Mitigating Reproductive Health Disparities in Young Women of Color: Remote Learning to Foster Cultural Responsiveness in Medical Residents

项目摘要/摘要 黑人和拉丁裔女孩(有色人种年轻妇女)因生殖健康状况不佳而背负着沉重的负担。 这些健康不平等在一定程度上是由于医疗保健差异中起作用的提供者级别的因素(即， 临床不确定性和沟通不畅)3.这些因素突显了医疗培训的不足。一致 NIMHD在临床和卫生服务研究方面的研究重点，特别是文化能力和 患者-临床医生交流4，目前的项目旨在提高#岁以下年轻女性的医疗质量 通过瞄准这一训练差距来涂抹色彩。这项研究将开发一个移动学习课程，并利用基于模拟的 评估，以促进对年轻人有效和高质量生殖保健的培训和评估 有色人种女人。候选人。我是一名健康服务研究员，有健康预防科学的背景。 存在明显种族和民族差异的危险行为。我正在申请为期五年的K23职业发展计划 获得培训、指导和研究经验以成为专家的奖项(能够获得R01 在保健和保健公平方面为小规模的儿科人口，特别是#年的年轻妇女提供资金 颜色。辅导。我已经组建了一支出色的指导团队，具有广泛的互补性 与研究目的和我的职业发展目标一致的专业知识。Sheana Bull博士是小学 Mentor以其在数字健康和数字教育方面的工作而闻名。我的共同导师包括：克里斯蒂娜博士 STUTS(在儿科人群中的传播和实施科学)，Evelinn Borrayo博士(使用混合- 方法、健康差距和卫生服务)，Jeffery Barsuk博士(医学教育和模拟 掌握学习)和克里斯托弗·霍克博士(青少年生殖健康干预)。研究。这个 拟议项目的目标是(1)综合文献、形成的利益相关者数据，以及 指导移动学习原型开发的专家小组；(2)进行反复的认知轮次 与住院医生、主治医生和项目主管进行面谈，使用快速成型周期来完善和敲定 移动学习课程；以及(3)小规模评估移动学习课程的初步效果 在接受移动学习课程的住院医生样本中进行随机对照试验，与等待名单对照。 训练。针对健康和医疗保健差距的具体培训将包括：制定 有效的循证数字保健工具、传播和实施战略(包括混合战略 研究设计)、高级混合方法技能和基于模拟的医学教育。这次培训将 通过强化辅导培训、参与辅导研究和初步研究来实现， 定向阅读、课程作业、网络研讨会和培训机构。在我优秀的指导团队的指导下，这些 培训和研究经验将为我的职业生涯奠定基础，成为一家独立的、由联邦政府资助的医疗服务机构 研究人员开发数字健康和模拟干预措施，以解决儿童少数群体健康和 通过可获得性、响应性和高质量的医疗保健实现医疗差距。

PROJECT SUMMARY/ABSTRACT Black and Latina girls (young women of color) are heavily burdened by poor reproductive health outcomes1-2. These health inequities are perpetuated, in part, by provider-level factors operative in healthcare disparities (i.e., clinical uncertainty and poor communication)3. These factors highlight inadequate medical training. Consistent with NIMHD’s Research Priorities in Clinical and Health Services Research, specifically cultural competence and patient-clinician communication4, the current project aims to improve health care quality for young women of color by targeting this training gap. The study will develop an mLearning course and utilize simulation-based assessment to facilitate training and assessment in effective and high-quality reproductive healthcare for young women of color. Candidate. I am a health services researcher with a background in prevention science for health risk behaviors with significant racial and ethnic disparities. I am applying for a five-year K23 Career Development Award to obtain training, mentorship, and research experience to become an expert (capable of obtaining R01 level funding) in health and healthcare equity for minoritized pediatric populations, in particular young women of color. Mentoring. I have put together an exceptional mentoring team with extensive and complementary expertise consistent with the study’s aims and my career development objectives. Dr. Sheana Bull is the Primary mentor renowned for her work in digital health and digital education. My co-mentorship includes: Dr. Christina Studts (dissemination and implementation science in pediatric populations), Dr. Evelinn Borrayo (using mixed- methods, health disparities, and health services), Dr. Jeffery Barsuk (medical education and simulation-based mastery learning), and Dr. Christopher Houck (adolescent reproductive health interventions). Research. The aims of the proposed project are to (1) integrate a synthesis of the literature, formative stake-holder data, and an expert panel to guide the development of an mLearning prototype; (2) conduct iterative rounds of cognitive interviews with residents, attendings, and program directors using a formative rapid cycle to refine and finalize the mLearning course; and (3) evaluate preliminary effectiveness of the mLearning course via a small scale randomized control trial in a sample of residents who receive the mLearning course versus a waitlist control. Training. Specific training in the context of health and healthcare disparities will include: the development of effective evidence-based digital health tools, dissemination and implementation strategies (including hybrid research designs), advanced mixed-methods skills, and simulation-based medical education. This training will be achieved through intensive mentored training, participation in mentored research and primary research, directed readings, coursework, webinars, and training institutes. Guided by my excellent mentorship team, these training and research experiences will establish my career as an independent, federally funded health services researcher developing digital health and simulated interventions to address pediatric minority health and healthcare disparities through accessible, responsive, and high-quality healthcare.