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

描述（由申请人提供）：跨性别人口是一个医疗服务不足和研究不足的人口与无数的障碍，以照顾。歧视、药物滥用、暴力、污名、艾滋病毒/性传播感染风险行为和社会孤立挑战着为有色人种跨性别妇女（transwomen，TW）提供初级和专业服务，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程序的试点数据，以提供虚拟医疗家园，作为参与和保留护理颜色TW的一种手段。本研究将评估一种新的远程医疗方法的可接受性和可行性，以减少对TW的护理障碍。通过远程为TW提供实时的文化敏感护理，我们可以克服经常遇到的结构性障碍。这项研究提供了将高效的远程医疗方法转化为 这一方法尚未得到验证的人群。如果证明是可行的、可接受的，并且与参与和保留护理的意图改善相关，则通过本初步研究获得的信息将作为未来R34或R 01研究的基础。本研究的目的是评估远程医疗作为虚拟医疗之家的可接受性和可行性，以克服障碍，利用医疗服务之间的护理TW的颜色。该研究分为两个阶段：1）在第一阶段，我们会与提供远程医疗服务的机构进行主要信息提供者访谈，并与远程医疗机构本身进行主要信息提供者访谈和焦点小组访谈，以评估远程医疗方法的可接受性。2)在第二阶段，我们将采用同行推荐的方式招募25名失检TW患者，他们将有3个月的比较期，然后是3个月的远程医疗/虚拟医疗之家试点研究期。这一目标将评估以下方面的可行性： 该方法及其与主要结局的关系，包括寻求护理的意图和医疗保健利用行为。如果成功的话，远程医疗可能会提供一个创新的战略， 医疗服务不足和急需医疗服务的弱势群体。

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.