Difference-making pathways to implementing systematic, partial, or no data collection of sexual orientation and gender identity in oncology settings: a coincidence analysis.

backgroundSystematic collection of sexual orientation and gender identity (SOGI) data has been promoted by national organizations to identify and address LGBTQ+ (i.e., lesbian, gay, bisexual, transgender, queer, etc.) health disparities across the cancer care continuum. The purpose of this study was to identify key difference-making pathways distinguishing cancer care settings that systematically collect SOGI data from those that partially collect or do not collect SOGI data in oncology practice settings.

methodsFrom September 2022 to August 2023, interviews (n = 62) were conducted in oncology practices (n = 23) diverse in geographic location, affiliation, patient mix, size, and setting. Interviews were scored using a 5-point scale ranging from +2 to -2, with +2 representing a strong positive effect and -2 a strong negative effect based on the influence of each construct on SOGI data collection at the practice level. Coincidence analysis was conducted to identify difference-making facilitators and barriers to SOGI data collection.

resultsTwo metafactors involving three constructs consistently distinguished practices with systematic, partial, or no SOGI data collection. One metafactor acted as a facilitator (a "metafacilitator") that was found across all seven sites reporting systematic SOGI data collection and consisted of the presence of either the maximum level of training or the maximum level of information technology (valence of +2). One metafactor served as a barrier (a "metabarrier") that was found in four of five sites reporting no SOGI data collection and represented the combined presence of negative values (-1 or -2) for both training and leadership support. The pathway that accounted for 10 of the 11 sites with partial SOGI data collection was the absence of both the metafacilitator and the metabarrier: that is, neither having a +2 score for the training construct or the information technology construct nor having negative values for both the training construct and the leadership support construct.

conclusionsThis analysis identified a difference-making metafacilitator and metabarrier that consistently distinguished between three levels of SOGI data collection. The training construct appeared in both the metafacilitator and the metabarrier at different values, underscoring its crucial importance for SOGI data collection initiatives.

trial registrationNot applicable.