{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:13:11Z","timestamp":1788415991592,"version":"build-2803163510"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"\n Introduction<\/jats:title>\n Gay-affirmative practice is considered an important component of equitable healthcare for sexual minority patients. However, little is known about the factors associated with affirmative beliefs and professional behaviors among paramedics. This study aimed to identify factors associated with gay-affirmative beliefs and behaviors among Polish paramedics, with particular emphasis on the role of LGBT clinical competence.<\/jats:p>\n <\/jats:sec>\n \n Methodology<\/jats:title>\n A cross-sectional online survey was conducted between January and June 2025 among practicing paramedics in Poland. Participants completed a survey comprised of a sociodemographic questionnaire, the Polish version of the Lesbian, Gay, Bisexual, and Transgender Development of Clinical Skills Scale (LGBT-DOCSS), and the Polish version of the Gay Affirmative Practice Scale (GAP). Univariable and multivariable linear regression analyses were performed to identify factors independently associated with the Beliefs and Behaviors domains of the GAP. Clinical trial number: not applicable.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 172 paramedics were included in the final analysis (mean age 29.4\u202fyears, 51.2% women). Higher LGBT clinical competence was independently associated with both more affirmative beliefs (\n \u03b2<\/jats:italic>\n \u202f=\u202f3.85, 95% CI: 1.21\u20136.50,\n p<\/jats:italic>\n \u202f=\u202f0.005) and behaviors (\n \u03b2<\/jats:italic>\n \u202f=\u202f7.29, 95% CI: 4.62\u20139.96,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001). Having close relationships with LGBT individuals was independently associated with more affirmative beliefs (\n \u03b2<\/jats:italic>\n \u202f=\u202f6.40, 95% CI: 1.97\u201310.84,\n p<\/jats:italic>\n \u202f=\u202f0.005), whereas right-wing political orientation was independently associated with lower affirmative beliefs (\n \u03b2<\/jats:italic>\n \u202f=\u202f\u221212.26, 95% CI: \u221217.53 to \u22126.99,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001) and behaviors (\n \u03b2<\/jats:italic>\n \u202f=\u202f\u22126.74, 95% CI: \u221212.07 to \u22121.41,\n p<\/jats:italic>\n \u202f=\u202f0.013).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n LGBT clinical competence was the factor most consistently associated with gay-affirmative beliefs and behaviors among Polish paramedics. These findings suggest that higher LGBT clinical competence may represent an important factor associated with more affirmative beliefs and behaviors. Future studies should evaluate whether educational interventions aimed at strengthening LGBT clinical competence translate into more affirmative prehospital care for LGBT patients.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1919205","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:21:15Z","timestamp":1788412875000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors associated with gay-affirmative practice among polish paramedics: a cross-sectional study"],"prefix":"10.3389","volume":"14","author":[{"given":"Micha\u0142","family":"Czapla","sequence":"first","affiliation":[{"name":"Department of Emergency Medical Service, Faculty of Nursing and Midwifery, Wroclaw Medical University","place":["Wroc\u0142aw, Poland"]},{"name":"Group for Research in Healthcare (GRUPAC), Faculty of Health Science, University of La Rioja","place":["Logro\u00f1o, Spain"]},{"name":"Faculty of Nursing and Podology, Nursing Care and Education Research Group (GRIECE), University of Valencia","place":["Val\u00e8ncia, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Karniej","sequence":"additional","affiliation":[{"name":"Group for Research in Healthcare (GRUPAC), Faculty of Health Science, University of La Rioja","place":["Logro\u00f1o, Spain"]},{"name":"Faculty of Finance and Management, WSB MERITO University in Wroc\u0142aw","place":["Wroc\u0142aw, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ra\u00fal","family":"Ju\u00e1rez-Vela","sequence":"additional","affiliation":[{"name":"Group for Research in Healthcare (GRUPAC), Faculty of Health Science, University of La Rioja","place":["Logro\u00f1o, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krzysztof","family":"Griesmann","sequence":"additional","affiliation":[{"name":"Department of Emergency Medical Service, Faculty of Nursing and Midwifery, Wroclaw Medical University","place":["Wroc\u0142aw, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamil","family":"K\u0119dzierski","sequence":"additional","affiliation":[{"name":"Department of Emergency Medical Service, Faculty of Nursing and Midwifery, Wroclaw Medical University","place":["Wroc\u0142aw, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksander","family":"Mickiewicz","sequence":"additional","affiliation":[{"name":"Department of Emergency Medical Service, Faculty of Nursing and Midwifery, Wroclaw Medical University","place":["Wroc\u0142aw, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Mart\u00ednez-Sabater","sequence":"additional","affiliation":[{"name":"Group for Research in Healthcare (GRUPAC), Faculty of Health Science, University of La Rioja","place":["Logro\u00f1o, Spain"]},{"name":"Faculty of Nursing and Podology, Nursing Care and Education Research Group (GRIECE), University of Valencia","place":["Val\u00e8ncia, Spain"]},{"name":"Care Research Group (INCLIVA), Hospital Cl\u00ednico Universitario de Valencia","place":["Val\u00e8ncia, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Dissen","sequence":"additional","affiliation":[{"name":"School of Health Sciences, Stockton University","place":["Galloway, NJ, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u0141ukasz","family":"Pietrzykowski","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care, Antoni Jurasz University Hospital No. 1 in Bydgoszcz","place":["Bydgoszcz, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacek","family":"Smereka","sequence":"additional","affiliation":[{"name":"Department of Emergency Medical Service, Faculty of Nursing and Midwifery, Wroclaw Medical University","place":["Wroc\u0142aw, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"974","DOI":"10.1093\/eurpub\/cky226","article-title":"A review of lesbian, gay, bisexual, trans and intersex (LGBTI) health and healthcare inequalities","volume":"29","author":"Zeeman","year":"2019","journal-title":"Eur J Pub Health"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"11801","DOI":"10.3390\/ijerph182211801","article-title":"Health inequities in LGBT people and nursing interventions to reduce them: a systematic review","volume":"18","author":"Medina-Mart\u00ednez","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"114","DOI":"10.3390\/healthcare14010114","article-title":"Bias at the bedside: a comprehensive review of racial, sexual, and gender minority experiences and provider attitudes in 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