Lacombe-Duncan Ashley, Hughson Luna, Kay Emma Sophia, Duncan Sydney, Willbrandt Camille
School of Social Work, University of Michigan, Ann Arbor, Michigan, USA.
Women's College Hospital, Women's College Research Institute, Toronto, Ontario, Canada.
Int J Transgend Health. 2023 Jul 24;25(3):321-351. doi: 10.1080/26895269.2023.2232353. eCollection 2024.
Pervasive health and healthcare disparities experienced by transgender (trans) and gender diverse (TGD) people require innovative solutions. Peer-based interventions may address disparities, and are an approach endorsed by TGD communities. However, the scope of the literature examining peer-based interventions to address health and healthcare access inclusive of TGD people is uncharted. This scoping review aimed to understand the extent of the literature about peer-based interventions conducted with and/or inclusive of TGD populations; specifically, study participants (e.g. sociodemographics), study designs/outcomes, intervention components (e.g. facilitator characteristics), and intervention effectiveness. Underpinned by Arksey and O'Malley's framework: (1) identifying the research question; (2) identifying studies; (3) study selection; (4) charting data; and (5) collating, summarizing, and reporting results, eligible studies were identified, charted, and thematically analyzed. Databases (e.g. ProQuest) and snowball searching were utilized to identify peer-reviewed literature published within 15 years of February 2023. Extracted data included overarching study characteristics (e.g. author[s]), methodological characteristics (e.g. type of research), intervention characteristics (e.g. delivery modality), and study findings. Thirty-six eligible studies documented in 38 peer-reviewed articles detailing 40 unique peer-based interventions were identified. Forty-four percent ( = 16/36) of studies took place in United States (U.S.) urban centers. Over half ( = 23/40, 58%) focused exclusively on TGD people, nearly three-quarters of which ( = 17/23, 74%) focused exclusively on trans women/transfeminine people. Ninety-two percent ( = 33/36) included quantitative methods, of which 30% ( = 10/33) were randomized controlled trials. HIV was a primary focus ( = 30/36, 83.3%). Few interventions discussed promotion of gender affirmation for TGD participants. Most studies showed positive impacts of peer-based intervention. Although promising in their effectiveness, limited peer-based interventions have been developed and/or evaluated that are inclusive of gender-diverse TGD people (e.g. trans men and nonbinary people). Studies are urgently need that expand this literature beyond HIV to address holistic needs and healthcare barriers among TGD communities.
跨性别者和性别多样化人群普遍面临的健康及医疗保健差异需要创新解决方案。基于同伴的干预措施可能有助于解决这些差异，这是跨性别和性别多样化群体认可的一种方法。然而，研究针对跨性别和性别多样化人群的基于同伴的干预措施以解决健康及医疗保健可及性问题的文献范围尚不明晰。本范围综述旨在了解有关针对跨性别和性别多样化人群开展的及/或包含这些人群的基于同伴的干预措施的文献程度；具体而言，包括研究参与者（如社会人口统计学特征）、研究设计/结果、干预组成部分（如促进者特征）以及干预效果。以阿克西和奥马利的框架为基础：（1）确定研究问题；（2）识别研究；（3）研究选择；（4）绘制数据；以及（5）整理、总结和报告结果，识别出符合条件的研究，进行绘制并进行主题分析。利用数据库（如ProQuest）和滚雪球搜索来识别2023年2月前15年内发表的同行评审文献。提取的数据包括总体研究特征（如作者）、方法学特征（如研究类型）、干预特征（如实施方式）以及研究结果。共识别出38篇同行评审文章中记录的36项符合条件的研究，详细介绍了40项独特的基于同伴的干预措施。44%（=16/36）的研究在美国城市中心进行。超过一半（=23/40，58%）的研究专门针对跨性别和性别多样化人群，其中近四分之三（=17/23，74%）专门针对跨性别女性/跨女性人群。92%（=33/36）的研究采用了定量方法，其中30%（=10/33）是随机对照试验。艾滋病毒是主要关注点（=30/36，83.3%）。很少有干预措施讨论促进跨性别和性别多样化参与者的性别肯定。大多数研究表明基于同伴的干预措施有积极影响。尽管基于同伴的干预措施在有效性方面很有前景，但针对包括性别多样化的跨性别和性别多样化人群（如跨性别男性和非二元性别者）的基于同伴的干预措施开发和/或评估有限。迫切需要开展研究，将这一文献范围从艾滋病毒扩展到解决跨性别和性别多样化群体的整体需求及医疗保健障碍。
