Statewide Implementation of Sexual Orientation and Gender Identity (SOGI) Data Collection to Advance Health Equity

About This Grant

Abstract National health authorities point to collecting sexual orientation and gender identity (SOGI) data as essential to systematically addressing the health and healthcare needs of sexual- and gender-diverse (SGD) people across all domains of life. The State of New Mexico answered this call by directing all its government agencies, including those overseeing or financing health and human service delivery, to collect voluntary self-reported SOGI data. These vital (a) illuminate the nature and extent of disparities and adverse health outcomes for a minoritized population, (b) encourage patient-centered care, and (c) develop equity-focused evidence-based interventions (EFEBIs) to eliminate long-standing disparities. New Mexico is a bellwether for other states wanting to routinize processes for robust demographic analyses of SGD people, enhance coordination of health services, guide policy and funding decisions, advance EFEBIs for their varied citizenries and monitor progress toward health equity for SGD people. New Mexico's health department (NMHealth) operates 53 public health offices (PHOs)— ideal settings for analyzing the uptake and sustainment of SOGI data collection. Staffed in large part by nurses, PHOs are a critical safety net for racially, ethnically, and geographically diverse communities in New Mexico, offering a wide range of health services, from immunizations, family planning, nutritional programming, substance use harm reduction, testing and treatment for sexually transmitted infections, cancer prevention and control, and other medical care across the lifespan. This multilevel, mixed-method R01 study will test the acceptability, appropriateness, and feasibility of implementation strategies in PHOs to enable SOGI data collection with different populations and in urban, rural, and frontier contexts. Guided by the Interactive Systems Framework, our interdisciplinary team will (1) assess gaps in implementation readiness to engage in accurate, reliable, and usable SOGI measurement in PHOs; and apply implementation mapping to systematically select and tailor implementation strategies to address barriers; (2) deploy and evaluate identified implementation strategies to enable SOGI data collection in PHOs in a sequential multiple assignment randomized trial (SMART); and (3) use the Discover, Design, Build, and Test framework to develop an online toolkit integrating manualized implementation strategy resources to disseminate SOGI data collection in service delivery settings. Our team of researchers, healthcare providers, and patient advocates are poised to foster use of implementation strategies for inclusive SOGI data collection, so the state and nation are prepared to identify, analyze, and advance EFEBIs to intervene in the alarming disparities negatively shaping SGD health and well-being. Through the innovative use of models and methods from dissemination and implementation science, our team's overall goal is to tackle a long-running, perplexing problem—the rampant deficiencies in state-sponsored data collection systems that abet the invisibility of SGD people in public health, medical, and human service records, thwart the development of EFEBIs, and buttress poor health outcomes.