Sex and gender minority people (SGM, i.e., lesbian, gay, bisexual, transgender, queer,
and other people of diverse sexual orientation or gender identity (SOGI) experience
significant cancer-related health disparities across the cancer continuum. SGM people
have an increased risk for some cancers, may be diagnosed at more advanced stages of the
disease, and have poor mental health outcomes. Despite calls from national organizations
for systematic collection of SOGI data, this information is not routinely collected in
health research or clinical health records, perpetuating the invisibility of SGM people
in research and clinical care and fueling health disparities. Systematic and standardized
collection of SOGI data is necessary for assessing cancer-related health outcomes through
cancer registries, for comparing outcomes and care delivery in clinical trials, and for
providing culturally relevant care for SGM people. Barriers to systematic SOGI data
collection come from patient, clinician, and system levels. Multilevel barriers to SOGI
data collection require a multilevel approach to create standardized, systematic program
implementation and evaluation at cancer centers across the country. Barriers and best
practices for SOGI data collection likely differ by region and institutional history and
culture. Ohio is traditionally a conservative 'red' state, with large rural and
Appalachian regions. The catchment area for The Ohio State University Comprehensive
Cancer Center (OSUCCC) encompasses Ohio's 88 counties and nearly 11.8 million people --
many of whom come from diverse, and often underserved, populations including urban,
rural, Appalachia, immigrant, Amish, and SGM communities. Thus, OSUCCC is well-positioned
to make a significant impact in the health of SGM Ohioans through systematic SOGI data
collection and improved SGM-sensitive clinical care and culture. The overall goal of this
Administrative Supplement is to assess multi-level barriers associated with SOGI data
collection as well as implementation factors including feasibility, acceptability, and
data completeness. To accomplish this goal, the investigators propose two aims. First,
the investigators will develop effective strategies to collect SOGI data based on
barriers and facilitators identified at the patient, staff/provider, and cancer center
levels. The investigators will accomplish this through community and patient focus
groups, staff/provider interviews, and a cancer center environmental scan. Second, the
investigators will implement a systematic SOGI data collection program at the patient,
staff/provider, and cancer center levels with systematic program evaluation at all
levels. The investigators will accomplish this through patient self-report,
staff/provider training, and changes in cancer center medical record, policy, and
environment of care. This proposal is innovative because our SOGI data collection program
operates at multiple levels within the healthcare delivery context and includes both
central medical campuses and satellite clinics. The results of this study will make a
significant impact by 1) making SOGI data available for cancer registries, 2) addressing
factors associated with implementation in a large comprehensive cancer center, and 3)
informing culturally responsive cancer care for SGM Ohioans.