Pratt-Chapman Mandi L, Mullins Megan A, Gold Beck O, Insalaco Milena E, Rosenberg Dana, Miech Edward J, Kamen Charles
Department of Medicine, GW Cancer Center, The George Washington University School of Medicine and Health Sciences, Washington, DC.
Department of Health Economics, Systems, and Policy, O'Donnell School of Public Health, UT Southwestern Medical Center, Dallas, Texas.
JAMA Netw Open. 2025 Jun 2;8(6):e2516941. doi: 10.1001/jamanetworkopen.2025.16941.
Sexual orientation and gender identity (SOGI) are rarely collected in clinical practice despite national calls to do so.
To explore what facilitators are associated with collection of SOGI data in oncology practice.
DESIGN, SETTING, AND PARTICIPANTS: In this qualitative study with purposive sampling for greatest heterogeneity, semistructured interviews across 23 institutions were conducted in oncology practices in diverse geopolitical regions in the US from September 1, 2022, to August 31, 2023.
Interviews were transcribed, double coded using deductive coding based on the Consolidation Framework for Implementation Research, and inductively coded based on emergent themes.
Of 23 cancer centers, most were academic cancer centers (14 [61%]) and located in urban settings (17 [74%]); 7 sites (30%) sites systematically collected SOGI data, 11 (48%) partially collected SOGI data, and 5 (22%) did not collect SOGI data. A total of 62 interviews were conducted. Mean (SD) participant age was 46 (11) years; 26 (42%) identified as female. Facilitators associated with collection of SOGI data included external mandates, forced workflows in the electronic medical record, structured data fields, perception that SOGI data were relevant to clinical practice, and leadership support. Among sites that partially collected SOGI data, existence of champions, training for SOGI data collection, and perception of the relevance of SOGI to cancer care were facilitators associated with collection. Sites that systematically collected SOGI data offered more rigorous training on the importance of SOGI data collection for use in practice. Sites that did not collect SOGI data indicated that a mandate or top-down leadership requirement would likely be needed to catalyze SOGI data collection.
This qualitative study of implementation factors associated with SOGI data collection in outpatient oncology practices found that systematic SOGI data collection occurred in a few centers. Factors associated with SOGI data collection were multifaceted, involving both external mandates and internal factors. Despite the collection of SOGI data, their clinical use varied, suggesting a need for ongoing clinician education and development of strategies to improve the integration of SOGI data into patient care.
尽管国家呼吁在临床实践中收集性取向和性别认同（SOGI）信息，但在实际操作中却很少有人这么做。
探讨肿瘤学实践中与收集SOGI数据相关的促进因素。
设计、背景和参与者：在这项定性研究中，为实现最大程度的异质性进行了目的抽样，于2022年9月1日至2023年8月31日期间在美国不同地缘政治区域的肿瘤学实践机构中进行了23次半结构化访谈。
访谈内容被转录，基于实施研究整合框架采用演绎编码进行双重编码，并根据新出现的主题进行归纳编码。
在23个癌症中心中，大多数是学术性癌症中心（14个[61%]），且位于城市地区（17个[74%]）；7个机构（30%）系统地收集SOGI数据，11个（48%）部分收集SOGI数据，5个（22%）未收集SOGI数据。总共进行了62次访谈。参与者的平均（标准差）年龄为46（11）岁；26人（42%）为女性。与收集SOGI数据相关的促进因素包括外部指令、电子病历中的强制工作流程、结构化数据字段、认为SOGI数据与临床实践相关以及领导支持。在部分收集SOGI数据的机构中，倡导者的存在、SOGI数据收集培训以及认为SOGI与癌症护理相关是与收集相关的促进因素。系统收集SOGI数据的机构提供了关于SOGI数据收集在实践中重要性的更严格培训。未收集SOGI数据的机构表示，可能需要指令或自上而下的领导要求来推动SOGI数据收集。
这项关于门诊肿瘤学实践中与SOGI数据收集相关实施因素的定性研究发现，只有少数中心系统地收集SOGI数据。与SOGI数据收集相关的因素是多方面的，涉及外部指令和内部因素。尽管收集了SOGI数据，但其临床应用各不相同，这表明需要持续开展临床医生教育并制定策略，以改善将SOGI数据整合到患者护理中的情况。
