Use of Telemedicine to overcome barriers to care among transwomen of color

描述（由申请人提供）：跨性别人群是一个医疗服务不足和研究不足的人群，有无数的护理障碍。歧视、药物滥用、暴力、污名化、艾滋病毒/性传播感染风险行为和社会孤立对有色人种变性妇女（transwomen， TW）提供初级和专业服务构成挑战，因此迫切需要新的护理模式。该应用程序将提供远程医疗应用的试点数据，以提供虚拟医疗之家，作为参与和保留有色人种护理的一种手段。本研究将评估一种针对TW的新型远程医疗方法的可接受性和可行性，以减少护理障碍。通过提供实时的远程文化敏感护理，我们可以克服经常遇到的结构性障碍。本研究提供了将高效的远程医疗方法转化为医疗服务的机会

DESCRIPTION (provided by applicant): The transgender population is a medically underserved and understudied population with myriad barriers to care. Discrimination, substance abuse, violence, stigma, HIV/STI risk behaviors, and social isolation challenge delivery of primary and specialty services for transgender women of color (transwomen, TW), and thus new models of care are urgently needed. This application will provide pilot data on the application of telemedicine to provide a virtual medical home as a means to engage and retain TW of color in care. This study will assess the acceptability and feasibility of a novel telemedicine approach specific to TW to reduce barriers to care. By providing real-time access to culturally-sensitive care for TW remotely, we can overcome frequently encountered structural barriers. This study offers the opportunity to translate highly effective telemedicine methods to a population on whom this approach has not yet been tested. If shown to be feasible, acceptable, and associated with improvements in intentions to engage and retain in care, information gained through this pilot study will serve as the foundation for a future R34 or R01 study. The purpose of this study is to assess acceptability and feasibility of telemedicine as a virtual medical home to overcome barriers to utilization of healthcare services among out-of-care TW of color. The study has two phases: 1) In Phase I, we will conduct key informant interviews with providers of TW, and key informant interviews and focus groups with TW themselves to evaluate the acceptability of the telemedicine approach. 2) In Phase II, we will use peer-referral to will recrut a sample of 25 out-of-care TW who will have a 3 month comparison period followed by a 3 month telemedicine/virtual medical home pilot study period. This aim will assess the feasibility of the approach and its association with primary outcomes including intention to seek care and healthcare utilization behavior. If successful, telemedicine may offer an innovative strategy for a medically underserved and vulnerable population in urgent need of healthcare services.