Background: Transgender and nonbinary (TNB) patients are underserved by the current US healthcare system and experience disparities across the cancer continuum. They face significant barriers to care, and data on cancer and cancer disparities are critically limited. An inclusive understanding of root causes of TNB cancer disparities will elucidate potential solutions and future PCOR/CER questions.
Proposed Solution to the Problem: This project will aim to bridge the gap in understanding between community and academic partners and build knowledge to create a patient-centered outcomes research/comparative clinical effectiveness research (PCOR/CER) agenda to reduce TNB cancer disparities. To achieve this, the project team will form a transdisciplinary (TD) team with diverse cultural, social, and scientific contexts to engage in a TD collaboration process, facilitating the openness, respect, trust, and stability needed for mutual learning.
Objectives: To achieve the goal of using TD collaboration with diverse stakeholders to create a patient-centered TNB cancer disparities CER agenda, the project team will pursue the following aims:
- Create a TD team with expertise from broad biomedical research disciplines and TNB community members and TNB-serving organizations
- Facilitate engagement across the TD team to co-learn and generate a conceptual model of TNB cancer disparities and co-create a PCOR/CER agenda
- Disseminate the team’s research agenda in community town halls and in clinical and academic settings
Through this process, the project team intends to change how academic researchers and community stakeholders work together to adopt approaches grounded in deep equity and integrating diverse perspectives to begin to understand the systems that perpetuate cancer disparities.
Activities: The co-leaders will recruit a TD team from the TNB community, TNB-serving organizations, and diverse research disciplines from a local academic medicine institution in Milwaukee, Wisconsin. Using tools from prior TD work and from the PCORI-funded SEED Method, the co-leaders will guide the team to:
- Co-learn about TNB cancer disparities and the community impact
- Create a preliminary conceptual model of cancer disparities validated through stakeholder focus groups
- Collectively develop a patient-centered research plan
- Present the plan at community town halls and academic seminars
Projected Outcomes and Outputs:
Short-term outcomes during the project period include changes in TD participants such as increased trust, cognitive shifts, and a greater understanding of how diverse partners can effectively collaborate. The project will produce a PCOR/CER agenda to guide future work and create a guide for TD collaboration.
Medium-term outcomes (zero-two years post-project period) include funding of the identified research questions along with increased interest and engagement of new community and research partners.
Long-term outcomes (three or more years post-project period) include expanding community and academics’ engagement beyond the original TD team and implementing relevant PCOR/CER projects to positively impact TNB cancer outcomes.
Patient and Stakeholder Engagement Plan: The project co-leaders will engage a diverse stakeholder group including clinicians, researchers, TNB-serving organizations, as well as TNB community members, allies, and patient advocates. Stakeholders will be engaged in a TD team led by an academic and nonacademic co-leader and through discussion sessions, town halls, and academic grand rounds.
Project Collaborators: This project is co-led by Chandler Cortina, MD, MS, MCW, and michael munson, FORGE Executive Director.