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

项目总结 候选人：Daphna Stroumsa，医学博士，公共卫生硕士，硕士，妇产科医生，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获取和质量 变性人和非二进制(TGNB)人。Stroumsa博士的长期职业目标是成为一名独立的 医生-研究人员，领导制定和评估减少健康差距的干预措施 影响到性别少数群体。 研究背景：TGNB人是高度边缘化的人群，在性别平等方面的需求未得到满足 以及令人震惊的心理健康差距。迫切需要有效的干预措施来解决这一问题 沉重的负担。同伴支持干预在提供批判性性别肯定方面有着巨大的希望 以及在对抗耻辱对健康的影响方面。然而，有必要了解如何最好地设计 并部署这种干预措施，以满足这一人群的特定需求。 具体目标：该提案的首要目标是调整和试行同伴支持干预措施，以 减少TGNB人群之间的心理健康差距。这项研究的具体目的是1)确定 TGNB人员获得性别肯定的同伴支持干预的期望性质和结构 荷尔蒙(GAH)，以及它们如何因性别和种族认同的交叉而变化；2)适应同伴支持 改善广州市TGNB人群心理健康的干预措施；3)可行性评价 临床环境下改善TGNB人群心理健康干预的可接受性。 研究计划：该计划依赖于社区参与的、结构化的流程，并与TGNB进行了访谈 人员和其他利益相关者确定干预的所需属性，2)迭代细化 有专家反馈的干预措施，以及3)为期六个月的RCT试点，以评估可行性和可接受性。 职业发展计划：为了实现独立，Stroumsa博士需要接受额外的培训1) 社区参与的研究，2)适应边缘人群的行为干预，以及3) 进行和评估临床试验。Stroumsa博士的培训将得到一个跨学科团队的支持 美国国立卫生研究院资助的导师。主要的联合导师Paul Pfeiffer博士和Rob Stephenson博士拥有广泛的 指导经验和专业知识设计和评估改善心理健康结果的干预措施 分别与性别和性少数群体有关。艾米·舒尔茨博士和克里斯蒂·加马雷尔博士(共同导师)是专家 在以社区为基础的参与性研究和同伴提供的行为干预中 分别为TGBN群落。培训还得到了来自顾问的定期反馈的支持， 高级教学课程，以及参加研讨会/研讨会。这些将使斯特鲁姆萨博士能够 无缝过渡成为独立研究员，致力于改善TGNB人的健康 通过开发和测试以患者为中心的干预措施的结果。

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.