MI: Empowering Women to Make Contraceptive Choices While Incarcerated

MI：赋予女性在监禁期间做出避孕选择的权利

• 批准号: 7860450
• 负责人: Jennifer Grace Clarke
• 金额: $ 29.01万
• 依托单位: MEMORIAL HOSPITAL OF RHODE ISLAND
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-06-01 至 2013-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7860450
• 关键词: Abstinence; Attention; Back; Behavior; Calendar; Clinic; Communities; Computers; Contraceptive Agents; Contraceptive Usage; Contraceptive methods; Counseling; Documentation; Evaluation; Failure; Feedback; Imprisonment; Infection prevention; Injection of therapeutic agent; Intervention; Jail; Length; Measures; Medical Records; Modeling; Population; Pregnancy; Pregnancy Tests; Professional counselor; Prostitution; Public Health; Randomized; Randomized Clinical Trials; Readiness; Recording of previous events; Recruitment Activity; Reproductive Health Services; Rhode Island; Risk; Services; Sex Behavior; Sexually Transmitted Diseases; Substance abuse problem; Techniques; Testing; Time; TimeLine; Training; United States; Unplanned pregnancy; Urine; Visit; Woman; base; computer generated; design; empowered; experience; follow-up; high risk; improved; innovation; motivational enhancement therapy; pill; primary outcome; programs; secondary outcome; service utilization

DESCRIPTION (provided by applicant): Unplanned pregnancies (defined as pregnancies that are either mistimed or unwanted) and sexually transmitted infections (STIs) are important and costly public health problems in the United States resulting from unprotected sexual activity. Women with a history of incarceration are at increased risk for these problems given the high rates of substance abuse and commercial sex work in this population. Highly effective (less than 2% annual failure rate with typical use) reversible contraceptive methods are readily available through Title X clinics. The Rhode Island Department of Corrections (RI DOC) has actively participated in the implementation and evaluation of a Title X program which provides contraceptive services to incarcerated women as well as transitional reproductive health services from the jail to the community. However, service utilization remains sub-optimal. This application is designed to evaluate an innovative intervention Motivational Interviewing with Computer Assistance (MICA) designed to improve contraceptive use for incarcerated women who do not want a pregnancy and are soon to be released into the community. We will utilize the Title X program which, in conjunction with RI DOC, provides reproductive health services in jail and then transitional services in the community after release. Building upon program experience and prior evaluations we have adapted CAMI, and plan to implement and evaluate MICA for increasing the initiation and continuation of highly effective contraceptive methods among women at risk for an unplanned pregnancy. We plan to recruit 400 women from the RI DOC women's jail and randomize them to two interventions: three sessions of personalized MICA or three sessions of Didactic Educational Counseling (DEC), both delivered individually by trained counselors. MICA is based on the principles of the Transtheoretical Model (TTM) and on Motivational Interviewing (MI), 3 an empirically supported counseling technique designed to enhance readiness to change targeted behaviors. The DEC provides didactic information about contraception, sexually transmitted infection (STI) prevention and abstinence, and is intended to control for the effects of assessment and attention. The two counseling interventions will be similar in length and timing, but will vary in content, counseling style and the individualized computer generated feedback that is reviewed with the counselor. Women entering jail usually have very brief periods of incarceration and are at high risk for unplanned pregnancies and STIs after release. We propose to evaluate an innovative motivationally based intervention in a randomized clinical trial of women entering jail in Rhode Island.

描述（由申请人提供）：在美国，意外怀孕（定义为不合时宜或意外怀孕）和性传播感染 (STI) 是由无保护性行为造成的重要且代价高昂的公共卫生问题。有监禁史的女性面临这些问题的风险更高，因为该人群中药物滥用和商业性工作的比例很高。 Title X 诊所可随时提供高效（典型使用情况下每年失败率低于 2%）的可逆避孕方法。罗德岛惩教署 (RI DOC) 积极参与了 Title X 计划的实施和评估，该计划为被监禁的妇女提供避孕服务以及从监狱到社区的过渡性生殖健康服务。然而，服务利用率仍然不理想。该应用程序旨在评估一项创新干预措施“计算机辅助动机访谈”(MICA)，该干预措施旨在改善不想怀孕且即将释放到社区的被监禁妇女的避孕措施。我们将利用 Title X 计划，该计划与 RI DOC 合作，在监狱中提供生殖健康服务，然后在释放后在社区提供过渡服务。根据计划经验和之前的评估，我们采用了 CAMI，并计划实施和评估 MICA，以提高有意外怀孕风险的妇女开始和继续采用高效避孕方法的机会。我们计划从 RI DOC 女子监狱招募 400 名女性，并将她们随机分配到两次干预措施：三轮个性化 MICA 或三轮教学教育咨询 (DEC)，两者均由经过培训的辅导员单独提供。 MICA 基于跨理论模型 (TTM) 和动机访谈 (MI) 的原则，3 是一种经验支持的咨询技术，旨在增强改变目标行为的准备程度。 DEC 提供有关避孕、性传播感染 (STI) 预防和禁欲的教学信息，旨在控制评估和关注的效果。两种咨询干预措施的长度和时间安排相似，但在内容、咨询风格以及由咨询师审查的个性化计算机生成的反馈方面会有所不同。入狱的女性通常会被监禁很短的时间，出狱后意外怀孕和性传播感染的风险很高。我们建议在罗德岛州入狱妇女的随机临床试验中评估基于动机的创新干预措施。