Researchers and participants can collaborate and design interfaces that make information accessible. The benefits of this approach include engaging co-designers (henceforth, participants) selected to be representative of the community of intended end users to thoroughly explore and prioritize target audience needs. Participatory design has proven to be successful in designing mobile health resources. Participatory Design and Web-Based Participatory Design We chose a mobile app (Android and iOS mobile operating system) user interface as the optimal method of delivery because of mobile phone ownership-85% of Americans own a smartphone -and mobile phones support anywhere and anytime access to information. To address this need, we developed the Transgender Health Information Resource (TGHIR). Digital tools might be important for TGD health self-management, but they are currently underutilized. Published literature highlights the lack of credible web-based information resources dedicated to the needs of TGD individuals. For this project, credible information was defined as information created or disseminated by clinicians and organizations, such as the Trevor Project, with expert knowledge about care specific to the needs of transgender individuals, and reputable sources of health information such as MEDLINEPlus. Ĭonsidering the known difficulties in seeking and determining the credibility of web-based transgender health information and the current lack of transgender-specific materials on the web, we aimed to create a health information resource to support the TGD population. The affordances of social media provide a network for peer-to-peer, emotional, appraisal, and informational support. There is evidence that social media is a key resource relied upon by the TGD community to obtain health and medical information. In another study, younger TGD individuals used various web-based platforms to explore transgender, nonbinary, and gender-diverse identities and to find support networks. A study found that gender transition mental health message boards are popular, especially on the Tumblr platform. A growing body of literature focuses on the TGD community and their health information–seeking behavior on the web. Documented examples of insensitive health care include gender insensitivity in which individuals were misgendered (using “he” when a “they” pronoun was requested) or forced care where some patients felt they were forced to do unnecessary examinations or dismissed as “psych cases”. Owing to stigma and discrimination when seeking health care, TGD community members often turn to health and medical information on the web. Moreover, TGD individuals often have to manage chronic stress owing to traumatic experiences over their life course. ![]() Transgender individuals experience stigma and discrimination across the social determinants of health, including bullying in schools, lack of stable income, and quality housing. TGD individuals report difficulties finding and accessing TGD-competent health care professionals, securing insurance coverage for their health care needs, and finding health care professionals who are sensitive to the needs of the TGD population. ![]() Three-fourths of TGD individuals report negative experiences with the health care system. Transgender and gender-diverse (TGD) individuals (defined as people whose current gender is different from that assigned at birth, including, but not limited to, nonbinary, queer, and gender nonconforming people, hereafter shortened to TGD) face health disparities including high degrees of stigma and discrimination from providers and health care systems. Transgender and Gender-Diverse Health and Medical Information Needs We defined an influential interaction as communication, either verbal or web-based content manipulation, that advanced the design process. We described and characterized engagement during a single design session by tracking the number of influential interactions among participants. The design process took place in several workshops over a period of 10 months. ![]() Recruitment was led by one of our community partners, One Colorado, who used private Facebook groups in which web-based flyers were dispersed. Justinmind was used to create prototypes that were shared and discussed via Zoom. REDCap allowed us to collect survey responses. Mural was used to perform exercises, such as free listing, brainstorming, and grouping. Zoom was used as an integrated platform for design activities. ![]() We used web-based collaborative tools, including Zoom (Zoom Video Communications), Mural (Mural), REDCap (Research Electronic Data Capture Vanderbilt University), and Justinmind (Justinmind), to engage the participants in the design process. We planned and conducted web-based design sessions to replace the proposed in-person sessions.
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