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Development of a telehealth intervention to promote care‐seeking among transgender women of color in Washington, DC
Author(s) -
Magnus Manya,
Edwards Elizabeth,
Dright Aurnell,
Gilliam Leandrea,
Brown Angela,
Levy Matthew,
Sikka Neal,
Siegel Marc,
Criss Vittoria,
Watson Christopher Chauncey,
Machtinger Edwards,
Kuo Irene
Publication year - 2020
Publication title -
public health nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.471
H-Index - 55
eISSN - 1525-1446
pISSN - 0737-1209
DOI - 10.1111/phn.12709
Subject(s) - telehealth , population , nursing , thematic analysis , psychological intervention , outreach , focus group , medicine , health care , psychology , health equity , intervention (counseling) , gerontology , qualitative research , public health , telemedicine , environmental health , sociology , social science , political science , law , economics , economic growth , anthropology
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.