Supporting Statement B

Request for Sub-collection under the Generic ICR:

Formative Research and Tool Development

OMB 0920-0840, Expiration Date 01/31/2019

Formative Research on Resilience and Transgender Youth

Supporting Statement B

October 14, 2016

Supported by:

Division of Adolescent and School Health

Centers for Disease Control and Prevention

Paula Jayne, PhD, MPH

CDC/OID/NCHHSTP, Health Scientist

(404) 718-8191

pij1@cdc.gov

B. Collections of Information Employing Statistical Methods

The information collection request does not employ statistical methods. The following is a description of our data collection procedures and qualitative data analysis techniques.

B.1 Respondent Universe and Sampling Methods

The respondent universe for the interviews consists of up to 48 transgender youth between the ages of 15 and 24 residing or using social services in the Atlanta Metro area. In order to maximize the diversity of transgender youth in our sample, we will use quotas and stratify our sample by birth sex and race. Because the experiences of female-to-male and male-to-female transgender youth may be developmentally distinct, we aim to sample up to 24 youth assigned male at birth, and up to 24 youth assigned female at birth. Additionally, we identified a need for diversity in participants’ race/ ethnicity, which may have implications for the protective factors youth access. In the eligibility screener (Attachment 6: Eligibility Screener) we will ask youth to identify their ethnicity (Hispanic or Latino, or not Hispanic or Latino) and their race. That information will be used to inform an ethnically and racially diverse sample. Our proposed quota structure aims to include up to 12 youth who identify as White, non-Hispanic, up to 12 who identify as Black, non-Hispanic, up to 12 who identify as Hispanic (regardless of racial identification), and up to 12 who identify as some other racial group (American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, or more than one racial group).

Exhibit B.1 Proposed Quota Structure of Sample

	Race/ Ethnicity
Sex on Birth Certificate	White, non-Hispanic	Black, non-Hispanic	Hispanic	Other Race	Total
Male	n=6	n=6	n=6	n=6	n=24
Female	n=6	n=6	n=6	n=6	n=24
Total	n=12	n=12	n=12	n=12	N=48

A purposive sampling technique will be used to identify transgender youth who meet these quota criteria. We worked with ICF International to identify Community Based Organizations (CBOs) which serve transgender youth in the Atlanta Metro area to assist with recruitment of a sample with adequate diversity. These CBOs will be involved as sub-contracts and provide assistance with identifying and enrolling eligible youth into the study.

B.2 Procedures for the Collection of Information

Recruitment

To ensure an adequate recruitment of transgender youth in the Atlanta Metro Area, sub-contracted CBOs will assist with recruitment efforts. These recruiters will participate in a 2-hour training on the research objectives, procedures, and their roles and responsibilities with regard to recruitment and data integrity. After the training, recruiters will conduct outreach by informing transgender youth accessing their agencies for services about the opportunity to participate in the interviews. Outreach about the study by recruiters will occur during regular CBO service delivery to this population, including during support groups, school and street outreach, HIV/STD testing and other interventions. Recruiters may also invite CDC staff or ICF contractors to speak about the study at appropriate gatherings of youth. CDC investigators and ICF contractors will provide recruiters with flyers and palm cards advertising the opportunity to participate in the qualitative interviews and contact information for the specific CBO recruitment contacts (Attachment 5: Recruitment Flyer/ Palmcard Text). Additional sites (“passive recruitment sites”) may be included solely for the purpose of material distribution in the form of flyers/ palm cards to advertise the study. Finally, this recruitment process will be supplemented with word of mouth referrals by enrolled participants. Participants who complete the study will be given three study palm cards to pass along to friends who might be eligible and interested in participation.

Data Collection

All interviews will be conducted by CDC investigators and ICF contractors trained in qualitative data collection methods. Interviews will take place face-to-face at local community organizations serving transgender youth in a private office or another private space. To create a standardized interview process, CDC and ICF International interviewers will follow a semi-structured interview guide to elicit participant responses (Attachment 3: Qualitative In-Depth Interview Guide). The guide is broken up into topical sections. Interviewers open with rapport building questions, segue into definitional discussions around health and gender identity, and then discuss protective factors across the social ecology of youth’s lives (i.e., individual, interpersonal, community and societal level factors). Because questions on the eligibility screener are not kept as records, the interview concludes with some demographic information. Interviews are estimated to last between 60 and 90 minutes. Interviews will be audio recorded in order to create an accurate record of the participant’s narrative. Upon completion of the interview, the interviewer will fill out an Interviewer Form (Attachment 7: Interviewer Form) to create a record of the interviewer’s experience of their time with the participant and note any unusual circumstances which may have influenced the interview data. (The Interviewer Form is completed by study staff and is not a component of the estimated burden to respondents.) All audio recordings of the interviews will be transcribed, and transcripts along with interviewer notes from the Interviewer form will be loaded into NVivo qualitative data analysis software The project has received IRB approval from both the CDC and ICF Human Subjects Review Boards (Attachment 10: IRB Approval Documentation).

B.3 Methods to Maximize Response Rates and Deal with No Response

The in-depth interview is brief (60 to 90 minutes) in order to minimize burden to the participants. Interviews will be scheduled at a time that is convenient for transgender youth, which may include evenings and weekends. All interviews will take place on site, in private offices, at sub-contracted CBOs that serve transgender youth. This will allow interviews to be conducted in a location that is familiar, comfortable, and private for youth. Interview candidates will be informed of measures that are in place to protect their identities; information about participants’ names is not kept as part of the data set, and thus not connected to any of their responses on the interview.

B.4 Test of Procedures or Methods to be Undertaken

The development of the in-depth interview guide (Attachment 3: Qualitative In-Depth Interview Guide) was informed by a systematic review of transgender youth and protective factors conducted by CDC staff and fellows in 2015 (Beltran et al., under review). Early versions of the interview guide received extensive input of expert consultants both internal and external to CDC. The interview guide was also piloted with four members of the CDC Transgender Working Group and their feedback was used to refine and finalize the instrument.

B.5 Individuals Consulted on Statistical Aspects and Individuals Collecting and/or Analyzing Data

Individuals who designed the data collection:

Paula Jayne, PhD, MPH

Health Scientist

CDC/OID/NCHHSTP

(404) 718-8191

pij1@cdc.gov

Michelle M Johns, MPH, PhD

Postdoctoral Research Fellow

CDC Foundation

Atlanta, GA

(404) 718-8858

mjohns1@cdc.gov

Individuals overseeing data collection:

Paula Jayne, PhD, MPH

Health Scientist

CDC/OID/NCHHSTP

(404) 718-8191

pij1@cdc.gov

Michelle M Johns, MPH, PhD

Postdoctoral Research Fellow

CDC Foundation

Atlanta, GA

(404) 718-8858

mjohns1@cdc.gov

Catherine Lesesne, PhD

Technical Director

ICF International

3 Corporate Square, Suite 370

Atlanta, GA 30329

Catherine.Lesesne@icfi.com

404-321-3211 (phone)

Individuals directing data analysis:

Paula Jayne, PhD, MPH

Health Scientist

CDC/OID/NCHHSTP

(404) 718-8191

pij1@cdc.gov

Michelle M Johns, MPH, PhD

Postdoctoral Research Fellow

CDC Foundation

Atlanta, GA

(404) 718-8858

mjohns1@cdc.gov

References

Beltran, O., Johns, M. M., Armstrong, H., Jayne, P. & Barrios, L. (in progress). A systematic review of protective factors experienced by transgender youth.

Guest, G., MacQueen, K., & Namey, E. (2012). Applied Thematic Analysis. Sage Publications.

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