: New patients at three sites were randomly assigned to complete either routine intake forms (control) or routine intake forms with SOGI questions (experimental); and (2) qualitative: interviews with patients who responded negatively to SOGI questions. PRINCIPAL FINDINGS:There were no significant differences in patient attitudes between experimental and control groups (p > .05). Of those who received SOGI questions, only 3 percent reported being distressed, upset, or offended by the SOGI questions. CONCLUSIONS:Collection of SOGI data as a part of the routine clinical patient intake process is not distressing to 97 percent of patients who are heterosexual, cisgender, and older than 50 years.

SUBMITTER: Rullo JE

PROVIDER: S-EPMC6153164 | biostudies-literature | 2018 Oct

REPOSITORIES: biostudies-literature

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Patient Acceptance of Sexual Orientation and Gender Identity Questions on Intake Forms in Outpatient Clinics: A Pragmatic Randomized Multisite Trial.

Rullo Jordan E JE Rullo Jordan E JE Foxen Jilian L JL Griffin Joan M JM Geske Jennifer R JR Gonzalez Cesar A CA Faubion Stephanie S SS van Ryn Michelle M

Health services research 20180309 5

<h4>Objectives</h4>To (1) test whether patient attitudes toward intake forms at three Midwestern outpatient clinics are significantly more negative among those who are asked to complete SOGI questions versus those who are not; and (2) gain an in-depth understanding of patient concerns about SOGI questions.<h4>Study setting</h4>Data were collected between 6/29/2015 and 2/29/2016 from new patients (N = 491) who presented at three outpatient clinics in a large academic medical center. This study wa ...[more]

PMID: 29522236

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Project description:ImportanceAddressing health disparities in lesbian, gay, bisexual, transgender, and queer (LGBTQ+) communities has been a significant policy focus for more than a decade. Ensuring access to safe, respectful primary health care from knowledgeable clinicians is crucial for reducing health inequalities.ObjectiveTo assess the engagement of primary care practices in LGBTQ+ affirming care activities and identify practice characteristics associated with increased engagement.Design, setting, and participantsThis cross-sectional study used data from the National Survey of Healthcare Organizations and Systems II, which focused on primary care practices in the US and was administered between June 2022 through February 2023. Participants were primary care physicians and practice managers. Percentages were weighted for national representation. Data were analyzed from November 2023 to December 2024.ExposurePractice characteristics including practice size, ownership, federally qualified health center (FQHC) designation; percentage of patients enrolled in Medicare; percentage of patients enrolled in Medicaid; having accountable care organization (ACO) contracts for Medicare, Medicaid, or commercial insurance; rurality; census region; and LGBTQ+ Equality Score by state policy.Main outcomes and measuresSexual orientation- and gender identity- (SOGI) affirming activities, a composite variable reflecting activity specific to SOGI patients.ResultsAmong 1245 practices in the sample (38.4% response rate), 923 (77.40%) collected data on gender identity, 921 (75.62%) on sexual orientation, and 742 (65.83%) on patients' pronouns. Only 412 practices (34.42%) provided LGBTQ+ training for clinicians and 480 practices (39.20%) provided training for staff. Practices designated as FQHCs had 3.16 (95% CI, 4.60 to 19.73) percentage points higher probability of engaging in all SOGI-affirming activities) compared with non-FQHCs (P = .001). Practices with a Medicaid payer mix at least 50% had 3.28 (95% CI, 1.19 to 5.36) percentage points higher probability than practices with less than 50% Medicaid payer mix (P = .002), and participation in a Medicaid ACO was associated with 4.26 (95% CI, 0.78 to 7.73) percentage points increased probability compared with nonparticipants (P = .02). Each 1-unit increase in the state-level LGBTQ+ Equality Score was associated with 1.07 (95% CI, 0.28 to 1.85) percentage points higher probability of engaging in all SOGI-affirming activities (P = .02). High performance was negatively associated with practice rurality (average marginal effect, -16.00 [95% CI, -29.72 to -2.28]; P = .02), and rural practices were less likely to provide appropriate referrals (average marginal effect, -15.47 [95% CI, -29.22 to -1.72]; P = .03).Conclusions and relevanceThese findings suggest there is a need for federal and state mandates to require LGBTQ+ health care and competency training for health professionals and standardized data collection on SOGI, and these may be particularly important in rural regions. These measures are essential to evaluate practice performance and address health disparities effectively.

Dataset Information

Patient Acceptance of Sexual Orientation and Gender Identity Questions on Intake Forms in Outpatient Clinics: A Pragmatic Randomized Multisite Trial.

Publications

Patient Acceptance of Sexual Orientation and Gender Identity Questions on Intake Forms in Outpatient Clinics: A Pragmatic Randomized Multisite Trial.

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