An intervention to promote healthy relationships among transgender and gender expansive youth

促进跨性别者和性别广泛青年之间健康关系的干预措施

• 批准号: 10697301
• 负责人: KYM R AHRENS
• 金额: $ 24.05万
• 依托单位: SEATTLE CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-05 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10697301
• 关键词: Adolescent; Advocate; Age; Agreement; Anatomy; Belief; Birth; Black race; Body Image; Clinical; Color; Communication; Communities; Consent; Contraceptive methods; Data; Data Collection; Development; Disclosure; Education; Electronics; Ensure; Family; Feasibility Studies; Feedback; Fostering; Funding; Future; Gender; Gender Identity; Gender expansive; Grant; Health; Health Resources; Human; Individual; Infection prevention; Intervention; Interview; Knowledge; Measurement; Measures; Medical; Methodology; Methods; Minority Health Research; Multimedia; National Institute of Child Health and Human Development; Outcome; Outcome Measure; Paper; Participant; Partner Communications; Pilot Projects; Preparation; Procedures; Protocols documentation; Provider; Puberty; Qualitative Methods; Randomized; Randomized, Controlled Trials; Recommendation; Reporting; Research; Research Design; Research Personnel; Resources; Risk; Risk Reduction; Sampling; Self Efficacy; Sex Behavior; Sex Education; Sexual Health; Sexual and Gender Minorities; Sexuality; Sexually Transmitted Diseases; Social support; Structure; Surveys; System; Techniques; Unwanted pregnancy; Work; Writing; Youth; acceptability and feasibility; advocacy organizations; children of color; cognitive interview; condoms; design; disparity reduction; dysphoria; evidence base; experience; family support; follow-up; gender affirmation; gender affirming intervention; gender diversity; gender dysphoria; gender minority group; health knowledge; high risk; high risk sexual behavior; human centered design; improved; infection risk; innovation; intervention effect; intimate partner violence; iterative design; nonbinary; peer; pilot test; post intervention; preference; primary outcome; promote resilience; prototype; recruit; resilience; sex; sex assigned at birth; sexual health intervention; sexual minority group; sexual risk behavior; skill acquisition; skills training; social; therapy development; tool; tool development; transfeminine; transgender; transmasculine; treatment arm; two spirit; unintended pregnancy; usability; user protection; violence exposure

PROJECT SUMMARY Transgender and gender expansive (TGE) youth identify as a gender different from their sex at birth. Research tends to define this group based on high rates of sexually transmitted infections (STIs), sexual risk behaviors, violence exposures, and other health outcomes. Little work has used a supportive, resilience-based framework or a human-centered approach. We conducted preliminary qualitative/co-design studies to understand sexual health content needs and format/design preferences. Content areas recommended by TGE youth, their families, providers, and/or advocates include: a) Youth/ providers noted that puberty can produce dysphoria for TGE adolescents and that information/tools would be beneficial; b) Participants asked for non-judgmental information about STI risks and prevention; c) Youth/providers asked for content around contraception that clarifies that gender-affirming medical interventions do not prevent unintended pregnancies; d) Participants recommended destigmatizing and normalizing diversity in sexual attractions and desires; e) TGE youth raised disclosure of TGE identity as a unique challenge and asked for communication skills training to help them maintain agency over when and how to disclose; and f) Participants described difficulties navigating partner consent because it is often described in heteronormative, binary terms in sexual education classes. TGE youth also described favoring written materials for more fact-based content on contraception and STIs, interactive formats for content that requires personalization by gender and/or degree of medical transition, and multimedia approaches emphasizing lived experience perspectives for information around desire, gender identity disclosure, and consent. Participants also provided design guidance (e.g., use of a covert color palette that would not unwantedly disclose users’ transgender status in public) and specific features (e.g., blacklisting functions to protect the user from triggering content; robust search and filter system to easily locate information specific to an individual’s needs). Based on these themes, we co-designed a paper intervention prototype with TGE youth. In this proposal, we will engage a Youth Advisory Board and Community Consultants to co-design a fully functional online interactive sexual education tool (OISET) with TGE youth (Aim 1a) and conduct cognitive interviews to refine select survey tools and ensure gender-affirming intervention effect measurement in a future R01 (Aim 1b). We will then conduct an unbalanced, randomized controlled pilot study with 40 youth (30 intervention:10 control) to refine content and establish feasibility of the OISET and data collection protocols/procedures (Aim 2). Primary outcomes will be intervention usability/feasibility/appropriateness/ acceptability and study feasibility. We will collect baseline, post-intervention, and 3 month data on knowledge; general/sexuality-specific self-efficacy; partner communication; risky sexual behaviors; social support; and resilience. This project is innovative, rigorous, and responsive to NICHD/NINR/SGMRO priorities. It will result in the first evidence- and strengths-based online sexual health intervention for TGE youth.

项目摘要 跨性别和性别扩张（TGE）青年认为自己的性别不同于出生时的性别。研究 倾向于根据性传播感染（STIs）的高发病率，性风险行为， 暴力暴露和其他健康结果。很少有工作使用了支持性的、基于服从的框架 还是以人为本的方法。我们进行了初步的定性/共同设计研究，以了解性行为 健康内容需求和格式/设计偏好。TGE青年推荐的内容领域， 家庭、提供者和/或倡导者包括：a）青少年/提供者指出，青春期可能会产生焦虑， TGE青少年和信息/工具将是有益的; B）参与者要求非判断性 关于性传播感染风险和预防的信息; c）青年/提供者要求提供有关避孕的内容， 阐明性别肯定的医疗干预措施不能防止意外怀孕; d）参与者 建议消除性吸引力和欲望的污名化和正常化; e）TGE青年提高 披露TGE身份是一个独特的挑战，要求进行沟通技能培训，以帮助他们 在何时以及如何披露方面保持代理权;以及f）参与者描述了在导航合作伙伴时遇到的困难 同意，因为在性教育课上，它经常被描述为异性恋，二元术语。TGE青年 还描述了赞成书面材料，以提供更多基于事实的避孕和性传播感染内容， 需要按性别和/或医疗过渡程度进行个性化的内容格式，以及多媒体 方法强调生活经验的观点，围绕欲望，性别认同 披露和同意。与会者还提供了设计指导（例如，使用隐蔽的调色板， 不会不必要地公开用户的变性人身份）和特定特征（例如，黑名单 保护用户不受触发内容影响的功能;强大的搜索和过滤系统，可轻松定位信息 满足个人需求）。基于这些主题，我们共同设计了一个纸质干预原型， TGE青年。在这项建议中，我们会委聘青年顾问委员会和社区顾问， 一个功能齐全的在线互动性教育工具（OISET），面向TGE青年（目标1a）和行为 认知访谈，以完善选定的调查工具，确保对性别平等干预效果的衡量 未来的R 01（目标1b）。然后，我们将对40名青少年进行一项不平衡的随机对照试验研究。 (30干预措施：10项控制措施），以完善OISET和数据收集的内容并确定其可行性 方案/程序（目标2）。主要结局为干预可用性/可行性/适当性/ 可接受性和研究可行性。我们将收集基线、干预后和3个月的知识数据; 一般性/性特异性自我效能;伴侣沟通;危险性行为;社会支持;以及 resilience.该项目具有创新性，严谨性，并响应NICHD/NINR/SGMRO的优先事项。其将导致 第一个基于证据和优势的TGE青少年在线性健康干预。