Practicum Highlight: Sara Rodriguez, MPH'24

Empowering Healthcare Equity: A Mixed Methods Study on lntersex Data Collection

Sara Rodriguez had worked in healthcare research and delivery in the Boston area for more than a decade when she enrolled in Dartmouth's 22-month online/hybrid master’s of public health program, intent on building the skills she would need for a leadership role in health equity promotion. As a data quality and program evaluation specialist at Fenway Institute and the Fenway Health Department of Public Health since 2018, Rodriguez designs and monitors evaluation plans and data collection for a healthcare system and research institute that centers and promotes health and well-being for sexual and gender minorities (SGM) and those affected by HIV.

For her MPH practicum, Rodriguez zeroed in on the needs and values of intersex people, individuals who experience a range of chromosomal, hormonal, or anatomical differences from the male-female binary.“Healthcare data fails to capture intersex individuals due to inadequate sexual orientation and gender identity data collection methods, leading to a lack of representation,” says Rodriguez. “The literature is very poor.”As a result, healthcare centers struggle to learn more about the population they serve, measure access to care, and evaluate the quality of care they provide to all gender identities, even as evidence mounts that intersex people experience a higher incidence of anxiety, depression, and psychological distress related to stigma and discrimination, as well as the health inequities common to people throughout the LGBTQIA population, including HIV, chronic illnesses, mental health issues, and substance use.

Rodriguez and her preceptor designed a two-phase, mixed methods study to collect community input and guidance on how and where to collect sexual orientation and gender identity data from intersex people in medical settings. In Phase I, Rodriguez designed an IRB-approved protocol and recruited focus group participants to provide guidance on how to phrase effective intersex-related questions for medical settings. For Phase II of the project, she incorporated that feedback into a quantitative survey to guide the inclusion of intersex-related questions in the Fenway Health patient registration process. To disseminate her findings beyond Fenway, Rodriguez and her preceptor plan to publish their findings and make conference presentations that help other healthcare systems provide more inclusive and culturally competent care for their intersex patients.“The cultural competency needed in practical, real-world situations turned out to be quite different from what I had anticipated, despite my previous experience working with diverse communities like the LGBTQIA+,” says Rodriguez. “Balancing respectful and inclusive interactions posed a challenge, but it was ultimately fulfilling.”

Written by: Sharon Tregaskis

POSTED 3/25/2024 AT 02:47 PM IN #practicum