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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.

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Rocky is the current board chair for Transgender Education Network of Texas ( TENT). He grew up in Austin Texas and has spent his life devoted to causes and creative pursuits. He is a loving husband to his wife Sarah and together they have an entertainment and lifestyle brand called SwirlBaby. Now at 35 years old, Rocky’s resume tells an interesting story of a young man with wide-ranging interests in health, wellness, entertainment, and entrepreneurship. As an advocate, Rocky has participated in countless leadership trainings and community-led fundraising events. As a health provider he has worked in careers ranging from certified nurse assistant to City of Austin Paramedic. Rocky’s story is one of tenacity, resilience, struggle, and triumph. He understands intimately the power of advocacy and action. As a paramedic, he served as the creator of the Austin Paramedic Relief fund and board member for the Paramedic Association in the early 2000’s, a member of the collective bargaining team for workers rights and wages with the City of Austin. He has learned the procedure and strategy necessary to create real change and he is eager to offer his experience and knowledge to the fight for protections for our community.

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Kory Thomas served as the Assistant Director for the statewide capacity building initiative, Extension for Community Health Outcomes (ECHO) Colorado based at the University of Colorado Anschutz Medical Campus for the five years prior to founding an independent coaching and consulting company, Core Capacities LLC. Her experience launching a statewide ECHO replication hub including multi-sector partnerships and extensive operational infrastructure enabling rapid ECHO initiative development lead to the successful launch of over 20 ECHO projects in the first year of programming. Kory has been supporting the National Network of Public Health Institutes on their integration of the ECHO model into activities for the Hurricane Response Hub, COVID-19 response and Opioid Prevention and Treatment Strategies in Public Health since early 2019. Kory is experienced in relationship development and management of a multitude of stakeholders including community members, leaders, organizations, subject matter experts, university faculty, board members and team members. Kory received her Masters in Public Health from the University of Michigan, is a graduating fellow of the Advance Leadership Training Program for the Regional Institute of Health and Environmental Leadership and recently received her Associate Certified Coach credential through the International Coaching Federation.

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John Oeffinger is Director, eLearning and Training for Texas Health Institute and Co-Director of TransFORWARD: Texas Transgender Health, a collaboration between Texas Health Institute and Equality Texas Foundation. He has 39 years’ experience in project management, distance education and eLearning in for-profit, association, and non-profit organizations. John currently leads or co-directs four eLearning or transgender health projects for THI developing collaborative partnerships with national, state, and community based partners. He has been project lead for thirty-three online courses including twenty-five that are currently online. John earned his Bachelor of Arts in Anthropology from Texas A&M University in 1976 and was named to Marquis Who’s Who in America in 1996. His primary research interests are in culturally competent transgender health, 3D immersive learning, web and mobile applications in health, and developing organizational knowledge.

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