AHP Awarded Funding to Study LGTQIA+ Trauma Care

An LGBTQIA+ trauma care study proposed by the UCSF Alliance Health Project (AHP) research team is one of six national studies to secure funding from the Patient-Centered Outcomes Research Institute (PCORI). The study will compare the effectiveness of PTSD treatments within sexual and gender minority populations. The PCORI grant will support a five-year study.

High rates of post-traumatic stress disorder (PTSD) among LGBTQ+ people are a known fact. This is often accompanied by other mental health problems and experiences of unique risks such as discrimination and prejudice that may contribute to PTSD. The AHP study will be a long overdue look at which treatments are most helpful for PTSD in our communities. “LGBTQ+ populations tend to be very under-studied,” said Annesa Flentje, PhD, who will lead the study at AHP.

In addition to her work with AHP, Flentje is the Director of the UCSF Center for Sexual & Gender Minority Health and the UCSF Site Director of The PRIDE Study, the first large-scale, long-term national health study of people who identify as lesbian, gay, bisexual, transgender, queer, or another sexual or gender minority (LGBTQ+). The term sexual and gender minority (SGM) is used in clinical and research settings as an inclusive and consistent way to refer to our diverse communities. It describes individuals who are minorities related to their sexual orientation or gender, including but not limited to people who identify as LGBTQ+.

The AHP research project will compare two PTSD treatments that are known to work but have not been tested with LGBTQIA+ people: Cognitive Processing Therapy and STAIR Narrative Therapy. The study will look at which ones work the best for LGBTQ+ people in real-world settings. Many clinical studies assess whether an approach to care works under carefully controlled conditions in specialized settings, but health care is rarely delivered in such optimized situations. The AHP Services Center is an ideal “real-world” clinical practice and perfect for this exciting research.

The study is scheduled to begin in late 2023 and will reach patients across the state of California. It will recruit cisgender gay or bisexual men, cisgender lesbian or bisexual women, gender expansive or non-binary individuals of any sexual orientation, transgender women of any sexual orientation, and transgender men of any sexual orientation. The study will also recruit among people who live in urban versus rural or suburban areas, and among racial and ethnic minority LGBTQ+ people—populations that often have difficulty accessing PTSD treatment and LGBTQ+ affirming care.

According to PCORI Executive Director Nakela L. Cook, M.D., MPH. “this project was selected for PCORI funding not only for its scientific merit and commitment to engaging patients and other healthcare constituents but also for its conduct in real-world settings. It has the potential to answer an important question about trauma and PTSD in sexual and gender minorities and fill this crucial evidence gap.”

PCORI is an independent, nonprofit organization authorized by Congress in 2010. Its mission is to fund research that will provide patients, their caregivers and clinicians with the evidence-based information needed to make better-informed healthcare decisions. In the award letter, Dr. Cook wrote: “We look forward to following the study’s progress and working with AHP to share its results.”

The study was selected through a highly competitive review process in which patients, caregivers and other constituents joined scientists to evaluate the proposals. It was selected for funding through a PCORI program seeking broadly applicable research results that can be quickly taken up in routine clinical practices serving a diverse range of patients.

A stakeholder advisory board, including clinicians, administrators, and people involved in paying for health care, will provide feedback. In addition, a patient leadership team will meet with investigators monthly to offer feedback.

Results of the study will be shared through multiple methods, including providing training to providers in the final year of the project and creating videos and other materials to inform patient choices and clinic and clinician practices.