DESCRIPTION (provided by applicant): The transgender population is a medically underserved and understudied population with myriad barriers to care. Discrimination, substance abuse, violence, stigma, HIV/STI risk behaviors, and social isolation challenge delivery of primary and specialty services for transgender women of color (transwomen, TW), and thus new models of care are urgently needed. This application will provide pilot data on the application of telemedicine to provide a virtual medical home as a means to engage and retain TW of color in care. This study will assess the acceptability and feasibility of a novel telemedicine approach specific to TW to reduce barriers to care. By providing real-time access to culturally-sensitive care for TW remotely, we can overcome frequently encountered structural barriers. This study offers the opportunity to translate highly effective telemedicine methods to a population on whom this approach has not yet been tested. If shown to be feasible, acceptable, and associated with improvements in intentions to engage and retain in care, information gained through this pilot study will serve as the foundation for a future R34 or R01 study. The purpose of this study is to assess acceptability and feasibility of telemedicine as a virtual medical home to overcome barriers to utilization of healthcare services among out-of-care TW of color. The study has two phases: 1) In Phase I, we will conduct key informant interviews with providers of TW, and key informant interviews and focus groups with TW themselves to evaluate the acceptability of the telemedicine approach. 2) In Phase II, we will use peer-referral to will recrut a sample of 25 out-of-care TW who will have a 3 month comparison period followed by a 3 month telemedicine/virtual medical home pilot study period. This aim will assess the feasibility of the approach and its association with primary outcomes including intention to seek care and healthcare utilization behavior. If successful, telemedicine may offer an innovative strategy for a medically underserved and vulnerable population in urgent need of healthcare services.

PUBLIC HEALTH RELEVANCE: The purpose of this study is to assess acceptability and feasibility of telemedicine as a virtual medical home to overcome barriers to utilization of healthcare services among out-of-care male-to-female transgender persons of color. It will examine telemedicine as a means to overcome barriers to care unique to this population. If successful, telemedicine may offer an innovative strategy for engagement and retention of a medically underserved and vulnerable population in urgent need of healthcare services.