LGBTQ training for obstetrical care providers in two urban settings: An examination of changes in attitudes, knowledge, and intended behavior

Recent progress in the LGBTQ civil rights movement, particularly regarding marriage equality rights, has set into motion a growing awareness of non-traditional family configurations. The need for a paradigm shift is especially evident in obstetrical (OB) health care settings, where gender and sexual diversity challenge providers to shift away from traditional heterosexist and cissexist thinking and language when caring for patients. A small, but growing, body of literature has documented the ways in which LGBTQ-inclusive OB care is similar to and different from traditional heteronormative OB care. Therefore, to best serve diverse childbearing populations, doctors, nurses, and midwives need to be adequately educated about LGBTQ health issues. To date, there have been no studies that have evaluated the effect of OB provider education on their knowledge, attitudes, and intended practice behaviors with LGBTQ obstetrical patients. Therefore, the purpose of the current study was to determine if a 20 to 40 minute LGBTQ-focused training could change OB health providers' knowledge, attitudes, and intended behavior toward their LGBTQ childbearing patients. Data were collected from eight sites in two large urban centers, Chicago and Philadelphia, in a quasi-experimental study using a pretest and posttest design. A total of 99 providers attended the LGBTQ training and 88 providers attended a training that had nothing to do with LGBTQ issues. The results of the pretest and posttests were compared to identify differences between the two groups. An analysis of main effects and a repeated measures analysis of variance revealed a significant difference between providers who received the training and providers who did not receive the training. Providers who received the LGBTQ training reported significant increases in preparation, knowledge, and sensitivity to language, and decreases in prejudice towards LGBTQ patients, heteronormative perspective, and misconceptions about LBGTQ patients compared to providers in the control condition. Post-hoc analyses identified regional differences in knowledge, attitudes and behaviors between Chicago and Philadelphia obstetrical healthcare providers prior to the training. This study suggests that not only is it possible to develop and deliver an LGBTQ training specifically geared toward OB healthcare providers, but that a 20 to 40 minute presentation can significantly impact providers knowledge, attitudes and intended practice behaviors. Further research is needed to evaluate if these immediate changes in knowledge and attitudes are sustained over time and if OB providers changed their practice behaviors with LGBTQ patients following the presentation.