Systematic review of educational interventions on older LGBT+ adults: recommendations for practice, education and research

Aim of the review: Research demonstrates that inequalities in outcomes on health and social wellbeing for LGBT+ older adults are perpetuated by a lack of inclusive services and cultural competence among the health and social care workforce. The aim of this review is to describe the educational interventions used to educate health and social care practitioners on the needs of older LGBT+ adults and the impact of such interventions on practitioners' knowledge, attitudes and competence. Search and review methodology: A systematic search of peer-reviewed papers published before February 2020 was conducted in the electronic databases MEDLINE, CINAHL, PsycINFO, EMBASE, ERIC, Social Sciences Full Text and Web of Science. The search resulted in a screening of 2509 papers with 9 matching the inclusion criteria which were rated using the MERSQI quality measure. Findings: Positive outcomes were demonstrated across the studies, especially an increase in knowledge. Increases in skills and attitudes was less evident, especially in studies using shorter and less diverse intervention designs. Findings suggest that interventions that incorporate diverse teaching strategies, especially interactive experiential activities such as storytelling and inclusion of LGBT+ older adults, leads to higher engagement, increased awareness and empathy in participants. Conclusions and implications: Professional and vocational education is an important tool to improve cultural competency. Findings suggest that educators need to diversify intervention contents, approach LGBT+ education from an interdisciplinary perspective and involve LGBT people in the design, delivery and evaluation of education. This may have a positive impact on transfer of learning into practice and provide a more sustainable approach in addressing LGBT+ ageing inequalities in practice settings. Findings also suggest that researchers need to develop more robust study designs such as randomized controlled trials and focus on the longitudinal effects of educational interventions, which could improve the quality of study designs. Ethical approval: Ethical approval was not necessary.