Use of Telemedicine to overcome barriers to care among transwomen of color

利用远程医疗克服有色人种跨性别女性的护理障碍

• 批准号: 8493286
• 负责人: Manya Magnus
• 金额: $ 19.81万
• 依托单位: GEORGE WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-07-16 至 2015-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8493286
• 关键词: Adherence; Adolescent; Adult; Affect; African American; Asians; Behavior; Behavioral; California; Caring; Color; Communities; Comprehensive Health Care; Data; Dimensions; Discrimination; District of Columbia; Enrollment; Evaluation; Face; Faculty; Female; Focus Groups; Foundations; Funding; Future; Gender; HIV; HIV Seropositivity; HIV prevention trials network; HIV/STD; Health Personnel; Health Services; Health Services Accessibility; Healthcare; Healthcare Systems; Home environment; Human Resources; Intention; Intervention; Interview; Latina; Life; Link; Medical; Medical Faculty; Methods; Minority; Modeling; Native Americans; Outcome; Pacific Island Americans; Participant; Persons; Phase; Pilot Projects; Plague; Population; Primary Health Care; Provider; Randomized; Risk Behaviors; Running; Sampling; San Francisco; Schedule; Services; Social isolation; Social support; Substance abuse problem; Telemedicine; Testing; Time; Training; Translating; Trauma; Universities; Violence; Visit; Vulnerable Populations; Washington; Woman; Work; base; care seeking; depressive symptoms; experience; health care service utilization; health information technology; high risk; informant; innovation; male; medical specialties; medically underserved; medically underserved population; novel; peer; primary outcome; programs; public health relevance; social stigma; transgender; virtual

DESCRIPTION (provided by applicant): The transgender population is a medically underserved and understudied population with myriad barriers to care. Discrimination, substance abuse, violence, stigma, HIV/STI risk behaviors, and social isolation challenge delivery of primary and specialty services for transgender women of color (transwomen, TW), and thus new models of care are urgently needed. This application will provide pilot data on the application of telemedicine to provide a virtual medical home as a means to engage and retain TW of color in care. This study will assess the acceptability and feasibility of a novel telemedicine approach specific to TW to reduce barriers to care. By providing real-time access to culturally-sensitive care for TW remotely, we can overcome frequently encountered structural barriers. This study offers the opportunity to translate highly effective telemedicine methods to a population on whom this approach has not yet been tested. If shown to be feasible, acceptable, and associated with improvements in intentions to engage and retain in care, information gained through this pilot study will serve as the foundation for a future R34 or R01 study. The purpose of this study is to assess acceptability and feasibility of telemedicine as a virtual medical home to overcome barriers to utilization of healthcare services among out-of-care TW of color. The study has two phases: 1) In Phase I, we will conduct key informant interviews with providers of TW, and key informant interviews and focus groups with TW themselves to evaluate the acceptability of the telemedicine approach. 2) In Phase II, we will use peer-referral to will recrut a sample of 25 out-of-care TW who will have a 3 month comparison period followed by a 3 month telemedicine/virtual medical home pilot study period. This aim will assess the feasibility of the approach and its association with primary outcomes including intention to seek care and healthcare utilization behavior. If successful, telemedicine may offer an innovative strategy for a medically underserved and vulnerable population in urgent need of healthcare services.

描述（由申请人提供）：跨性别人口是医学上服务不足的人口，有无数的护理障碍。歧视，滥用药物，暴力，污名，艾滋病毒/性传播感染风险行为以及社会隔离挑战为有色人种的跨性别妇女提供主要和专业服务（Transwomen，TW），因此紧急需要新的护理模式。该应用程序将提供有关远程医疗应用程序提供虚拟医疗之家的试验数据，以此作为参与和保留TW颜色的手段。这项研究将评估特定于TW的新型远程医疗方法的可接受性和可行性，以减少护理障碍。通过为TW提供实时访问对文化敏感的护理，我们可以克服经常遇到的结构障碍。这项研究提供了将高效远程医疗方法转化为 尚未对此方法进行测试的人口。如果证明是可行的，可接受的，并且与参与和保留护理的意图的改善有关，则通过此试点研究获得的信息将成为未来R34或R01研究的基础。这项研究的目的是评估远程医疗作为虚拟医疗之家的可接受性和可行性，以克服在颜色外护理TW中利用医疗服务的障碍。这项研究有两个阶段：1）在第一阶段，我们将对TW的提供者进行关键的线人访谈，以及与TW的主要知情人士访谈和焦点小组，以评估远程医疗方法的可接受性。 2）在第二阶段，我们将使用同行推荐来招募25个托管外TW的样本，该样本将有3个月的比较期，然后进行3个月的远程医疗/虚拟医疗家庭试点研究期。这个目标将评估 该方法及其与主要成果的关联，包括寻求护理和医疗保健利用行为的意图。如果成功，远程医疗可能会为 迫切需要医疗服务的医疗服务不足和脆弱的人口。