Using Telehealth to Improve Access to Gender-Affirming Care for BIPOC and Rural Gender-Diverse Youth
A telehealth solution--the Technology-based Enhanced Gender Support platform--has the potential to increase access to gender-affirming care to rural communities, leading to improvements in mental health outcomes.
Project Details -
Ongoing
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Grant NumberK08 HS029028
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Funding Mechanism(s)
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AHRQ Funded Amount$429,171
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LocationSeattleWashington
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Project Dates04/01/2023 - 03/31/2026
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Technology
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Care Setting
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Medical Condition
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Type of Care
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Health Care Theme
The prevalence of gender-diverse youth (GDY) in high school is estimated to be nearly 10 percent, with Black and Latinx adolescents having higher rates than Whites. This same group disproportionally experiences mental health disparities, with an attempted suicide rate five times higher than their peers. Gender-affirming care has been shown to improve mental health outcomes. In general, those that identify as Black, Indigenous, or People of Color (BIPOC), as well as those living in rural areas, are underrepresented in pediatric gender clinics, with access to such care being a barrier. While these individuals may receive medical and mental health care in their communities, their providers may have little training in GDY care, without an ability to consult with transgender specialists.
Providing such care via telehealth is a promising approach to close this gap in care. This research will first identify barriers that BIPOC and rural GDY experience when seeking gender-affirming care. The researchers will then identify design and implementation considerations in providing this care via telehealth. Next, they will develop and conduct a pilot study of a technology platform called Technology-based Enhance Gender Support (TEGS), with community pediatric settings to support the provision of gender-affirming care.
The specific aims of the research are as follows:
- Identify existing barriers BIPOC and rural GDY experience to receiving gender-affirming care and explore design and implementation considerations for facilitating access to care via telehealth.
- Develop a stakeholder-engaged platform (TEGS) to facilitate gender-affirming care provision in the community pediatric setting.
- Conduct a pilot study to assess the feasibility and acceptability of the TEGS platform versus usual care with electronic consultation support.
A survey will be developed and administered to GDY adolescents via social media to identify the needs of BIPOC and rural GDYs for gender-affirming services and support, as well as to identify barriers and facilitators to accessing this care. The TEGS platform will be developed, followed by a pilot study to assess feasibility and acceptability of the platform conducted with six providers and 36 GDY-caregiver dyads.
The overall goal of the research will be to improve access to gender-affirming care for BIPOC and rural GDY using telehealth. Results will inform a future randomized trial to fully evaluate the TEGS platform’s impact on GDYs mental health, perceived care needs, and community provider knowledge and behavior.