An intervention to promote healthy relationships among transgender and gender expansive youth

促进跨性别者和性别广泛青年之间健康关系的干预措施

基本信息

批准号：
10354155
负责人：
KYM R AHRENS
金额：
$ 21.65万
依托单位：
SEATTLE CHILDREN'S HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-05 至 2024-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10354155
关键词：
Adolescent Advocate Age Anatomy Area Belief Birth Black race Body Image Clinical Color Communication Communities Consent Contraceptive methods Data Data Collection Development Disclosure Education Ensure Family Feasibility Studies Feedback Fostering Funding Future Gender Gender Identity Grant Health Health Resources Human Individual Infection prevention Intervention Interview Knowledge Life Measurement Measures Medical Methodology Methods Minority Health Research Multimedia National Institute of Child Health and Human Development Outcome Paper Participant Partner Communications Pilot Projects Preparation Procedures Protocols documentation Provider Puberty Qualitative Methods Randomized Randomized Controlled Trials Reporting Research Research Design Research Personnel Resources Risk Self Efficacy Sex Behavior Sex Education Sexual Health Sexual and Gender Minorities Sexuality Sexually Transmitted Diseases Social support Stigmatization Structure Surveys System Techniques Unwanted pregnancy Work Youth acceptability and feasibility advocacy organizations base children of color cognitive interview condoms design disparity reduction dysphoria evidence base experience family support follow-up gender diversity gender dysphoria gender minority group health knowledge high risk high risk sexual behavior human centered design improved infection risk innovation intervention effect intimate partner violence iterative design peer pilot test post intervention preference primary outcome prototype recruit resilience sex sexual health intervention sexual minority group sexual risk behavior skill acquisition skills training social therapy development tool tool development transfeminine transgender transmasculine treatment arm two spirit unintended pregnancy usability violence exposure

项目摘要

PROJECT SUMMARY Transgender and gender expansive (TGE) youth identify as a gender different from their sex at birth. Research tends to define this group based on high rates of sexually transmitted infections (STIs), sexual risk behaviors, violence exposures, and other health outcomes. Little work has used a supportive, resilience-based framework or a human-centered approach. We conducted preliminary qualitative/co-design studies to understand sexual health content needs and format/design preferences. Content areas recommended by TGE youth, their families, providers, and/or advocates include: a) Youth/ providers noted that puberty can produce dysphoria for TGE adolescents and that information/tools would be beneficial; b) Participants asked for non-judgmental information about STI risks and prevention; c) Youth/providers asked for content around contraception that clarifies that gender-affirming medical interventions do not prevent unintended pregnancies; d) Participants recommended destigmatizing and normalizing diversity in sexual attractions and desires; e) TGE youth raised disclosure of TGE identity as a unique challenge and asked for communication skills training to help them maintain agency over when and how to disclose; and f) Participants described difficulties navigating partner consent because it is often described in heteronormative, binary terms in sexual education classes. TGE youth also described favoring written materials for more fact-based content on contraception and STIs, interactive formats for content that requires personalization by gender and/or degree of medical transition, and multimedia approaches emphasizing lived experience perspectives for information around desire, gender identity disclosure, and consent. Participants also provided design guidance (e.g., use of a covert color palette that would not unwantedly disclose users’ transgender status in public) and specific features (e.g., blacklisting functions to protect the user from triggering content; robust search and filter system to easily locate information specific to an individual’s needs). Based on these themes, we co-designed a paper intervention prototype with TGE youth. In this proposal, we will engage a Youth Advisory Board and Community Consultants to co-design a fully functional online interactive sexual education tool (OISET) with TGE youth (Aim 1a) and conduct cognitive interviews to refine select survey tools and ensure gender-affirming intervention effect measurement in a future R01 (Aim 1b). We will then conduct an unbalanced, randomized controlled pilot study with 40 youth (30 intervention:10 control) to refine content and establish feasibility of the OISET and data collection protocols/procedures (Aim 2). Primary outcomes will be intervention usability/feasibility/appropriateness/ acceptability and study feasibility. We will collect baseline, post-intervention, and 3 month data on knowledge; general/sexuality-specific self-efficacy; partner communication; risky sexual behaviors; social support; and resilience. This project is innovative, rigorous, and responsive to NICHD/NINR/SGMRO priorities. It will result in the first evidence- and strengths-based online sexual health intervention for TGE youth.

项目概要跨性别和性别扩张（TGE）青年认为自己的性别与出生时的性别不同。根据性传播感染（STI）高发率、性危险行为、暴力暴露和其他健康结果很少有工作使用基于复原力的支持性框架。或以人为本的方法，我们进行了初步定性/协同设计研究来了解性。 TGE 青年推荐的健康内容需求和格式/设计偏好。家庭、提供者和/或倡导者包括： a) 青少年/提供者指出，青春期可能会产生烦躁不安 TGE 青少年和信息/工具将是有益的 b) 参与者要求不带评判性； c) 青少年/提供者要求提供有关避孕的内容澄清性别肯定医疗干预措施并不能防止意外怀孕 d) 参与者；建议消除性吸引力和性欲的多样性并使其正常化 e) TGE 青少年的成长；披露 TGE 身份是一项独特的挑战，并要求进行沟通技巧培训以帮助他们保持对何时以及如何披露的代理权；以及 f) 参与者描述了引导合作伙伴的困难同意，因为在青少年性教育课程中，它经常被用异性恋、二元术语来描述。还描述了倾向于书面材料，以提供更多关于避孕和性传播感染的基于事实的内容，互动需要按性别和/或医疗过渡程度进行个性化的内容格式和多媒体方法强调从生活经验角度获取有关欲望、性别认同的信息参与者还提供了设计指导（例如，使用隐蔽的调色板不会在公共场合无意地披露用户的跨性别身份）和特定功能（例如，列入黑名单）保护用户免受触发内容的功能；强大的搜索和过滤系统以轻松定位信息针对个人的需求）根据这些主题，我们与以下人员共同设计了纸质干预原型。在这项提案中，我们将聘请青年顾问委员会和社区顾问来共同设计。一个功能齐全的在线互动性教育工具（OISET），与 TGE 青少年（目标 1a）和行为认知访谈，以完善选定的调查工具并确保性别肯定干预效果的衡量在未来的 R01（目标 1b）中，我们将针对 40 名青少年进行一项不平衡的随机对照试点研究。（30 次干预：10 次控制）细化内容并建立 OISET 和数据收集的可行性方案/程序（目标 2）是干预措施的可用性/可行性/适当性/。我们将收集基线、干预后和 3 个月的知识数据；一般/特定性别的自我效能感；危险的性行为；以及该项目具有创新性、严谨性，并且响应 NICHD/NINR/SGMRO 的优先事项。这是第一个针对 TGE 青少年的基于证据和优势的在线性健康干预措施。