Duke University

Creating Access to Resources and Economic Support - Project Summary/abstract Transgender People Experience Economic and Psychosocial Inequities That Make Them Particularly Vulnerable to COVID-19 Pandemic-related Financial and Mental Health Harms. Sustainable, Multilevel Interventions Are Needed to Address These Harms and Promote Covid- 19 Prevention Behaviors. Transgender-led Organizations Have Been Galvanized to Provide Emergency Financial and Peer Support for Transgender People Negatively Impacted by Covid- 19. However, the Efficacy of These Interventions Have Not Been Evaluated. Leveraging Existing Community Partnerships and Ongoing Cohorts, the Study Seeks to Assess the Efficacy of Feasible, Acceptable, Community-derived Interventions to Reduce Economic and Psychological Harms Experienced by Transgender People in the Wake of COVID-19. the Specific Aims of the Project Are to (1) Compare the Efficacy of Microgrants With or Without Peer Mentoring to Reduce Psychological Distress and Increase COVID-19 Prevention Behaviors; (2) Examine Mechanisms by Which Microgrants With or Without Peer Mentoring May Impact Psychological Distress; and (3) Explore Transgender Participants' Intervention Experiences and Perceived Efficacy. These Aims Will Be Met by Enrolling 360 Transgender Adults Into an Embedded, Mixed Methods, 3-ARM, 12- Month Randomized Controlled Trial. Participants Will Be Randomized 1:1:1 to the Following Arms: (a) a Single Microgrant Plus Monthly Financial Literacy Education (usual Care); (B) Usual Care Plus Monthly Microgrants; or (C) Usual Care Plus Monthly Microgrants Combined With Peer Mentoring. All Intervention Arms Will Last for 6 Months, and Participants Will Complete Semi-annual Web- Based Surveys at 0, 6, and 12 Months as Well as Text-based Process Measures at 3 and 6 Months to Meet Aims 1 and 2. a Subset of 36 Participants, 12 Per Arm, Will Complete Longitudinal in Depth Interviews at 3 and 9 Months to Meet Aim 3. in Addition to Addressing the Pressing Impacts of the COVID-19 Pandemic on a Vulnerable Health Disparities Population, This Study Will Advance the Science of Minority Stress and Mental Health Inequities by Testing Interventions That Operate on General Stressors – I.e., Material Hardship and Community Connection – Rather Than Minority Stressors Such as Enacted Stigma. This National, Online Study Will Address Multilevel – Structural and Community – Factors Driving COVID-19 Pandemic Harms. Its Equitable Community Partnership Will Ensure That Study Findings Are Actionable and Disseminated Rapidly to Inform Sustainable Community-based Responses to the COVID-19 Pandemic as Well as Future Emergencies.