Educating Service Providers: A Community-Based Intervention to Support Lgbtq Youth

Background and Purpose:

Lesbian, gay, bisexual, transgender and queer (LGBTQ) youth experience disparities in their health and mental health.  These disparities may provide increased opportunities for interactions with health and social service providers as young people seek treatment, contributing to recommendations for additional population-specific training to reduce marginalization and improve care (Lambrese & Hunt, 2012; Travers et al., 2010).  However, research detailing the effectiveness of affirmative educational initiatives is scarce.  This study evaluated a Community-Based Educational Intervention (CBEI) developed to increase participant knowledge, skills and intention to take action to support LGBTQ youth.  The CBEI utilized the Information-Motivation-Behavioral Skills (IMB) model (Fisher & Fisher, 1992) based on previous research describing important elements in professional training for working with LGBTQ populations.  In designing the CBEI, consideration was given to effectively educating individuals across the life course.

Methods:

This pilot study used a post-test-only pre-experimental design to investigate self-reported learning outcomes through completion of a survey following participation (2008-2011).  A sub-sample (n=2850) of the total participants who participated in the training (n=8550) was randomly selected for analysis in SPSS.  Participants ranged in age from under 18-66 and were students or practitioners from a variety of service-providing professions (e.g., health, education, law).  They were primarily female (67%), Hispanic (49%), and straight (81%). There was minimal missing data (0-3%) and bias corrected bootstrapping methods were employed.  The measure was a compilation of questions from the Sample Participant Satisfaction Evaluation Form (CDC, 2006) and the Knowledge and Attitudes Scale for Heterosexuals(Worthington et al., 2005).  Four questions addressed behavioral intention (BI) to implement the results of the CBEI, and results were dichotomized into ‘intend to act’ or ‘do not intend to act’.  A logistic regression was conducted to identify the contribution of training components on BI in a test of the IMB approach.

Results:

Participants generally found the CBEI to be a positive experience; mean scores on training components all fell into the ‘agree’ range. With regard to BI, 80% of participants intended to take at least one action to support LGBTQ youth as a result of their participation.  The full model was statistically significant, indicating associations between the factors influencing BI were significant (χ²=398.29/27, p<.001), reflecting a moderate relationship (Nagelkerke’s R²=.28).  The odds of BI were significantly higher when trainings were: experientially relevant (OR=1.3); sensitive (OR=1.3); developed skills (OR=1.1); and/or incorporated policy (OR=1.2).  Health professionals had higher odds of BI (OR=1.7) following the training than other professions.  Finally, straight participants reported lower likelihood of BI (OR= -.123) compared to their LGBTQ colleagues.

Conclusions and Implications:

These pilot results suggest CBEIs may be contribute to participant knowledge about LGBTQ youth that can enhance participant BI.  Newly acquired knowledge, skills and self-efficacy may encourage participants to support LGBTQ youth, facilitating a level of professional and cultural competence.  Implications for research initiatives and delivery of community-based trainings will be considered, including ways such IMB interventions can be made most effective with participant groups who are diverse in terms of age, occupation and sexuality.