Staying Connected: Community-engaged research to address the impacts of the COVID-19 Pandemic among transgender women through an m-health prevention program

保持联系：社区参与研究，通过移动健康预防计划解决 COVID-19 大流行对跨性别女性的影响

• 批准号: 10168264
• 负责人: CHARLES Howard KLEIN
• 金额: $ 17.85万
• 依托单位: DFUSION, INC.
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-21 至 2021-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10168264
• 关键词: AIDS prevention; Address; Adherence; Administrative Supplement; Affect; Anxiety; Anxiety Disorders; Behavior; COVID-19; COVID-19 pandemic; Caring; Cognitive; Color; Communities; Data; Discrimination; Disease; Disease Outbreaks; Economics; Educational Activities; Evaluation; Focus Groups; Gender; HIV Infections; HIV antiretroviral; Health; Health Promotion; Healthcare Systems; Housing; Infection; Intervention; Measures; Mental Depression; Mental Health; Morbidity - disease rate; Population; Prevention program; Process; Public Health; Randomized Controlled Trials; Relaxation; Research; Risk; Self Care; Sexual Health; Shapes; Social isolation; Societies; Substance abuse problem; Time; United States; Vaccines; Viral; antiretroviral therapy; arm; cost effective; effective intervention; epidemiologic data; health care service utilization; health disparity; improved; insight; mHealth; member; mobile application; mortality; parent grant; physical conditioning; resilience; skills; social; theories; transgender women; transmission process; uptake

ABSTRACT: Staying Connected: Community-engaged research to address the impacts of the COVID-19 Pandemic among transgender women through an mhealth prevention program The COVID-19 pandemic has reminded the world that viral outbreaks are a reality and can quickly generate high levels of mortality and morbidity, overwhelm health-care systems, and produce massive social and economic upheaval. Epidemiological data suggest that COVID-19 will have its most devastating impact on the most vulnerable members of society, and in the process, exacerbate existing health disparities. In the United States, transgender women, and in particular transgender women of color, are particularly at risk for COVID-19 infection due to high levels of HIV infection, substance abuse, depression, anxiety disorders, and social isolation. Research demonstrates that these health disparities and vulnerabilities are connected to the multiple forms of discrimination that shape transgender women’s lives. In this context, the COVID-19 pandemic and accompanying mitigation strategies affect not only COVID-19 transmission and disease, but also transgender women’s adherence to HIV anti-retroviral therapies, utilization of the HIV prevention continuum, financial and housing stability, and anxiety and depression associated with the disruption of gender-affirming care. This proposed administrative supplement will build on our current project, Trans Women Connected (TWC), an mhealth sexual health promotion app for transgender women, by conducting research to gain greater understanding of and ways to respond to these inter-connected and still evolving trans-specific COVID-19 impacts. Specifically, we aim to: 1) Conduct rapid formative research to examine the impact of COVID-19 and mitigation strategies, including unintended negative consequences, on transgender women through focus groups, expert advisors, and an engaged community advisory board; 2) Develop a culturally tailored, community- strengths and cognitive behavior theory informed module of interactive COVID-19 educational activities for integration into the overall TWC mobile app. The skills-building activities seek to support COVID-19 mitigation strategies, reduce COVID-19 morbidity and mortality, and in general, improve health care utilization, increase self-care and resilience, and promote connectedness among transgender women, thereby leading to improved overall mental and physical health; and 3) Evaluate the impact of the COVID-19 module as part of the larger parent grant 2-arm cluster randomized controlled trial with 450 transgender women. This evaluation will enable us to collect data on COVID-19 and the impact of the mhealth module on transgender women over a 12-month time period likely encompassing relaxation of distancing measures, possible second and third waves of infections and additional periods of lockdown, and potentially, the emergence of a vaccine. The project offers the possibility of unprecedented insights into effects of the COVID-19 pandemic on the health, connectedness, and behaviors of one of the most vulnerable and socially marginalized populations in the US.

摘要：保持联系：社区参与的研究，以应对COVID-19的影响 跨性别女性通过移动健康预防计划流行 COVID-19大流行提醒世界，病毒爆发是一个现实，可以迅速产生高 死亡率和发病率高，使卫生保健系统不堪重负，并产生大规模的社会和经济影响。 剧变流行病学数据表明，COVID-19将对大多数人产生最具破坏性的影响， 在这一过程中，健康差距进一步扩大。在美国， 跨性别女性，特别是有色人种的跨性别女性，感染COVID-19的风险尤其高 由于高水平的艾滋病毒感染、药物滥用、抑郁症、焦虑症和社会孤立。 研究表明，这些健康差距和脆弱性与多种形式的 歧视，塑造了跨性别女性的生活。在此背景下，COVID-19疫情和 伴随的缓解策略不仅影响COVID-19的传播和疾病，还影响跨性别者 妇女坚持接受艾滋病毒抗逆转录病毒疗法，利用艾滋病毒预防连续体， 住房不稳定，以及与性别平等护理中断有关的焦虑和抑郁。这 拟议的行政补充将建立在我们目前的项目，跨性别妇女连接（TWC）， mhealth性健康促进应用程序的跨性别妇女，通过进行研究，以获得更大的 理解和应对这些相互关联且仍在发展的跨特异性COVID-19的方法 影响。具体而言，我们的目标是：1）进行快速形成性研究，以检查COVID-19的影响， 减轻战略，包括对变性妇女的意外负面影响， 团体，专家顾问和一个参与的社区咨询委员会; 2）发展一个文化上适合的，社区- 优势和认知行为理论告知模块的互动COVID-19教育活动， 集成到整个TWC移动的应用程序中。技能培养活动旨在支持COVID-19缓解 战略，降低COVID-19发病率和死亡率，并在总体上提高卫生保健利用率，增加 自我照顾和复原力，并促进跨性别妇女之间的联系，从而改善 整体身心健康;以及3）评估COVID-19模块的影响，作为更大的 父母资助的两组随机对照试验，450名变性妇女。这项评估将使 我们将在12个月内收集有关COVID-19的数据以及移动健康模块对跨性别女性的影响 一段时间可能包括放宽隔离措施，可能出现第二波和第三波感染 和额外的封锁期，以及潜在的疫苗的出现。该项目提供了一种可能性 关于COVID-19大流行对健康、连通性和行为的影响的前所未有的见解 美国最脆弱和最边缘化的人群之一。