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Cultural Humility: A Way to Reduce LGBTQ Health Disparities at the End of Life.
Am J Hosp Palliat Care 2019; :1049909119880548AJ

Abstract

Sexual and gender minorities experience disparities throughout the life course. These are especially detrimental at the end-of-life and can include disenfranchised grief, homophobia and transphobia from medical staff, and forced outing. The best healthcare training approach to ameliorate health disparities is debated. Cultural competency trainings for clinicians have been commonly proposed by major medical institutions and certifying bodies to ameliorate lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) health disparities. However, cultural competency trainings have limitations, including (1) false competence, (2) measurement issues, and (3) ecological fallacy (i.e., assuming individuals conform to the norms of their cultural group). The purpose of this commentary is to describe the limitations of cultural competency training and argue for healthcare systems to implement cultural humility trainings as a way to reduce LGBTQ health disparities at the end-of-life. The strengths of cultural humility training include focus on (1) individuals instead of their cultural groups, (2) self-reflection, and (3) active listening. While there are challenges to implementing cultural humility trainings in the health-care system, we assert that these trainings align with the aims of healthcare systems and can be an essential tool in reducing LGBTQ health disparities. We suggest practical components of successful cultural humility trainings including leadership buy-in, appropriate outcome measurements, multiple training sessions, and fostering a safe reflection space.

Authors+Show Affiliations

Department of Supportive Oncology, Levine Cancer Institute, Charlotte, NC, USA.Department of Supportive Oncology, Health Services Researcher, Levine Cancer Institute, Charlotte, NC, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31607141

Citation

Sprik, Petra, and Danielle Gentile. "Cultural Humility: a Way to Reduce LGBTQ Health Disparities at the End of Life." The American Journal of Hospice & Palliative Care, 2019, p. 1049909119880548.
Sprik P, Gentile D. Cultural Humility: A Way to Reduce LGBTQ Health Disparities at the End of Life. Am J Hosp Palliat Care. 2019.
Sprik, P., & Gentile, D. (2019). Cultural Humility: A Way to Reduce LGBTQ Health Disparities at the End of Life. The American Journal of Hospice & Palliative Care, p. 1049909119880548. doi:10.1177/1049909119880548.
Sprik P, Gentile D. Cultural Humility: a Way to Reduce LGBTQ Health Disparities at the End of Life. Am J Hosp Palliat Care. 2019 Oct 13;1049909119880548. PubMed PMID: 31607141.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cultural Humility: A Way to Reduce LGBTQ Health Disparities at the End of Life. AU - Sprik,Petra, AU - Gentile,Danielle, Y1 - 2019/10/13/ PY - 2019/10/15/entrez KW - LGBTQ KW - cultural competence KW - cultural humility KW - end of life KW - health disparities KW - training SP - 1049909119880548 EP - 1049909119880548 JF - The American journal of hospice & palliative care JO - Am J Hosp Palliat Care N2 - Sexual and gender minorities experience disparities throughout the life course. These are especially detrimental at the end-of-life and can include disenfranchised grief, homophobia and transphobia from medical staff, and forced outing. The best healthcare training approach to ameliorate health disparities is debated. Cultural competency trainings for clinicians have been commonly proposed by major medical institutions and certifying bodies to ameliorate lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) health disparities. However, cultural competency trainings have limitations, including (1) false competence, (2) measurement issues, and (3) ecological fallacy (i.e., assuming individuals conform to the norms of their cultural group). The purpose of this commentary is to describe the limitations of cultural competency training and argue for healthcare systems to implement cultural humility trainings as a way to reduce LGBTQ health disparities at the end-of-life. The strengths of cultural humility training include focus on (1) individuals instead of their cultural groups, (2) self-reflection, and (3) active listening. While there are challenges to implementing cultural humility trainings in the health-care system, we assert that these trainings align with the aims of healthcare systems and can be an essential tool in reducing LGBTQ health disparities. We suggest practical components of successful cultural humility trainings including leadership buy-in, appropriate outcome measurements, multiple training sessions, and fostering a safe reflection space. SN - 1938-2715 UR - https://www.unboundmedicine.com/medline/citation/31607141/Cultural_Humility:_A_Way_to_Reduce_LGBTQ_Health_Disparities_at_the_End_of_Life L2 - http://journals.sagepub.com/doi/full/10.1177/1049909119880548?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -