Facilitators and barriers to providing affirming care for transgender patients in primary care practices in Arkansas.

Autor: Marshall SA; Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA., Stewart MK; Department of Health Policy and Management, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA., Barham C; College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA., Ounpraseuth S; Department of Biostatistics, Fay W. Boozman College of Public Health/College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA., Curran G; College of Pharmacy/College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
Jazyk: angličtina
Zdroj: The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association [J Rural Health] 2023 Jan; Vol. 39 (1), pp. 251-261. Date of Electronic Publication: 2022 May 29.
DOI: 10.1111/jrh.12683
Abstrakt: Purpose: This study assessed factors affecting the provision of affirming-care best practices (ACBPs) for transgender individuals by primary care providers (PCPs) in a rural, southern state METHODS: We conducted a sequential explanatory mixed-methods study in 2020, including a statewide survey (phase 1) and interviews (phase 2). Surveyed PCPs (phase 1) included Medical Doctors/Doctors of Osteopathy (MDs/DOs), nurse practitioners, and 1 physician assistant. Interview participants (phase 2) included providers and staff in 6 practices throughout the state. We used an exploratory approach to data collection and performed content analysis to classify interview data into categories representing overarching themes RESULTS: Among surveyed PCPs who reported they had provided care to transgender patients (n = 35), the most common reason for providing gender-affirming medical services was "because of my ethical obligation to treat patients equally" (n = 27, 77%). The most common reason for not providing such services was because the PCPs "have not been trained/don't feel competent to provide these services" (n = 12, 34%). Interviews revealed the following themes: (1) willingness to provide "culturally competent care"; (2) continuum of accepting to affirming attitudes toward transgender individuals; (3) basic understanding of stigma and an awareness of its impact; (4) changes needed to provide "culturally competent care"; and (5) preferred clinical support strategies.
Conclusion: Training and education to provide ACBPs are warranted and would meet the needs of patients and providers. Facilitating telemedicine visits for transgender patients with gender-affirming care experts was a favorable implementation strategy for clinical support and is recommended to address access to affirming care.
(© 2022 National Rural Health Association.)
Databáze: MEDLINE
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