Equity in Cancer Treatment
Mandi Pratt-Chapman, associate center director for patient-centered initiatives and health equity at the GW Cancer Center and an associate professor of medicine at the GW School of Medicine and Health Sciences, recently launched a pilot training program to help organizations that administer cancer care services or address cancer disparities provide patient-centered, culturally affirming care.
The Together, Equitable, Accessible, Meaningful (TEAM) Cancer Care for Sexual and Gender Minority (SGM) Patients Training aims to provide guidance, tools and resources for health care professionals over 13 weeks. Individuals from organizations across the country are currently going through the program, which covers a range of subjects from implicit bias to understanding how to distinguish between the constructs of sexual orientation, sexual attraction, sexual behavior, gender identity, gender expression, and sex assigned at birth. The training also includes subjects such as how to collect sexual orientation and gender identity data, legal and policy considerations such as potential insurance claim denials for gender nonconforming individuals, trauma-informed cancer screening and care, oncology management considerations for sexual and gender minorities, supportive and palliative care strategies for affirming care, and interpersonal and organizational strategies to advance health equity for LGBTQI patients.
Participants will work in teams to develop an action plan to implement improved practices within their settings. Dr. Pratt-Chapman will follow up with them at three and six months after the training to document what types of changes they made within their system and any barriers they encountered.
Many health care professionals have not received formal training on how to provide affirming and culturally competent care for LGBTQ patients, Dr. Pratt-Chapman said. This became even clearer when analyzing results from a recent community-driven study on transgender cancer screening experiences in the Washington, D.C., area. The need for improved provider communication skills, affirming care environments and clinical and cultural competence of providers were key themes arising from the study, she said.
“There’s a whole lot of education that needs to happen to extend the understanding of queer lived experience among people that may not have thought about queer-specific health or healthcare needs, even if they have queer friends or family members,” she said. “None of us can actually be culturally competent, truly culturally competent, in any lived experience other than our own, but we can have an ongoing process of learning. That’s what we are promoting and what we are trying to instill in our trainees.”
Negative health care experiences—even from well-meaning clinicians—can result in LGBTQI individuals delaying care or force them to seek out new providers, which can be time consuming and costly.
Dr. Pratt-Chapman is also working with about 20 other national experts as part of a team led by Whitman-Walker Health and the National LGBT Cancer Network to publish a forthcoming white paper, “Recommended National Standards and Best Practices for LGBTQI Cultural Competency Trainings of Healthcare and Social Service Providers and Staff,” and a corresponding manuscript. The white paper will include example materials such as workshop exercises, readings, video recommendations and role play scenarios that can be used and adapted for training.
