Development of a telehealth intervention to promote care‐seeking among transgender women of color in Washington, DC

Magnus, Manya; Edwards, Elizabeth; Dright, Aurnell; Gilliam, Leandrea; Brown, Angela; Levy, Matthew E.; Sikka, Neal; Siegel, Marc; Criss, Vittoria; Watson, Christopher Chauncey; Machtinger, Edwards; Kuo, Irene

doi:10.1111/phn.12709

Cited by 17 publications

(10 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The developer engages the community on Tumblr, where updates are shared and user feedback is solicited (46). (103). The aim of the intervention was to leverage telehealth and mobile technology toward overcoming the structural barriers faced by many trans women of color when they try to secure healthcare access.…”

Section: Gender Affirmation Dimensionmentioning

confidence: 99%

“…The qualitative data focused on housing stability as a key determinant of health and wellbeing, the primacy of hormone access among healthcare needs, and pervasive experiences of discrimination, stigma, and medical mistrust. In turn, the peer-delivered telehealth model was adapted to provide users with convenience, individualized care, and relief from unwelcoming healthcare settings (103). In a small (N=25) feasibility study enrolling trans women of color with experiences of encountering structural barriers to care in the prior 6 months, the 3-month intervention was linked to significant increases in intention to seek TGE-responsive care, and intentions to seek specialty, mental health, and HIV care among users with depressive symptoms (104).…”

Section: Gender Affirmation Dimensionmentioning

confidence: 99%

See 1 more Smart Citation

mHealth for transgender and gender-expansive youth: harnessing gender-affirmative cross-disciplinary innovations to advance HIV prevention and care interventions

Skeen

Cain

Gamarel

et al. 2021

mHealth

View full text Add to dashboard Cite

Transgender and gender-expansive (TGE) youth endure stark disparities in health and wellbeing compared to their cisgender peers. A key social determinant of health for TGE adolescents and emerging adults is gender affirmation, which encompasses multidimensional validations of an individual's lived gender. Lacking available resources for one's gender affirmation, TGE young people may engage in highrisk maladaptive coping behaviors, linked to their disproportionately high HIV-acquisition risk. A range of innovative mobile technologies are guided by the Gender-Affirmative Framework to promote the health of TGE communities, including through HIV prevention and care continuum outcomes. The aim of this review was to examine key features of existing mobile technologies that can be leveraged to advance the field of TGE-responsive mHealth. We systematically searched scientific records, gray literature, and the iOS and Android app distribution services. To be eligible, platforms and interventions needed to be tailored exclusively to a TGE user base, incorporate gender-affirming features, and be optimized for or adaptive to mobile technologies. Eligible interventions (N=24) were compared on evidence of utility, core functionalities, and dimensions of gender affirmation. Smartphone applications (apps) and webapps (n=16) were the most common delivery modality. Many interventions (n=9) aimed to address HIV-related outcomes and integrated gender-affirmative features. The most common gender-affirmative features originated in fields of human-computer interactions and informatics, or were crowdfunded by TGE developers. HIV-focused interventions incorporated evidence-based health behavior change strategies and utilized rigorous evaluation methods. Across modalities and disciplines, behavioral self-monitoring and access to HIV prevention services were the most frequent features. Over two-thirds of the interventions reviewed aimed to provide medical gender affirmation (e.g, provided guidance on obtaining medically sanctioned hormone therapies, or safely practicing non-medical options such as chest-binding) or psychological gender affirmation (e.g, provided linkage to mental health counseling). Our results show that mHealth and other technology-mediated interventions offer a diverse range of both evidence-based and innovative features; however, many have not been rigorously evaluated in a randomized controlled trial to support TGE users. A continuing commitment to evidence-based health behavior change strategies, exemplified by the HIV-focused interventions included in this review, is essential to advancing gender-affirmative mHealth. The unique and highly innovative features of platforms originating outside the fields of HIV prevention and care suggest new directions for TGE-responsive mHealth, and the need for more conscientious models of knowledge exchange with investigators across scientific disciplines, private-sector developers, and potential users. mHealth, 2021

show abstract

Section: Gender Affirmation Dimensionmentioning

confidence: 99%

Section: Gender Affirmation Dimensionmentioning

confidence: 99%

mHealth for transgender and gender-expansive youth: harnessing gender-affirmative cross-disciplinary innovations to advance HIV prevention and care interventions

Skeen

Cain

Gamarel

et al. 2021

mHealth

View full text Add to dashboard Cite

show abstract

“…Both during and after the pandemic, telehealth has the potential to expand the reach of gender specialists. Data in adults suggest telehealth can reduce barriers to care by providing specialist support to PCPs [ 12 , 13 ], but this has only recently begun to be explored in youth for whom care is complex and assurances regarding privacy and confidentiality are essential [ 14 ]. The objective of this study was to examine transgender youth's interest in receiving gender-affirming care from gender specialists via telemedicine or from their PCP with telehealth support.…”

mentioning

confidence: 99%

Transgender Youths' Perspectives on Telehealth for Delivery of Gender-Affirming Care

Sequeira

Kidd

Coulter

et al. 2021

Journal of Adolescent Health

View full text Add to dashboard Cite

Purpose We aimed to examine transgender youths' interest in receiving gender-affirming care via telemedicine or through primary care with telehealth support. Methods We surveyed 12- to 26-year-old transgender youth receiving care in a multidisciplinary gender clinic. Descriptive statistics and bivariate analyses were used to assess relationships between demographic and gender-related characteristics and interest in receiving care via telemedicine. Results Almost half (47%) of the 204 youth surveyed expressed interest in receiving gender care via telemedicine. Additionally, youth with lower levels of perceived parental support were more likely to express an interest in utilizing telemedicine ( p = .001). Approximately half (45%) of youth were interested in receiving gender care in the primary care setting, with a majority expressing willingness to do so if their primary care provider had telehealth support. Conclusions Many transgender youth expressed interest in receiving gender care via telehealth, particularly for ongoing care and monitoring. Increased interest in telemedicine was seen among youth with lower perceived parental support.

show abstract

“…Based on formative data collection and community input described elsewhere, 26 a telehealth intervention was developed to increase intention to access primary and specialty health care services (primary aim) and increased selfreported service receipt (secondary aim). Due to the short length of follow-up (3 months preintervention that was compared with 3 months on the intervention), intention to seek care was selected as the primary aim.…”

Section: Description Of the Interventionmentioning

confidence: 99%

A Feasibility Study of a Telehealth Intervention on Health Care Service Utilization among Transgender Women of Color in Washington, DC

et al. 2018

Self Cite

View full text Add to dashboard Cite

Background Transgender women of color (TWC) are a medically underserved population who often experience substantial barriers to care. TWC experience high rates of stigma, violence, and entrenched barriers to receiving routine or specialty health services. Novel ways to improve access for TWC are urgently needed. Telehealth is one way to support TWC in overcoming barriers, yet this approach has been largely unexamined. The purpose of this study was to develop a TWC-specific telehealth intervention to increase access to primary and specialty care and then pilot test this intervention in a sample of TWC with at least one structural barrier to care. Methods Eligible participants were 18 years or older, identified as male sex at birth with a current gender identity of either female or transgender, a member of a racial/ethnic minority, and had experienced at least one study-defined structural barrier to primary or specialty care in the past 6 months. Following a 3-month preintervention phase, participants began a 3-month telehealth intervention which provided secure, remote access to trained, culturally appropriate, peer health consultants (PHCs) via video chat, e-mail, text, or phone. Health care utilization was assessed monthly via computer-assisted self-interview. Outcomes of intention to seek care in the next month and receipt of care in the past month were modeled using generalized estimating equations (GEE). Results Twenty-five eligible participants were enrolled in the study; a majority were black (96%), older than 25 years (69%), living with human immunodeficiency virus (HIV) (52%), and reported depressive symptomatology (67%). Of the 16 who had at least one pre- and one intervention data collection point, 13 downloaded the mobile video chat application and 7 participated in a qualitative exit interview. The intervention was associated with significantly (p < 0.05) increased odds of intention to seek transgender-specific care (adjusted odds ratio, aOR: 1.76 [95% confidence interval, CI: 1.001–3.08]); participants with depression defined by an elevated Center for Epidemiologic Studies 8-item depression scale (CES-D-8) score were significantly more likely to have intention to seek specialty care (aOR: 10.53 [95% CI: 1.42–77.97]), HIV-specific care (aOR: 2.56 [95% CI: 1.27–5.17]), and mental health care (aOR: 2.56 [95% CI: 1.27–5.17]) during the intervention period. Participants with elevated CES-D-8 scores had significantly greater odds of having sought HIV-specific care (aOR: 2.31 [95% CI: 1.31–4.06]) during the intervention period relative to those with lower scores. Conclusion These pilot data suggest that telehealth with remote access to PHCs who can provide immediate, culturally competent, nonclinical, education, and referral guidance may be effective in overcoming multiple barriers and improving care utilization outcomes for TWC. Telehealth may be an innovative, low-cost solution to improve health outcomes for populations with multiple barriers to health care services.

show abstract

Development of a telehealth intervention to promote care‐seeking among transgender women of color in Washington, DC

Cited by 17 publications

References 41 publications

mHealth for transgender and gender-expansive youth: harnessing gender-affirmative cross-disciplinary innovations to advance HIV prevention and care interventions

mHealth for transgender and gender-expansive youth: harnessing gender-affirmative cross-disciplinary innovations to advance HIV prevention and care interventions

Transgender Youths' Perspectives on Telehealth for Delivery of Gender-Affirming Care

A Feasibility Study of a Telehealth Intervention on Health Care Service Utilization among Transgender Women of Color in Washington, DC

Contact Info

Product

Resources

About