Development and evaluation of the Australian cancer LGBTIQ+ Toolkit (CanLIT)

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OBJECTIVES: Oncology healthcare professionals (HCPs) consistently report low knowledge and confidence in caring for LGBTIQ+ patients, contributing to inequities in cancer care. This study developed and evaluated the Australian Cancer LGBTIQ+ Inclusivity Toolkit (CanLIT) comprising training modules, inclusion strategies and information resources for working with LGBTIQ+ cancer patients and carers. METHODS: CanLIT was based on the findings of the Out with Cancer Study, co-designed with key stakeholders, and evaluated against national panel consensus recommendations for LGBTIQ+ cultural competency training standards, encompassing learner knowledge, attitudes, intention to change, and training acceptability. RESULTS: One hundred and forty-one learners completed four online training modules and pre-post surveys. Eleven participants were interviewed. Participants demonstrated significant (p < .001) gains in knowledge, confidence, support for LGBTIQ+ inclusivity, and intention to engage in inclusive practice, alongside reduced anti-inclusion beliefs. While overall comfort with LGBTIQ+ patients did not change significantly, likely due to high baselines, comfort increased for treating sexuality-diverse (LGBQ) and intersex patients. Participants endorsed CanLIT as relevant, high quality, and easy to understand, and would recommend it to colleagues. Participants identified implementation barriers, including IT and administrative systems blocking SOGI data collection and preferred names, and fear of causing offence and uncertainty about language. CONCLUSION: CanLIT is a promising, evidence-based training package associated with increased knowledge, confidence, and support for LGBTIQ+ inclusion in cancer care. Following minor modifications, CanLIT is freely available nationally through the Cancer Institute NSW EviQ Education platform. PRACTICE IMPLICATIONS: LGBTIQ+ inclusivity training should be a core component of professional development for all cancer healthcare workers. Training should be supplemented with supervised practice such as simulation and role play to build clinical comfort. Health services need to invest in information infrastructure accommodating preferred names, pronouns, and SOGI data collection. Sustaining change requires ongoing organisational support, including refresher education, peer mentoring, and visible leadership commitment.

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