Implementing structurally competent critical time intervention for transgender and gender-diverse patients

Active Project Grant Awarded Last action

Award ID
R01HS029683
Recipient
Awarding agency
Obligated
$794,496

Award facts

Completion date 43% complete
Funding agency
Office of Extramural Research Education and Priority Populations Agency for Healthcare Research and Quality, Department of Health and Human Services
Place of performance
New Mexico, USA

Award details come from USAspending.gov.

Description

As the agency reported it.

Abstract
The approximately 1.6 million americans who are transgender or gender diverse (TGD)-individuals with gender identities that differ from their SEX assigned at birth-are impacted by an extraordinarily high incidence of negative mental and physical health outcomes compared to their cisgender peers. Such outcomes include mental distress, suicide, substance use issues, and HIV and other sexually transmitted infections. These health inequities are attributable to "upstream" or structural factors, including systematic societal, political, and economic marginalization, medical pathologization, and violence. Research points to rampant multilevel access barriers for TGD people and major social needs that undermine engagement in healthcare. There is a public health imperative to develop healthcare interventions to reduce disparities for TGD people by facilitating access to and engagement with appropriate services, addressing their unique social determinants of health (sdoh), and integrating them into the social fabric of communities. Structural interventions target the social causes of ILL- health, inadequate and fragmented treatment, and inequalities affecting TGD people. In partnership with TGD community members, we created a structurally competent adaptation of the evidence-based critical time intervention (CTI), a robust case management program originally developed for persons with serious mental illness transitioning from institutions into communities, to ameliorate the disparities that impede the full integration of TGD people into healthcare systems. We will rigorously implement and evaluate this TGD-specific adaptation (CTI-t) in new mexico service systems and analyze impacts on TGD people exiting institutional settings, including shelter care and residential programs, hospitals, and jails/prisons. We will cultivate meaningful collaboration and inclusion of diverse partners to enable structural competency and CTI-t uptake at the multiple levels where care barriers exist by applying implementation mapping, a participatory process for planning and selecting implementation strategies (methods to adopt and implement interventions). We will leverage a seminal implementation model, the interactive systems framework, to guide efforts to embed CTI-t in professional service delivery contexts. A real-time evaluation of implementation and impact using a mixed-methods approach will facilitate dual testing of the CTI-t and its implementation strategies. By innovating CTI to prioritize structurally competent approaches, this study responds to the dearth of evidence-based intervention research targeting the sdoh responsible for the well-documented access barriers and excessive morbidity and mortality faced by TGD people.

Transactions

Action Obligated Date
Amendment $0
Amendment $397,248
Original award $397,248

Subawards

Subrecipient Amount Awarded
University Of California, San Diego Dr. Sommerfeld from the University of California, San Diego (UCSD) will support the design and implementation of the quantitative data collection strategies… $36,301
The Transgender Resource Center Of New Mexico The primary responsibility of the TGRC is to collaborate with PIRE in implementing Critical Time Intervention-Transgender and Gender-Diverse Adaptation (CTI-T).… $42,987

Quick answers

Who received award R01HS029683?

R01HS029683 was awarded to Pacific Institute For Research & Evaluation by Division of Grants Management (Agency for Healthcare Research and Quality) on September 30, 2024.

How much is award R01HS029683 worth?

$794,496 has been obligated on R01HS029683.

Which agency awarded R01HS029683?

Division of Grants Management (Agency for Healthcare Research and Quality) awarded R01HS029683, with funding from Office of Extramural Research Education and Priority Populations (Agency for Healthcare Research and Quality).

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