Assessing Health Provider Perspectives Regarding Barriers American Indian/Alaska Native Transgender and Two-Spirit Youth Face Accessing Healthcare.
J Racial Ethn Health Disparities
; 7(4): 630-642, 2020 08.
Article
em En
| MEDLINE
| ID: mdl-31933174
ABSTRACT
BACKGROUND:
American Indian/Alaska Native (AI/AN) youth disproportionately face barriers accessing healthcare compared with non-AI/AN youth. AI/AN youth who also identify as transgender or Two-Spirit (2S) face higher rates of mental health issues and suicidality, along with increased rates of disease, due to health inequity and historical trauma.OBJECTIVES:
This project evaluated health provider knowledge of context surrounding gender and sexuality in AI/AN communities. It assessed provider perspectives of provider-side and patient-side barriers accessing care to develop suggestions for improvement.METHODS:
Semi-structured interviews (SSI) and focus group discussions (FGD) were held among healthcare providers across four sites in the Pacific Northwest. Questions were developed using a community-based participatory research conceptual model, considering the impacts of context, partnerships, and community knowledge. A grounded theory approach was used to analyze transcripts. This project received exemption from the University of Washington IRB and approval from each tribal ethical/research committee.RESULTS:
Twenty healthcare providers from varied geographic settings, provider types, and ethnic backgrounds participated in this study. Knowledge regarding contexts surrounding gender in AI/AN communities varied. Long-standing effects of settler colonialism, trauma, and systemic issues presented as overarching concepts. Participants also shared a number of patient and provider-side barriers impacting care and suggested solutions to reduce these barriers.CONCLUSIONS:
Patient and provider-side barriers inhibit AI/AN transgender and 2S youth access to healthcare. Historical trauma and community resilience play a role in health for these youth. Understanding history, the intersection of identities, and community strengths can help with the development of solutions to provide high quality care to AI/AN transgender or 2S youth.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Atitude do Pessoal de Saúde
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Indígenas Norte-Americanos
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Pessoal de Saúde
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Pessoas Transgênero
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Identidade de Gênero
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Acessibilidade aos Serviços de Saúde
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Grupos Minoritários
Tipo de estudo:
Prognostic_studies
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Qualitative_research
Limite:
Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Racial Ethn Health Disparities
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Estados Unidos