8
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: not found

      Improving correctional healthcare providers’ ability to care for transgender patients: Development and evaluation of a theory-driven cultural and clinical competence intervention

      research-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Rationale

          Correctional healthcare providers’ limited cultural and clinical competence to care for transgender patients represents a barrier to care for incarcerated transgender individuals.

          Objective

          The present study aimed to adapt, deliver, and evaluate a transgender cultural and clinical competence intervention for correctional healthcare providers.

          Method

          In the summer of 2016, a theoretically-informed, group-based intervention to improve transgender cultural and clinical competence was delivered to 34 correctional healthcare providers in New England. A confidential survey assessed providers’ cultural and clinical competence to care for transgender patients, selfefficacy to provide hormone therapy, subjective norms related to transgender care, and willingness to provide gender-affirming care to transgender patients before and after (immediately and 3-months) the intervention. Linear mixed effects regression models were fit to assess change in study outcomes over time. Qualitative exit interviews assessed feasibility and acceptability of the intervention.

          Results

          Providers’ willingness to provide gender-affirming care improved immediately post-intervention (β = 0.38; SE = 0.41, p < 0.001) and from baseline to 3-months post-intervention (β = 0.36; SE = 0.09; p < 0.001; omnibus test of fixed effects χ 2 = 23.21; p < 0.001). On average, transgender cultural competence ( χ 2 = 22.49; p < 0.001), medical gender affirmation knowledge ( χ 2 = 11.24; p = 0.01), self-efficacy to initiate hormones for transgender women, and subjective norms related to transgender care ( χ 2 = 14.69; p = 0.001) all significantly increased over time. Providers found the intervention to be highly acceptable and recommended that the training be scaled-up to other correctional healthcare providers and expanded to custody staff.

          Conclusion

          The intervention increased correctional healthcare providers’ cultural and clinical competence, selfefficacy, subjective norms, and willingness to provide gender-affirming care to transgender patients. Continued efforts should be made to train correctional healthcare providers in culturally and clinically competent gender-affirming care in order to improve the health of incarcerated transgender people. Future efficacy testing of this intervention is warranted.

          Related collections

          Author and article information

          Journal
          8303205
          7517
          Soc Sci Med
          Soc Sci Med
          Social science & medicine (1982)
          0277-9536
          1873-5347
          1 November 2017
          30 October 2017
          December 2017
          02 December 2017
          : 195
          : 159-169
          Affiliations
          [a ]Yale School of Public Health, United States
          [b ]The Fenway Institute, Fenway Health, United States
          [c ]University of California Los Angeles Fielding School of Public Health, United States
          [d ]Yale School of Medicine, United States
          [e ]Boston Children’s Hospital/Harvard Medical School, United States
          [f ]Harvard T.H Chan School of Public Health, United States
          Author notes
          [* ]Corresponding author. Yale School of Public Health, United States. jaclyn.white@ 123456yale.edu (J.M. White Hughto)
          Article
          PMC5712271 PMC5712271 5712271 nihpa916732
          10.1016/j.socscimed.2017.10.004
          5712271
          29096945
          e69266ff-331c-4c66-b245-0ac0f13f72f8
          History
          Categories
          Article

          Providers,Incarceration,Healthcare,Transgender,Intervention
          Providers, Incarceration, Healthcare, Transgender, Intervention

          Comments

          Comment on this article