Hines mnrs presentation


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Summarizes lessons learned from a pilot study designed to test strategies used to recruit HIV positive transgender women for a grounded theory study.

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Hines mnrs presentation

  1. 1. How to Reach the Hidden:Strategies for Recruiting HIV-PositiveTransgender WomenDana D. Hines, MSN, RNPredoctoral Fellow
  2. 2. Acknowledgements• Research Mentors & Co-Investigators– Dr. Barbara HabermannIndiana University School of Nursing-Indianapolis– Dr. Eric WrightRichard M. Fairbanks School of Public Health-IUPUI• Funding– F31 NR013864-01– T32 Training in Health Behaviors Research-IUPUI
  3. 3. Objectives• Study overview• Discuss recruitment strategies• Describe recruitment challenges• Outline lessons learned• Propose new strategies for recruitment
  4. 4. Has been limitedIncluded in the broaderscope of LGB studiesPolicy makers havecalled for greateremphasis on transgenderhealthTransgender Research
  5. 5. • Using a grounded theoryapproach and qualitativeinterviews, this study willexplore:– Social network influences onhealthcare utilization– Patterns of healthcare use– Quality of healthcareencountersResearch Priorities:Social and structural influences onhealthcareInequities in healthcare accessTransgender specific health needsStudy Overview & Aims
  6. 6. Transgender Women• Transgender women(TGW)– Biological men who livetheir lives as women.– Most marginalized of allgender and sexualminorities– Increased risk forviolence anddiscrimination.
  7. 7. Transgender Women and HIV High rates of HIV prevalence High rates of morbidity and mortality Least likely to establish and remain engaged in HIVcare
  8. 8. HIV-Related Stigma• HIV remains one of themost stigmatizingillnesses• HIV positive TGWespecially face socialmarginalization andstigma related to theirgender identity and HIVstatus
  9. 9. Pilot Study Aims• Test recruitment strategies andappropriateness of interview guide• Recruit 5 HIV-positive TGW using purposiveand snowball sampling
  10. 10. Pre-recruitment phaseRecruitment/Collaborating Sites Number of HIV+ TGW(served in previous 12months)Indiana State Department of Health (ISDH) 34*Marion County Public Health Department (MCPHD) 32*Wishard Infectious Disease Clinic 12IU Health Life Care Infectious Disease Clinic 10Community Infectious Disease of Indiana ~5The Damien Center (AIDS service organization( ASO) 17Brothers United of Indianapolis (ASO) 68***Represents unique and non-overlapping TGW**Includes both HIV+/- TGWData as of 1/201266
  11. 11. Recruitment• Phase I– Introductory letters andstudy flyers were mailedto HIV + TGW– Flyers posted atcollaborating clinics andASO.• Phase II– Held informationmeetings with staff atcollaborating agencies– Posted recruitmentflyers in areasdesignated by staff
  12. 12. Other Recruitment StrategiesIndy Gay PRIDEIndiana AIDS WalkTalbott Street Night ClubBlack PRIDE Festival
  13. 13. Recruitment Timeline, Activities & OutcomesDate Activity Number ofrecruitmentflyersdistributedNo. lettersreturnedNumber ofsuccessfulinterviewsscheduled8/11/12 Attended Indy Black PRIDE 8 NA 08/17/12 Study overview and recruitment meeting--state health department10 3 09/14/12 Study overview and recruitment meetingtransgender peer contact5 NA 19/25/12 Study overview meeting with localpharmaceutical representative3 NA 09/27/12 Study overview and recruitment meeting- -county health department5 0 110/10/12 Study overview and recruitment meeting-Life Care clinic14 0 111/5/12 Study overview and recruitment meeting-Damien Center7 0 052 N=3
  14. 14. Recruitment FlyerIf you answered yes to the questions above you may beable to take part in a study about the experiences ofseeking, entering, and staying in HIV care. Informationfrom this study will increase knowledge and awareness oftransgender women’s HIV health needs and improve theHIV healthcare experiences of transgender women.Are you a transgender woman who is:Living with HIV/AIDS and at least 18years or older?Please note that all eligible participants will be asked to take part in a one-on-one 60-90 minute interview. Interviews will be held in private location. Yourname and personal information are not required to participate. A gift cardwill be given to all women who complete the interviews.Call Dana H. RN, MSNIndiana University School of Nursingat (317) 759-3885 for more information
  15. 15. Lessons Learned• Opt-in recruitment• Recruitment through the state healthdepartment• Community events• Community gate-keeper (transgender peer)• Phone calls versus letters
  16. 16. Lessons Learned• Face-to-face interviews preferred• “I am a woman, just like you”• Include incentives on recruitment flyer• Employ less restrictive inclusion criteria• Include question about other strategies forrecruitment
  17. 17. Next Steps/New Directions• Form a transgenderadvisory board• Respondent drivensampling• Increase recruitmentincentive from $25 to$50• Include incentive onrecruitment flyers• Include question aboutbest strategies forrecruitment in interview
  18. 18. Contact InformationResearch TeamDana Hines, RN, MSNPredoctoral FellowIndiana University School of Nursingdcheatem@iupui.eduBarbara Habermann, PhD, RN, FAANIndiana University School of Nursinghabermab@iupui.eduEric Wright, PhDRichard M. Fairbanks School of Public Health-IUPUIewright@iupui.edu