Reducing reproductive health disparities among Latinx youth living in rural communities

项目概要/摘要 少女怀孕（TP）在很大程度上是意外的，可能导致不利的健康，教育和经济 对母亲和孩子都有好处。尽管美国的TP率在过去几十年里有所下降， 差距依然存在。美国拉丁裔青少年的出生率是全国平均水平的1.5倍 农村地区的青少年比农村白色青少年高出2倍以上。拉丁裔移民定居农村 这些地区代表了美国农村地区最大和增长最快的少数民族群体。的最佳做法 在这些独特的社区实施循证TP预防计划仍然是未知的。 因此，迫切需要制定和评价一套专门针对以下方面的应对措施： 这些脆弱的青少年创译实施科学框架已被用于解决其他 拉丁裔农村社区的健康差距。基于我们之前的工作，证明了TP的必要性 为满足这一独特人群的需求，我们将利用这一框架， 根据Cuídate（照顾），这是一种基于证据的，文化上敏感的干预措施，已被证明， 减少城市拉丁裔青年的性风险行为。Barral博士是一位青少年医学医生， 这个职业发展奖的候选人，致力于以病人为导向的临床研究生涯 有针对性地采取干预措施，以减少生殖健康方面的差距。她的五年职业发展计划 包括结构化的指导和正式的教学方法，以解决她在培训中的关键差距， 行为改变理论，青少年行为研究临床试验和社区方面的专业知识 从事研究。拟议的研究通过提供实践经验补充其他培训活动 在干预共同发展和可行性试验。在确定了所需的关键因素之后， 为农村拉丁裔青少年制定可接受的TP预防干预措施，Barral博士将使用 我们还将与创译框架合作，共同开发最适合社区独特需求和背景的干预措施。 博士Barral将进行单组可行性试验，以评价共同创建的 干预拟议的调查将通过以下方式提高对TP预防差异的科学认识： 解决新移民拉丁裔人口中发生的TP的交叉性和背景 深入农村社区。她将全面纳入社区和利益相关者的指导 变成一个共同创造的新颖的干预，最适合这些独特的新移民的当地需求， 人口。研究结果将为更大规模的混合有效性实施研究的开发提供信息， 在K23授标期间提交的R 01文件支持。这个培训和研究计划是一致的 国家卫生研究院和国家少数民族健康研究所的使命 差异。

Project Summary/Abstract Teenage pregnancy (TP) is largely unintended and can lead to adverse health, educational, and economic outcomes for both the mother and the child. Although TP rates have declined in the U.S. over several decades, disparities persist. Birth rates among Latinx teens in the U.S. are 1.5 times higher than the national average and more than 2 times higher in rural areas compared to rural White teens. Latinx immigrants settling in rural areas represent the largest and fastest growing minority group in rural America. Best practices for implementing evidence-based TP prevention programs in these unique communities remain largely unknown. Thus, a critical need exists to develop and evaluate a set of responsive interventions tailored specifically to these vulnerable teens. The transcreation implementation science framework has been used to address other health disparities among Latinx rural communities. Based on our previous work demonstrating the need for TP prevention interventions tailored to meet needs in this unique population, we will use this framework to build upon Cuídate (Take Care), an evidence-based, culturally responsive intervention that has been shown to decrease sexual risk behaviors among urban Latinx youth. Dr. Barral, an adolescent medicine physician and candidate for this career development award, is committed to a patient-oriented clinical research career targeting interventions to reduce reproductive health disparities. Her five-year career development plan includes structured mentoring and formal didactics to address critical gaps in her training through acquisition of expertise in theories of behavior change, clinical trials for adolescent behavioral research, and community engaged research. The proposed study complements other training activities by enabling hands-on experience in intervention co-development and feasibility trial. Following identification of key factors needed for the development of an acceptable TP prevention intervention for rural Latinx teens, Dr Barral will use the transcreation framework to co-develop an intervention that best fits the community’s unique needs and context. Dr. Barral will conduct a one arm feasibility trail to evaluate acceptability and practicality of the co-created intervention. The proposed investigation will improve scientific knowledge in disparities in TP prevention by addressing the intersectionality and context of TP occurring among emerging immigrant Latinx populations embedded in rural communities. She will comprehensively incorporate community and stakeholder guidance into a co-created and novel intervention that optimally fits local needs of these unique new immigrant populations. Study findings will inform the development of a larger hybrid efficacy implementation study, supported by an R01 submission during the K23 award period. This training and research plan are consistent with the mission of the National Institutes of Health and the National Institute on Minority Health and Health Disparities.