Peer specialist intervention to reduce disparities in the mental health of transgender and nonbinary individuals

项目摘要 候选人：Daphna Stroumsa，医学博士，公共卫生硕士，理学硕士，是一名妇产科医生和早期职业健康 密歇根大学的服务研究员，专注于改善医疗保健的可及性和质量， transgender and nonbinary（TGNB）斯特劳姆萨博士的长期职业目标是成为一名独立的 医生-研究人员领导制定和评估干预措施，以减少健康差距 影响性别少数群体。 研究背景：TGNB人是一个高度边缘化的人群，性别平等需求未得到满足 以及惊人的心理健康差异。迫切需要采取有效的干预措施来解决这一问题 重大负担。同侪支助干预措施在提供重要的性别平等肯定方面具有巨大的前景 以及消除污名对健康的影响。然而，有必要了解如何最好地设计 并部署此类干预措施，以满足这一人群的具体需求。 具体目标：本提案的总体目标是调整和试点测试同伴支持干预措施， 减少TGNB人群的心理健康差异。本研究的具体目标是：1）确定 为获得性别平等肯定的TGNB人提供同伴支持干预的理想性质和结构 激素（GAH），以及这些如何通过交叉性别和种族身份而变化; 2）适应同伴支持 干预措施，以改善TGNB人的心理健康，为GAH提出;和3）评估的可行性 和可接受的干预措施，以改善TGNB人的心理健康在临床设置。 研究计划：该计划依赖于社区参与的结构化过程，包括1）与TGNB的访谈 人和其他利益相关者，以确定干预的理想属性，2）迭代完善 专家反馈的干预，以及3）为期6个月的试点RCT，以评估可行性和可接受性。 职业发展计划：为了实现独立，Stroumsa博士需要接受以下方面的额外培训： 社区参与的研究，2）适应边缘化人群的行为干预措施，以及3） 开展和评估临床试验。斯特劳姆萨博士的培训将得到一个跨学科团队的支持 国家卫生研究院资助的导师主要的共同导师，保罗·菲佛博士和罗布斯蒂芬森，有广泛的 指导经验和专业知识，设计和评估干预措施，以改善心理健康结果 性别和性少数群体。Amy Schulz和Kristi Gamarel博士（共同导师）是专家 在以社区为基础的参与性研究和同行交付的行为干预设计与和为 TGBN社区，分别。培训还得到顾问定期反馈的进一步支持， 高级教学课程和参加讲习班/研讨会。这些将使斯特鲁姆萨博士的 无缝过渡到成为一名独立研究人员，致力于改善TGNB人民的健康 通过开发和测试以患者为中心的干预措施来改善结果。

PROJECT SUMMARY Candidate: Daphna Stroumsa, MD, MPH, MSc, is an obstetrician-gynecologist and early career health services researcher at the University of Michigan, focused on improving healthcare access and quality for transgender and nonbinary (TGNB) people. Dr. Stroumsa’s long-term career goal is to become an independent physician-researcher leading the development and evaluation of interventions to decrease health disparities affecting gender minorities. Research Context: TGNB people are a highly marginalized population, with unmet gender-affirming needs and staggering mental health disparities. There is a critical need for effective interventions that address this significant burden. Peer support interventions hold immense promise in providing critical gender affirmation and in countering the effects of stigma on health. It is, however, necessary to understand how best to design and deploy such interventions to meet the specific needs of this population. Specific Aims: The overarching goal of this proposal is to adapt and pilot-test a peer support intervention to decrease mental health disparities among TGNB people. The study’s specific aims are to 1) identify the desired properties and structure of a peer support intervention for TGNB people accessing gender affirming hormones (GAH), and how these vary by intersecting gender and racial identities; 2) adapt a peer support intervention to improve mental health among TGNB people presenting for GAH; and 3) evaluate the feasibility and acceptability of the intervention for improving TGNB people’s mental health in a clinical setting. Research Plan: The plan relies on a community-engaged, structured process with 1) interviews with TGNB people and other stakeholders to identify the desired properties of the intervention, 2) An iterative refinement of the intervention with expert feedback, and 3) A six-month pilot RCT to assess feasibility and acceptability. Career Development Plan: To achieve independence, Dr. Stroumsa requires additional training in 1) Community-engaged research, 2) Adaptation of behavioral interventions for marginalized populations, and 3) Conducting and evaluating clinical trials. Dr. Stroumsa’s training will be supported by an interdisciplinary team of NIH-funded mentors. The primary co-mentors, Drs. Paul Pfeiffer and Rob Stephenson, have extensive mentoring experience and expertise designing and evaluating interventions to improve mental health outcomes with gender and sexual minorities, respectively. Drs. Amy Schulz and Kristi Gamarel (co-mentors) are experts in community-based participatory research and peer-delivered behavioral interventions designed with and for TGBN communities, respectively. The training is further supported by regular feedback from advisors, advanced didactic coursework, and participation in workshops/seminars. These will enable Dr. Stroumsa’s seamless transition to becoming an independent researcher, working to improve TGNB people’s health outcomes by developing and testing patient-centered interventions.