Ignite Creation Date:
2024-10-26 @ 3:41 PM
Last Modification Date:
2024-10-26 @ 3:41 PM
Study NCT ID:
NCT06615401
Status:
NOT_YET_RECRUITING
Last Update Posted:
None
First Post:
2024-09-23
Brief Title:
Understanding Perceived Access and Receipt of Gender-affirming Treatments Among Transgender Veterans
Sponsor:
None
Organization:
None
Study Overview
Official Title:
Understanding Perceived Access and Receipt of Gender-affirming Treatments Among Transgender Veterans
Status:
NOT_YET_RECRUITING
Status Verified Date:
2024-09
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
No
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
Transgender Veterans trans Vets frequently experience gender dysphoria or distress related to discord between their gender identity and birth sex Gender-affirming treatments GATs are medically necessary treatments to reduce gender dysphoria However not much is known about the barriers and facilitators that influence GAT access and receipt in VA and VA Community Care CC among trans Vets who desire GATs The goals of this mixed-methods study are to determine which GATs trans Vets receive and in which setting identify barriers and facilitators associated with desired GAT receipt in VA and CC how barriers and facilitators influence GAT access and desire and how to improve GAT access in VA and CC In partnership with the Stakeholder Advisory Group the investigators will develop patient-centered implementation strategies to address barriers and enhance facilitators to GAT access The proposed study will position us to deploy these strategies in a follow-up study to mitigate barriers improve GAT access in VA and CC and promote trans health equity
Detailed Description:
Background Transgender people experience discord between their gender identity and birth sex defined as gender dysphoria Gender-affirming treatments GATs are medically necessary treatments to reduce gender dysphoria However among transgender Veterans trans Vets who desire GATs not much is known about barriers and facilitators to accessing and receiving GATs in VA and VA Community Care CC To ensure effective and equitable GAT access for trans Vets it is critical to understand 1 GATs trans Vets receive and where they receive them 2 barriers including social determinants of health SDOH barriers that are highly prevalent among trans Vets and facilitators associated with desired GAT receipt in VA and CC 3 how barriers and facilitators influence GAT access and desire and 4 how to improve GAT access in VA and CC
Significance This study addresses the 2022 HSRD priority areas of Access to Care Health EquitySDOH MISSION Act and research gap of underserved LGBTQ Veterans It is also a high priority for the operational partners in VA LGBTQ Health Program Pharmacy Benefits Management Office of Integrated Veteran Care and Office of Mental Health and Suicide Prevention Knowledge gained from this study will ensure that GAT delivery in the VA is patient-centered and is responsive to the lived realities and needs of trans Vets
Innovation and Impact This study will be the first to characterize the GATs received in VA andor CC to understand how VA and CC are balanced in terms of delivering GATs This study will also provide novel data on trans Vet experiences related to GAT access in CC which will be likely relevant to other underserved Veterans accessing CC Further it will be innovative in providing data on services and resources used by trans Vets to address barriers that influence GAT access This will be key to developing patient-centered implementation strategies to improve GAT access in VA and CC
Specific Aims The investigators propose a sequential explanatory mixed method study whose aims are to
Aim 1 Characterize the GATs received by trans Vets in VA andor CC VACC Aim 2 Identify barriers and facilitators associated with desired GAT receipt in VA and CC Aim 3 Understand trans Vet experiences related to GAT access in VA and CC
Methodology Database Aim 1 The investigators will expand the VA cohort of 9608 trans Vets IIR 17-238 from 2006-18 to the data available at the time of funding The investigators will add CC data to determine the types of GATs received by trans Vets in VA andor CC Survey Aim 2 The investigators will survey a national sample of trans Vets identified from Aim 1 Among trans Vets who desire GATs the investigators will determine SDOH barriers other barriers and facilitators associated with desired GAT receipt Among trans Vets who did not desire GATs the investigators will determine reasons for not wanting GATs Qualitative Aim 3 From Aim 2 participants the investigators will recruit a purposive sample of trans Vets who received all desired GATs who received some desired GATs and who received no desired GATs The investigators will also recruit a national sample of LGBTQ Veteran Care Coordinators The investigators will seek to understand experiences and perspectives on GAT access in VA and CC how SDOH barriers other barriers and facilitators influence GAT access and desire and how to improve GAT access in VA and CC Informed by study findings and in partnership with the Stakeholder Advisory Group the investigators will develop patient-centered implementation strategies to mitigate barriers and enhance facilitators to improve GAT access in VA and CC
Next StepsImplementation The investigators will conduct a follow-up hybrid implementation effectiveness study to deploy these strategies to address barriers that impede GAT access and improve GAT access in VA and CC
Significance This study addresses the 2022 HSRD priority areas of Access to Care Health EquitySDOH MISSION Act and research gap of underserved LGBTQ Veterans It is also a high priority for the operational partners in VA LGBTQ Health Program Pharmacy Benefits Management Office of Integrated Veteran Care and Office of Mental Health and Suicide Prevention Knowledge gained from this study will ensure that GAT delivery in the VA is patient-centered and is responsive to the lived realities and needs of trans Vets
Innovation and Impact This study will be the first to characterize the GATs received in VA andor CC to understand how VA and CC are balanced in terms of delivering GATs This study will also provide novel data on trans Vet experiences related to GAT access in CC which will be likely relevant to other underserved Veterans accessing CC Further it will be innovative in providing data on services and resources used by trans Vets to address barriers that influence GAT access This will be key to developing patient-centered implementation strategies to improve GAT access in VA and CC
Specific Aims The investigators propose a sequential explanatory mixed method study whose aims are to
Aim 1 Characterize the GATs received by trans Vets in VA andor CC VACC Aim 2 Identify barriers and facilitators associated with desired GAT receipt in VA and CC Aim 3 Understand trans Vet experiences related to GAT access in VA and CC
Methodology Database Aim 1 The investigators will expand the VA cohort of 9608 trans Vets IIR 17-238 from 2006-18 to the data available at the time of funding The investigators will add CC data to determine the types of GATs received by trans Vets in VA andor CC Survey Aim 2 The investigators will survey a national sample of trans Vets identified from Aim 1 Among trans Vets who desire GATs the investigators will determine SDOH barriers other barriers and facilitators associated with desired GAT receipt Among trans Vets who did not desire GATs the investigators will determine reasons for not wanting GATs Qualitative Aim 3 From Aim 2 participants the investigators will recruit a purposive sample of trans Vets who received all desired GATs who received some desired GATs and who received no desired GATs The investigators will also recruit a national sample of LGBTQ Veteran Care Coordinators The investigators will seek to understand experiences and perspectives on GAT access in VA and CC how SDOH barriers other barriers and facilitators influence GAT access and desire and how to improve GAT access in VA and CC Informed by study findings and in partnership with the Stakeholder Advisory Group the investigators will develop patient-centered implementation strategies to mitigate barriers and enhance facilitators to improve GAT access in VA and CC
Next StepsImplementation The investigators will conduct a follow-up hybrid implementation effectiveness study to deploy these strategies to address barriers that impede GAT access and improve GAT access in VA and CC
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
None
Is a FDA Regulated Device?:
None
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None