Facilitators of and barriers to healthcare utilization among racially and ethnically diverse transgender and gender nonbinary young adults

不同种族和民族的跨性别者和非二元性别年轻人利用医疗保健的促进者和障碍

• 批准号: 10646417
• 负责人: Shannon K Carter
• 金额: $ 18.87万
• 依托单位: UNIVERSITY OF CENTRAL FLORIDA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-15 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10646417
• 关键词: Address; Adolescent; Affect; Area; Asian; Behavior; Black race; COVID-19 pandemic; Caring; Categories; Code; Communities; Comparative Study; Consent; Data; Disparity; Elderly; Enabling Factors; Ethnic Origin; Ethnic Population; Florida; Future; Gender; Gender Identity; Health; Health Personnel; Health Services Accessibility; Health Status; Healthcare; Individual; Interview; Knowledge; Latinx; Lesbian Gay Bisexual Transgender Queer; Literature; Medical; Minority; Modeling; Not Hispanic or Latino; Parents; Participant; Pattern; Persons; Population; Predisposing Factor; Race; Recommendation; Reduce health disparities; Research; Research Personnel; Resources; Risk Taking; Sampling; Science; Services; Sexism; Structure; Surveys; System; Telephone; United States National Institutes of Health; Universities; aged; barrier to care; cisgender; classism; comparison group; critical developmental period; design; ethnic diversity; ethnic identity; ethnic minority; experience; gender minority; gender transition; health care quality; health care service; health care service utilization; high risk population; improved; innovation; intersectionality; marginalization; marginalized population; nonbinary; racial diversity; racial minority; racial population; racism; recruit; social; social media; social stigma; social structure; therapy development; transgender; transgender men; transgender women; treatment choice; young adult

PROJECT SUMMARY Transgender and gender nonbinary (TGNB) people are diverse and have distinct healthcare needs, yet demonstrate lower levels of healthcare utilization and greater likelihood of delaying needed care than their cisgender counterparts. Further, TGNB young adults experience more barriers to healthcare utilization and are more likely to delay care than TGNB adolescents and older adults. Though limited research indicates healthcare needs and patterns of healthcare utilization among TGNB people may vary by race/ethnicity and TGNB identity, little research exists on distinct healthcare needs and utilization patterns based on the intersection of specific race/ethnicity and TGNB identity among young adults. Further, a gap in the literature exists regarding nuanced differences in how race/ethnicity intersects with specific TGNB identities to create barriers to healthcare utilization, including during the COVID-19 pandemic, especially among young adults. Also, few studies have examined facilitators of healthcare utilization in a nuanced and in-depth way specifically among racial/ethnic minority TGNB people, particularly during young adulthood. The proposed study will use an innovative theoretical strategy that examines intersectionality within a leading healthcare utilization model. To address gaps in the research, we will pursue the following specific aims: (1) Examine the applicability of an expanded healthcare utilization model that includes specific intersectional factors for each model domain for racially/ethnically diverse TGNB young adults; and (2) Identify patterns in facilitators of and barriers to healthcare utilization by the intersection of specific gender identity and race/ethnicity among TGNB young adults. We will use quota sampling to intentionally recruit 105 TGNB young adults in Florida aged 18 to 26 who are diverse in terms of intersectional TGNB identity (35% transgender men, 35% transgender women, 35% nonbinary) and race/ethnicity (30% non-Hispanic Black, 30% Latinx, 30% non-Hispanic White, 15% Asian). The sample will be recruited mostly through social media platforms, but also Florida community partner organizations, House and Ballroom communities, Florida university organizations, and snowball sampling. Participants will complete a telephone survey and an in-depth, semi-structured qualitative interview. We will use an intersectionality framework in the design of our interview guide, layered thematic coding of qualitative data, gender identity x race/ethnicity group comparisons, triangulation of quantitative and qualitative data, and interpretation of the study findings in the context of the healthcare utilization model. The impact of this research involves evaluating the applicability of an expanded healthcare utilization model to TGNB young adult experiences and assessing the compatibility of the model with an intersectional approach that considers experiences of gender and racial/ethnic minority young adults to advance the science on quality healthcare for this population.

项目概要 跨性别者和非二元性别 (TGNB) 人群具有多样性，并且具有不同的医疗保健需求，但 与他们相比，医疗保健利用率较低，并且延迟所需护理的可能性更大 顺性别同行。此外，TGNB 年轻人在利用医疗保健方面遇到更多障碍，并且 与 TGNB 青少年和老年人相比，更有可能延迟护理。尽管有限的研究表明 TGNB 人群的医疗保健需求和医疗保健利用模式可能因种族/民族和 TGNB 身份，关于基于 TGNB 的不同医疗保健需求和利用模式的研究很少 年轻人中特定种族/族裔与 TGNB 身份的交叉点。此外，文献中的空白 种族/族裔如何与特定 TGNB 身份相交叉以创建的细微差别存在 医疗保健利用的障碍，包括在 COVID-19 大流行期间，特别是在年轻人中。 此外，很少有研究以细致入微和深入的方式专门研究医疗保健利用的促进因素 少数民族 TGNB 人群中，特别是在青年时期。拟议的研究将使用 一种创新的理论策略，研究领先的医疗保健利用模型中的交叉性。 为了弥补研究中的差距，我们将追求以下具体目标：（1）检查研究的适用性 扩展的医疗保健利用模型，包括每个模型域的特定交叉因素 种族/族裔多样化的 TGNB 年轻人； (2) 识别促进和阻碍的模式 TGNB 年轻人中特定性别认同和种族/民族交叉的医疗保健利用 成年人。我们将使用配额抽样有意招募 105 名佛罗里达州 18 至 26 岁的 TGNB 年轻人，他们 跨性别跨性别者身份的多样性（35% 跨性别男性、35% 跨性别女性、35%） 非二元性别）和种族/民族（30% 非西班牙裔黑人、30% 拉丁裔、30% 非西班牙裔白人、15% 亚洲人）。 样本将主要通过社交媒体平台招募，但也会通过佛罗里达州社区合作伙伴招募 组织、众议院和宴会厅社区、佛罗里达大学组织以及滚雪球抽样。 参与者将完成电话调查和深入的半结构化定性访谈。我们将 在我们的采访指南设计中使用交叉性框架，定性的分层主题编码 数据、性别认同 x 种族/族裔群体比较、定量和定性数据的三角测量，以及 在医疗保健利用模型的背景下解释研究结果。这项研究的影响 涉及评估扩大的医疗保健利用模式对 TGNB 年轻人的适用性 经验并评估模型与交叉方法的兼容性，该方法考虑了 性别和种族/族裔少数年轻人的经验，以推进高质量医疗保健的科学 这个人口。