Online learning modules improve confidence in providing gender affirming care for youth.

Juanita K Hodax, Nicole F Kahn, Julia M Crouch, Janis L Sethness, Kevin M Bocek, Catherine Sumerwell, Gina M Sequeira
Author Information
  1. Juanita K Hodax: Division of Endocrinology, Department of Pediatrics, Seattle Children's Hospital, 4800 Sand Point Way NE, MS OC.7.920, Seattle, WA, 98105, USA. Juanita.hodax@seattlechildrens.org.
  2. Nicole F Kahn: Division of Adolescent Medicine, Department of Pediatrics, Seattle Children's Hospital, Seattle, WA, USA.
  3. Julia M Crouch: Division of Adolescent Medicine, Department of Pediatrics, Seattle Children's Hospital, Seattle, WA, USA.
  4. Janis L Sethness: Division of Adolescent Medicine, Department of Pediatrics, Seattle Children's Hospital, Seattle, WA, USA.
  5. Kevin M Bocek: Division of Adolescent Medicine, Department of Pediatrics, Seattle Children's Hospital, Seattle, WA, USA.
  6. Catherine Sumerwell: Division of Adolescent Medicine, Department of Pediatrics, Seattle Children's Hospital, Seattle, WA, USA.
  7. Gina M Sequeira: Division of Adolescent Medicine, Department of Pediatrics, Seattle Children's Hospital, Seattle, WA, USA.

Abstract

PURPOSE: Healthcare providers often lack training and education in caring for gender diverse youth. We aimed to explore changes in provider confidence and behaviors following the implementation of an online learning course focused on gender affirming care for youth.
METHODS: An asynchronous, online training consisting of 2 modules was made available in October 2021. Participants were asked to complete 3 surveys for each module they completed: a pre-survey, a post-survey, and a 3-month follow-up survey. Surveys included demographic data and an assessment of provider confidence and self-reported behaviors related to the provision of gender affirming care for adolescents that were in line with the objectives outlined in each module. Paired sample t-tests were used to compare participant confidence at all timepoints.
RESULTS: Participants (n = 487) completed at least one survey from one module. There was notable diversity in provider types, including mental health providers (n = 86, 17.7%), community health workers (n = 71, 14.6%), and medical students or health professionals (n = 61, 12.5%). Participants were significantly more confident in all aspects of care provision when comparing pre-surveys and post-surveys (p < 0.001 for all survey items focused on change in provider confidence ). At 3-month follow-up after module completion, improvements in confidence were sustained in providing information and resources to adolescents and their families, and having conversations with them about gender identity along with the importance of using affirming language. However, these modules did not result in self-reported behavior change regarding provision of gender affirming hormones or puberty blockers.
CONCLUSIONS: Online learning modules may be an effective means of educating a large number of healthcare providers about caring for gender diverse youth in a variety of settings and across disciplines.

Keywords

References

  1. Transgend Health. 2017 Jul 01;2(1):91-95 [PMID: 28861552]
  2. Pediatrics. 2016 Mar;137(3):e20153223 [PMID: 26921285]
  3. J Gerontol Soc Work. 2014;57(2-4):335-48 [PMID: 24341968]
  4. JAMA Pediatr. 2018 Dec 1;172(12):1145-1152 [PMID: 30304350]
  5. J Womens Health (Larchmt). 2015 Feb;24(2):114-8 [PMID: 25525682]
  6. J Adolesc Health. 2020 Jun;66(6):699-704 [PMID: 32273193]
  7. LGBT Health. 2020 Jul;7(5):237-247 [PMID: 32456545]
  8. JAMA Pediatr. 2021 Nov 1;175(11):1159-1173 [PMID: 34279538]
  9. J Am Acad Child Adolesc Psychiatry. 2017 Sep;56(9):739-746 [PMID: 28838578]
  10. J Med Educ Curric Dev. 2020 Jun 24;7:2382120520934813 [PMID: 32637641]
  11. J Adolesc Health. 2018 Oct;63(4):503-505 [PMID: 29609917]
  12. Bull World Health Organ. 2021 Apr 1;99(4):296-303 [PMID: 33953447]
  13. J Assoc Nurses AIDS Care. 2009 Sep-Oct;20(5):362-72 [PMID: 19732695]
  14. J Adolesc Health. 2016 Nov;59(5):489-495 [PMID: 27544457]
  15. J Adolesc Health. 2016 Sep;59(3):254-261 [PMID: 27235374]
  16. J Adolesc Health. 2017 Apr;60(4):425-430 [PMID: 28065519]
  17. Pediatrics. 2014 Oct;134(4):696-704 [PMID: 25201798]
  18. Can Med Educ J. 2016 Oct 18;7(2):e70-e78 [PMID: 28344694]
  19. BMC Health Serv Res. 2012 May 04;12:110 [PMID: 22559234]
  20. MedEdPORTAL. 2019 Jan 18;15:10796 [PMID: 30800996]
  21. J Clin Endocrinol Metab. 2017 Nov 1;102(11):3869-3903 [PMID: 28945902]
  22. Clin Teach. 2018 Jun;15(3):214-220 [PMID: 29573566]
  23. Teach Learn Med. 2015;27(3):254-63 [PMID: 26158327]
  24. Pediatrics. 2020 Feb;145(2): [PMID: 31974216]
  25. JAMA Netw Open. 2022 Feb 1;5(2):e220978 [PMID: 35212746]
  26. Adv Med Educ Pract. 2018 May 21;9:377-391 [PMID: 29849472]
  27. Perspect Med Educ. 2022 Dec;11(6):306-308 [PMID: 36435909]
  28. Pediatrics. 2022 Dec 1;150(6): [PMID: 36443242]
  29. Int J Transgend Health. 2022 Sep 6;23(Suppl 1):S1-S259 [PMID: 36238954]
  30. J LGBT Health Res. 2007;3(2):49-61 [PMID: 19835041]
  31. N Engl J Med. 2023 Jan 19;388(3):240-250 [PMID: 36652355]
  32. Transgend Health. 2023 Jul 28;8(4):307-327 [PMID: 37525832]
  33. J Dev Behav Pediatr. 2019 Oct/Nov;40(8):589-596 [PMID: 31166250]
  34. Am J Prev Med. 2020 May;58(5):707-714 [PMID: 32044143]
  35. JAMA. 2011 Sep 7;306(9):971-7 [PMID: 21900137]
  36. Curr Opin Endocrinol Diabetes Obes. 2016 Apr;23(2):168-71 [PMID: 26910276]
  37. J Adolesc Health. 2015 Feb;56(2):251-3 [PMID: 25620310]
  38. AIDS Behav. 2009 Oct;13(5):902-13 [PMID: 19199022]
  39. J Grad Med Educ. 2017 Apr;9(2):178-183 [PMID: 28439350]
  40. Arch Pediatr Adolesc Med. 2011 Feb;165(2):171-6 [PMID: 21300658]
  41. Fam Med. 2015 May;47(5):383-7 [PMID: 25905882]
  42. J Adolesc Health. 2015 Mar;56(3):274-9 [PMID: 25577670]
  43. J Adolesc Health. 2015 Oct;57(4):374-80 [PMID: 26208863]
  44. Rev Endocr Metab Disord. 2018 Sep;19(3):271-275 [PMID: 29922962]
  45. Acad Med. 2021 Jun 1;96(6):828-835 [PMID: 34031304]
  46. Can Med Educ J. 2018 Jul 27;9(3):e41-e55 [PMID: 30140346]

MeSH Term

Humans
Adolescent
Male
Female
Education, Distance
Health Personnel
Adult
Surveys and Questionnaires
Transgender Persons
Gender-Affirming Care

Word Cloud

Created with Highcharts 10.0.0genderconfidenceaffirmingcareyouthproviderlearningmodulesmoduleprovidersParticipantssurveyprovisionhealthOnlinetrainingcaringdiversebehaviorsonlinefocused3-monthfollow-upself-reportedadolescentsonechangeprovidingPURPOSE:HealthcareoftenlackeducationaimedexplorechangesfollowingimplementationcourseMETHODS:asynchronousconsisting2madeavailableOctober2021askedcomplete3surveyscompleted:pre-surveypost-surveySurveysincludeddemographicdataassessmentrelatedlineobjectivesoutlinedPairedsamplet-testsusedcompareparticipanttimepointsRESULTS:n = 487completedleastnotablediversitytypesincludingmentaln = 86177%communityworkersn = 71146%medicalstudentsprofessionalsn = 61125%significantlyconfidentaspectscomparingpre-surveyspost-surveysp < 0001itemscompletionimprovementssustainedinformationresourcesfamiliesconversationsidentityalongimportanceusinglanguageHoweverresultbehaviorregardinghormonespubertyblockersCONCLUSIONS:mayeffectivemeanseducatinglargenumberhealthcarevarietysettingsacrossdisciplinesimproveEducationGender

Similar Articles

Cited By