Providers are implementing some but not all best practices for communicating with LGBT adolescents about sexual health. They reported using open-ended questions, inclusive language, and emphasizing confidentiality, but not techniques like sensitive nonverbal communication, shared decision-making, storytelling, and engaging patients. Barriers included a lack of provider education and training as well as time constraints. Improving ongoing provider education around LGBT healthcare communication best practices could help address gaps in care.

1. Identifying the Gap Between Best Practices for and Implementation of
Lesbian, Gay, Bisexual and Transgender (LGBT) Adolescent
Sexual Healthcare Communication
Emily Gordon
Preceptor: Jeanelle Sheeder, PhD, MSPH
Site: University of Colorado School of Medicine – Ob/Gyn Dept.
Background: LGBT adolescents are a unique patient population that experiences adverse sexual
health outcomes at a higher rate than their heterosexual counterparts. Adolescent health visits
offer an opportunity to intervene. Sensitive and inclusive communication between adolescents
and their healthcare providers about sexual health could improve patient-provider relationships
which could lead to better health outcomes. What are the best practices for LGBT adolescent
sexual healthcare communication and are adolescent providers implementing them?
Methods: A review of the literature of adolescent healthcare communication revealed patient
preferences, guidelines and recommendations for best practices. Qualitative data were collected
from a focus group of adolescent healthcare providers at Children’s Hospital of Colorado and
family planning fellows at the University of Colorado School of Medicine to determine
implementation of best practices. Data were collected in October 2015 in Aurora, Colorado.
Inductive category development was used to analyze the data.
Results: Providers reported implementing the following best practices: reinforcing
confidentiality, using open-ended questions and inclusive language, and creating opportunities
for patient-led/patient-informed care. Providers did not report use of remaining best practices:
sensitive nonverbal communication, shared decision-making, story telling, and patient
engagement in healthcare. Provider education/training background, provider beliefs/assumptions
and time constraints were identified as communication modifiers.
Conclusions: Provider communication training should be on-going, include best practices and
evaluated regularly for providers to stay current with the changing field of LGBT healthcare
communication. The communication modifiers could be interpreted as opportunities upon which
provider communication programs and interventions could be based.