TransFORWARD ECHO Framework
The Patient-Centered Outcomes Research Institute (PCORI) 1-year COVID-19 Enhancement will yield critical emerging information about the impact of the COVID-19 pandemic on the transgender and gender-diverse communities. Trans people were already less likely to seek or be able to access culturally-competent transgender medical care. The community is at a higher risk for social isolation and suicide compared to the general population. Trans people are also much less likely to be included in patient-centered outcomes research. In order to address the substantial inequities experienced by the BIPOC (Black Indigenous People of Color) community, a primary goal is to ensure the BIPOC community is substantially represented in all of TransFORWARD’s efforts.
The TransFORWARD ECHO Framework is centered by the core initiative goal — improving health outcomes of transgender and gender diverse communities across Texas. This central why is informed by personal narratives, stories, reflections, clinical experience, data, and current community engagement grassroots models.
Moving outward from the central goal represents the how, a multidimensional ring of collaborative partnerships. Engaging community, nonprofit, private sector, government, and academic partners at all program levels is fundamental to the interconnected roles required to achieve the goal. The partnership ring represents complex relationships with a multitude of assets reflected in a Key Stakeholder Matrix.
Examples of stakeholders include LGBTQ+ community leaders, clinicians, educators, and elected officials. Additional stakeholders provide wellness, disabilities, 65+ experience, historical, cultural, safety and access experiences. The matrix lists the stakeholder’s assets (experiences) across the top and the types of organizations with individuals on the left side. The completed matrix illuminates stakeholders who bring a diversity of knowledge and experiences (assets) to identify issues to solve.
The TransFORWARD COVID-19 Project Leadership team developed additional asset mapping tools to scale the project with accountable, equitable, intentional, and strategically representative partnership participation goals. Anchored by the “why” and made possible through the “how” the outer ripples represent the what of programming efforts. The three layers engage partners and information in a variety of ways. The Engagement Scale (Figure B) is a tool to describe community response through three important keys in creating impact: emotional intensity, engagement, and empowerment.
Topic Focus ECHO Sessions
The inner layer represents ECHO sessions on specific topics over the course of several months,focused on health impacts in the transgender and gender diverse communities across Texas during the COVID-19 pandemic. For example, over 12 weeks, six sessions will be held with a smaller group of partners who have experience with the specific topic of mental health. The following 12 weeks, six additional sessions are held with a focus on employment. Finally, the last 12 weeks of the initiative will include six sessions with a focus on housing. The partners participating in each series may overlap with the participants from the other series or may be different based on the shift in focus.
Community Collaboration ECHO Sessions
Continuous progress updating was identified as a central theme in the eight Regional Summits. The Community Collaborative ECHO sessions begin to address this request.
These large sessions will introduce the results of the Texas LGBTQ+ and You COVID-19 survey from transgender and gender diverse experience. This will frame future work with a clear understanding where the concerns are present in data and the importance of community perspective in building solutions. Future sessions will report highlights from the mental health, housing, and employment topic series.
TransCONNECT: Community Collaboration Portal
TransCONNECT is a collaborative online learning community for strengthening our collective fight to improve the transgender and gender diverse lives. The platform is designed to connect members across sectors to share knowledge and best-practices, build research capacity, and amplify impact. The Facebook and Twitter like interface enables community members to focus on collaboration without learning new technology. Community members register to help ensure safety and respect. Activity feeds, discussions, Zoom meeting announcements with recordings and a sophisticated document system enable real time collaboration.
TransFORWARD’s Framework will be evaluated to measure project outcomes. The final objective is a package of deliverables that other organizations can apply in various settings.