Vanderbilt University School of Nursing, Nashville, Tennessee.
Center for Sexuality and Health Disparities, University of Michigan School of Nursing, Ann Arbor, Michigan.
J Rural Health. 2019 Jun;35(3):362-373. doi: 10.1111/jrh.12322. Epub 2018 Sep 10.
PURPOSE: Health disparities among LGBTQ people have been documented across various settings and recent research has indicated that many disparities are heightened in the context of rurality. Among these disparities is the decreased rate of primary care utilization by rural LGBTQ individuals. Understanding and addressing provider knowledge and attitudes related to LGBTQ health provides a relevant avenue for addressing underutilization. METHODS: The study presented was a mail-out survey regarding rural primary care providers' knowledge and experiences regarding LGBTQ health. Publicly available records were compiled to recruit a total sample of 113 primary care providers, at a response rate of 19.8%. FINDINGS: A majority of respondents reported experience providing care to LGBTQ patients, while only slightly over half had received LGBTQ health education. Data analyses revealed significant associations between reported experiences and patient characteristics including religion, religiousness, age, length of time practicing in current provider role, and gender identity. Provider knowledge of LGBTQ health varied greatly across the items assessed. Provider profession (physician, nurse practitioner, physician assistant) and length of current county residence were significantly predictive of LGBTQ knowledge scores. CONCLUSION: Results provide insight into rural health care for LGBTQ people. Preeminent findings were: (1) an existing need for LGBTQ health education, (2) variation in knowledge across content areas, and (3) association between knowledge, profession, and length of current county residence. Promotion of rural LGBTQ health may benefit by addressing identified gaps in current care.
目的: LGBTQ 人群在各种环境中存在健康差距,最近的研究表明,在农村环境中,许多差距更加突出。这些差距包括农村 LGBTQ 个人初级保健利用率降低。了解和解决与 LGBTQ 健康相关的提供者知识和态度为解决利用不足提供了一个相关途径。
方法:本研究是一项关于农村初级保健提供者 LGBTQ 健康知识和经验的邮寄调查。通过公开可用的记录,共招募了 113 名初级保健提供者,回复率为 19.8%。
发现:大多数受访者报告有为 LGBTQ 患者提供护理的经验,而只有略多于一半的人接受过 LGBTQ 健康教育培训。数据分析显示,报告的经验与患者特征之间存在显著关联,包括宗教、宗教信仰、年龄、当前提供者角色的从业时间长短以及性别认同。提供者对 LGBTQ 健康的知识在评估的项目上差异很大。提供者的专业(医生、护士从业者、医师助理)和当前县居住时间长短是 LGBTQ 知识得分的显著预测因素。
结论:研究结果为了解农村 LGBTQ 人群的医疗保健提供了深入的见解。突出的发现包括:(1)LGBTQ 健康教育培训的现有需求,(2)知识在不同内容领域的差异,以及(3)知识、专业和当前县居住时间之间的关联。通过解决当前护理中的差距,可能会促进农村 LGBTQ 健康。
Rural Remote Health. 2019-11
Health Promot Pract. 2019-3