Developing a Toolkit for Transgender and Gender Diverse-Affirming Health Communication: A Community-Based Participatory Research Partnership Approach

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Abstract Message tailoring in public health campaigns is especially important in health disparate minority populations, such as transgender and gender diverse (TGD) people, that often have barriers to care that include distrust of the health system, societal stigmatization, and financial barriers. TGD health disparities include, for example, elevated rates of diabetes, cardiovascular disease, anxiety, depression, and substance abuse compared to rates for cisgender populations. Furthermore, the TGD population is subjected to societal exclusion and negative public perception that contributes to exacerbating these problems. However, little to no attention is paid to TGD populations when designing health promotion campaigns for conditions for which this population has elevated risk, even though the effectiveness of such campaigns is well-documented for the general population. Health promotion messaging that can engage TGD people in needed care and prevention activities is an essential tool in addressing their health disparities. However, launching specific health promotion campaigns for a host of health conditions in health disparate populations, such as TGD communities, is not feasible due to the volume of specific conditions needing to be addressed individually. Furthermore, national health promotion campaigns with TGD populations in mind can still fail to reach TGD communities in the Central Great Plains because they do not match the lived reality of this region with the compounding issues of high stigmatization, and less access to care than in coastal regions. To overcome these challenges, this project will use a community-based participatory research network to build a TGD-affirming toolkit for health communicators to use to tailor messages to this community with the following specific aims: 1) Identify and explore potential barriers to care generated through non-TGD tailored health communication aimed at Type 2 diabetes, anxiety and depression, colorectal cancer, substance abuse, and cervical cancer. Through a series of interviews with TGD individuals in the Central Great Plains and national TGD content creators, the impact of both non-TGD specific and TGD-specific health messages will be explored. Qualitative and critical cultural analyses coupled with iterative feedback from community and national boards will generate a preliminary toolkit of TGD-affirming principles for health communication. 2) This toolkit will then be tested through an innovative dialogic workshop in which health communication professionals apply the toolkit to a health promotion campaign and share it with TGD community members, and communication professionals who identify as TGD, ending with any needed revisions of the toolkit. The multidisciplinary Trans Collaborations research team has a successful history of federal funding and producing innovative outcomes that have significant scientific and community impact. The well-established Local Community and National Advisory Boards inform all projects. Development of a community-informed toolkit for TGD-affirming health messaging is another step on our long term goal of addressing TGD health disparities in underserved areas.