Storytelling to improve healthcare worker understanding, beliefs, and practices related to LGBTQ + patients: A program evaluation

• Published in: Evaluation and program planning 2022-02, Vol.90, p.101979, Article 101979
• Main Authors: Long, Amanda, Jennings, Jacky, Bademosi, Kehinde, Chandran, Aruna, Sawyer, Simone, Schumacher, Christina, Greenbaum, Adena, Fields, Errol L.
• Format: Article
• Language: English
• Subjects: Beliefs; Bias; Cultural competence; Disease prevention; Health care; Health care worker; Health disparities; Health education; Health equity; HIV; Human immunodeficiency virus; Implicit bias; LGBTQ; LGBTQ people; Medical distrust; Medical personnel; Patients; Polls & surveys; Prevention programs; Preventive medicine; Program evaluation; Qualitative research; Storytelling; Trust; Understanding
• ISSN: 0149-7189; 1873-7870
• DOI: 10.1016/j.evalprogplan.2021.101979

•Examined whether storytelling events changed health care workers understanding and practices related to LGBTQ + patients.•Analyzed surveys of HCW to measure differences in understanding, beliefs, and practices.•Used thematic analysis to explore written feedback/notes obtained as part of a reflective exercise at storytelling events.•Themes from written feedback/notes included improved understanding and new approaches for engaging LGBTQ + patients.•Attending an event was associated with more favorable beliefs and practices related to LGBTQ + patients. LGBTQ + persons experience significant health inequities and medical distrust resulting from anti-LGBTQ + bias or cultural incompetence from health care workers (HCW). This program evaluation examined whether storytelling events where LGBTQ + persons shared personal and patient experiences changed HCW understanding, beliefs, and practices related to LGBTQ + patients. Five storytelling events, held biannually in Baltimore, Maryland from 2016 to 2018, were evaluated using post-event surveys, written reflections/notes during the event, and a survey of HCW in a citywide care collaborative focused on HIV prevention and treatment for LGBTQ + persons that did and did not attend a storytelling event. We analyzed surveys to measure differences in understanding, beliefs and practices and used thematic qualitative analysis of written reflections/notes from the storytelling events. 416 persons attended storytelling events; 124(30 %) completed post-event surveys and 449 written reflections/notes were collected. 56 HCW completed post-event surveys; 49(87.5 %) strongly agreed/agreed they better understood LGBTQ + patients. Emergent themes from the 43 HCW written reflections/notes included improved understanding and new approaches for engaging LGBTQ + patients. Among HCW survey respondents (n = 111), attending an event was associated with significant differences in beliefs (p = 0.024) and practices (p = 0.000) related to LGBTQ + patients. Storytelling events may serve as effective tools for increasing HCW’s understanding, beliefs and practices. This strategy may ultimately help decrease anti-LGBTQ + bias, reduce medical distrust and lower barriers to HIV prevention/treatment for LGBTQ + persons.