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

项目概要/摘要 黑人和拉丁裔女孩（有色人种的年轻女性）的生殖健康结果很差，负担沉重1 -2。 这些健康不平等现象在一定程度上是由医疗保健差距中的提供者因素造成的（即， 临床不确定性和沟通不良）3。这些因素突出表明医疗培训不足。一致 与NIMHD的临床和卫生服务研究的研究重点，特别是文化能力， 病人-临床医生沟通4，目前的项目旨在提高年轻妇女的保健质量， 针对这一培训缺口。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，以促进对年轻人进行有效和高质量生殖保健的培训和评估 女人的颜色。候选人我是一名健康服务研究员，有健康预防科学的背景。 危险行为与显著的种族和民族差异。我正在申请为期五年的K23职业发展 获得培训、指导和研究经验以成为专家的奖励（能够获得R 01 在健康和医疗保健公平方面，为少数民族儿童群体，特别是年轻妇女， 颜色.指导。我组建了一支出色的辅导团队， 专业知识与研究的目的和我的职业发展目标相一致。Sheana Bull博士是第一位 她的导师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 Studts（儿科人群的传播和实施科学），Evelinn Borrayo博士（使用混合- 方法，健康差距和卫生服务），博士杰弗里Barsuk（医学教育和模拟为基础的 掌握学习）和Christopher Houck博士（青少年生殖健康干预措施）。Research.的 拟议项目的目标是（1）整合文献的综合，形成持有者数据， 一个专家小组来指导mLearning原型的开发;（2）进行迭代的认知循环 与住院医师、主治医师和项目主任进行访谈，使用快速形成周期进行完善和最终确定 mLearning课程;以及（3）通过小规模评估mLearning课程的初步效果 在接受mLearning课程的居民样本中进行的随机对照试验与等待名单对照。 训练在健康和保健不平等方面的具体培训将包括： 有效的循证数字卫生工具、传播和实施战略（包括混合 研究设计），先进的混合方法技能和基于模拟的医学教育。本次培训将 通过强化指导培训、参与指导研究和初级研究， 定向阅读、课程、网络研讨会和培训机构。在我优秀的导师团队的指导下，这些 培训和研究经验将建立我的职业生涯作为一个独立的，联邦资助的卫生服务 研究人员开发数字健康和模拟干预措施，以解决儿科少数民族健康问题， 通过可获得的、反应灵敏的和高质量的医疗保健来消除医疗保健差距。

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.