Development of a telehealth intervention to promote care-seeking among transgender women of color in Washington, DC.
Adult
Cross-Sectional Studies
District of Columbia
Ethnicity
/ psychology
Female
Focus Groups
Health Services Accessibility
/ statistics & numerical data
Humans
Male
Patient Acceptance of Health Care
/ statistics & numerical data
Qualitative Research
Racial Groups
/ psychology
Telemedicine
/ organization & administration
Transgender Persons
/ psychology
access to care
health disparities
tailored intervention development
telehealth
telemedicine
transgender health
Journal
Public health nursing (Boston, Mass.)
ISSN: 1525-1446
Titre abrégé: Public Health Nurs
Pays: United States
ID NLM: 8501498
Informations de publication
Date de publication:
03 2020
03 2020
Historique:
received:
09
04
2019
revised:
21
11
2019
accepted:
05
01
2020
pubmed:
6
2
2020
medline:
10
2
2021
entrez:
5
2
2020
Statut:
ppublish
Résumé
Transgender women of color (TWC) are an underserved population who often experience high rates of HIV and barriers to care including stigma, violence, and trauma. Few health information technology interventions are tailored to serve TWC. The purpose of this study was to inform the development of a TWC-specific telehealth intervention to increase access to care. Formative qualitative semi-structured interviews and focus groups were conducted to develop a customized telehealth intervention for TWC. Participants were TWC ≥ 18 years living in the Washington, DC metropolitan area, with at least one structural barrier to care and clinicians ≥18 years who provide care to TWC. Transcripts were analyzed using thematic coding and content analysis; barriers for TWC were categorized into Individual, Organizational, and Environmental levels. Several day-long meetings with TWC and stakeholders were convened to develop the intervention. Saturation of theme on barriers to care was reached with 22 interviews. Identified barriers to service receipt included survival, instability, temporal discounting, and prioritizing hormone therapy over care, incongruence between providers and patients, pessimism, and lack of cultural competency. Each was intentionally addressed with the telehealth intervention. Data informed the development of an innovative and customized telehealth intervention for TWC. Through the integration of technology and peer consultant outreach, we developed a novel approach that can address population-specific challenges to care. Further development of this model may be able to improve health outcomes among TWC.
Sections du résumé
BACKGROUND
Transgender women of color (TWC) are an underserved population who often experience high rates of HIV and barriers to care including stigma, violence, and trauma. Few health information technology interventions are tailored to serve TWC. The purpose of this study was to inform the development of a TWC-specific telehealth intervention to increase access to care.
METHODS
Formative qualitative semi-structured interviews and focus groups were conducted to develop a customized telehealth intervention for TWC. Participants were TWC ≥ 18 years living in the Washington, DC metropolitan area, with at least one structural barrier to care and clinicians ≥18 years who provide care to TWC. Transcripts were analyzed using thematic coding and content analysis; barriers for TWC were categorized into Individual, Organizational, and Environmental levels. Several day-long meetings with TWC and stakeholders were convened to develop the intervention.
RESULTS
Saturation of theme on barriers to care was reached with 22 interviews. Identified barriers to service receipt included survival, instability, temporal discounting, and prioritizing hormone therapy over care, incongruence between providers and patients, pessimism, and lack of cultural competency. Each was intentionally addressed with the telehealth intervention.
CONCLUSIONS
Data informed the development of an innovative and customized telehealth intervention for TWC. Through the integration of technology and peer consultant outreach, we developed a novel approach that can address population-specific challenges to care. Further development of this model may be able to improve health outcomes among TWC.
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
262-271Subventions
Organisme : NIA NIH HHS
Pays : United States
Organisme : NHLBI NIH HHS
Pays : United States
Organisme : NIGMS NIH HHS
Pays : United States
Organisme : FIC NIH HHS
Pays : United States
Organisme : NIMH NIH HHS
Pays : United States
Organisme : NIH HHS
ID : AI117970
Pays : United States
Organisme : NCI NIH HHS
Pays : United States
Organisme : NIMHD NIH HHS
ID : 5R21MD008624
Pays : United States
Organisme : NICHD NIH HHS
Pays : United States
Organisme : NIDDK NIH HHS
Pays : United States
Organisme : NIDA NIH HHS
Pays : United States
Informations de copyright
© 2020 Wiley Periodicals, Inc.
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