Development and Validation of the Professional Readiness in Diversity and Equity Scale: Protocol for a Scale...

Lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI+) patients continue to experience stigma, discrimination, and inadequate knowledge among mental health and medical professionals. These barriers can negatively impact health care outcomes, leading to delayed treatment, mistrust, and unmet medical needs within LGBTQI+ communities. Providing culturally competent care to LGBTQI+ people remains a critical challenge within health and social care. The development and use of reliable and valid assessments examining LGBTQI+ health care professional competency continue to be important in understanding and ameliorating LGBTQI+ health inequalities.

The aim of the study is to develop and psychometrically validate a new multinational instrument designed to assess health care professionals' LGBTQI+ attitudes, awareness, general skills, and knowledge, as well as to examine LGBTQI+ workplace affirmative policies, support, and climate.

An initial pool of 100 new scale items was developed by reviewing existing LGBTQI+ health care scales and consulting with LGBTQI+ health care experts in the summer of 2023. Leading experts in LGBTQI+ health care were then asked to participate in the Delphi method to provide numeric and qualitative feedback on the 100 items. This process yielded a final primary survey comprising 39 test items. A cross-sectional multicenter, multicountry scale validation study using a web-based survey was administered to health care professionals and trainees in Italy, the United States, and the United Kingdom between October 2024 and December 2025 using a convenience sampling approach complemented by snowball recruitment. Research participants were asked to complete a demographic and professional survey, the 39 new test items, the 18-item Lesbian, Gay, Bisexual, and Transgender Development of Clinical Skills Scale (LGBT-DOCSS), and the 12-item Workplace Support subscale of the LGBT Climate Inventory (LGBTCI).

Funding commenced in May 2023, and data collection was conducted from October 2024 to December 2025. A total of 1339 eligible people completed the survey. Data analysis has started, and results will be reported in theautumn of 2026. It is anticipated that the Professional Readiness in Diversity and Equity (PRIDE) scale will emerge as a reliable and valid tool for assessing health care professionals' LGBTQI+ attitudes, awareness, general skills, and knowledge, as well as examining LGBTQI+ workplace affirmative policies, support, and climate. The instrument may also serve as a useful outcome measure in research evaluating professional practice and development.

The development and validation of the new PRIDE scale represent a significant advancement toward improved cultural competence among health care professionals. Validating the scale in both English- and Italian-speaking populations will support the development of international interventions and, ultimately, treatment outcomes for LGBTQI+ people. The PRIDE scale has the potential to exert a far-reaching impact on the delivery of clinical care and public health services worldwide.