Rationale, Design, and Methods for Nen Unkumbi/Edahiyedo ("We Are Here Now"): A Multi-Level Randomized Controlled Trial to Improve Sexual and Reproductive Health Outcomes in a Northern Plains American Indian Reservation Community.
Rationale, Design, and Methods for Nen Unkumbi/Edahiyedo ("We Are Here Now"): A Multi-Level Randomized Controlled Trial to Improve Sexual and Reproductive Health Outcomes in a Northern Plains American Indian Reservation Community.
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DOI：
10.3389/fpubh.2022.823228
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发表时间：
2022
影响因子：
5.2
通讯作者：
Baldwin, Julie
中科院分区：
文献类型：
--
作者：
Rink, Elizabeth;Firemoon, Paula;Anastario, Michael;Johnson, Olivia;GrowingThunder, Ramey;Ricker, Adriann;Peterson, Malory;Baldwin, Julie
关键词：
与非土著白色青年相比，美国的美洲印第安人青年在性健康和生殖健康方面存在不成比例的差距，包括性传播感染率上升、初次性行为较早、青少年生育率上升以及获得性健康和生殖健康服务的机会减少。过去的研究表明，为了改善保留地社区AI青年的SRH结果，干预措施必须解决影响性风险行为的复杂因素和多层次的社区。在这里，我们描述了一个多层次，多组分的随机对照试验（RCT）的发展，干预后SRH的结果在北方平原美国印第安人保留社区。我们的干预措施植根于基于社区的参与性研究框架，并采用阶梯式楔形设计进行评估，该设计将5所保留高中整合为5年随机分组RCT。采用生态系统理论设计干预措施，包括（1）学校特定文化性健康和生殖健康课程的个人层面组成部分，（2）教育的父母组成部分，以改善亲子沟通有关性健康和生殖健康和健康的关系，（3）文化指导的社区组成部分，（4）系统层面的组成部分，以改善保留地医疗机构提供的性健康和生殖健康服务。在这篇文章中，我们提出了我们的研究设计，仪器，数据收集协议，分析方法和社区参与干预的基本原理和细节。我们的干预措施建立在现有的社区优势之上，并将传统的土著知识和价值观与当前的公共卫生知识相结合，以减少性健康和生殖健康方面的差距。
American Indian (AI) youth in the United States experience disproportionate sexual and reproductive health (SRH) disparities relative to their non-Indigenous, white counterparts, including increased rates of sexually transmitted infections (STIs), earlier sexual debut, increased rates of teen birth, and reduced access to SRH services. Past research shows that to improve SRH outcomes for AI youth in reservation communities, interventions must address complex factors and multiple levels of community that influence sexual risk behaviors. Here, we describe development of a multi-level, multi-component randomized controlled trial (RCT) to intervene upon SRH outcomes in a Northern Plains American Indian reservation community. Our intervention is rooted in a community based participatory research framework and is evaluated with a stepped wedge design that integrates 5 reservation high schools into a 5-year, cluster-randomized RCT. Ecological Systems Theory was used to design the intervention that includes (1) an individual level component of culturally specific SRH curriculum in school, (2) a parental component of education to improve parent-child communication about SRH and healthy relationships, (3) a community component of cultural mentorship, and (4) a systems-level component to improve delivery of SRH services from reservation healthcare agencies. In this article we present the rationale and details of our research design, instrumentation, data collection protocol, analytical methods, and community participation in the intervention. Our intervention builds upon existing community strengths and integrates traditional Indigenous knowledge and values with current public health knowledge to reduce SRH disparities.
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影响因子：
3.1
作者：
Chadda RK;Deb KS
通讯作者：
Deb KS
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作者：
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Borek AJ;Abraham C;Smith JR;Greaves CJ;Tarrant M
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Christopher, Suzanne;Watts, Vanessa;Young, Sara
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Trotter, RT