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Reproductive Planning for Women Veterans

女性退伍军人的生殖计划

基本信息

批准号：
8982104
负责人：
Lisa Susanne Callegari
金额：
--
依托单位：
VA PUGET SOUND HEALTHCARE SYSTEM
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-10-01 至 2020-09-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8982104
关键词：
Address Address Adherence Adherence Age Age Area Area Benefits and Risks Benefits and Risks Centers for Disease Control and Prevention (U.S.)Centers for Disease Control and Prevention (U.S.)Chronic Chronic Comorbidity Comorbidity Conflict (Psychology)Conflict (Psychology)Contraceptive Agents Contraceptive Agents Contraceptive Usage Contraceptive Usage Contraceptive methods Contraceptive methods Data Data Decision Aid Decision Aid Decision Making Decision Making Development Development Development Plans Discipline of obstetrics Discipline of obstetrics Doctor of Philosophy Doctor of Philosophy Effectiveness Effectiveness Evidence based intervention Evidence based intervention Fellowship Fellowship Female Female Foundations Foundations Genetic screening method Genetic screening method Goals Goals Gynecologist Gynecologist Gynecology Gynecology Health Health Health Policy Health Policy Health Services Health Services Health Services Research Health Services Research Healthcare Healthcare Intervention Intervention Interview Interview K-Series Research Career Programs K-Series Research Career Programs Knowledge Knowledge Life Life Medical Medical Mental Depression Mental Depression Mental Health Mental Health Mentorship Mentorship Methods Methods Obesity Obesity Outcome Outcome Pamphlets Pamphlets Patients Patients Pilot Projects Pilot Projects Planned Pregnancy Planned Pregnancy Post-Traumatic Stress Disorders Post-Traumatic Stress Disorders Pregnancy Pregnancy Pregnancy Outcome Pregnancy Outcome Prevention Research Prevention Research Primary Care Physician Primary Care Physician Primary Health Care Primary Health Care Provider Provider Publishing Publishing Qualitative Methods Qualitative Methods Randomized Controlled Trials Randomized Controlled Trials Reproductive Health Reproductive Health Reproductive Health Services Reproductive Health Services Research Research Research Methodology Research Methodology Research Personnel Research Personnel Risk Risk Science Science Self Efficacy Self Efficacy Site Site Structure Structure Supervision Supervision Testing Testing Time Training Training Uncertainty Uncertainty Universities Universities Unplanned pregnancy Veterans Veterans Washington Washington Woman Woman Women&apos s Health Women&apos s Health Women&apos s Health Services Women&apos s Health Services Work Work adverse pregnancy outcome arm arm base base care providers career career career development career development child bearing child bearing clinical practice clinical practice computerized computerized design design disorder prevention evidence base evidence base evidence based guidelines evidence based guidelines experience experience fetal fetal health administration health administration health care service implementation science implementation science improved improved innovation innovation interest interest novel novel novel strategies novel strategies patient oriented patient oriented preference preference prenatal prenatal prevent prevent primary care setting primary care setting primary outcome primary outcome professor professor public health relevance public health relevance reproductive reproductive satisfaction satisfaction service intervention service intervention shared decision making shared decision making skills skills training sound sound trial design trial design unintended pregnancy unintended pregnancy

项目摘要

DESCRIPTION (provided by applicant): BACKGROUND. Lisa Callegari, MD, MPH is a postdoctoral HSR&D fellow at VA Puget Sound, a VA Staff Gynecologist, and an Assistant Professor of Obstetrics & Gynecology at the University of Washington. Since beginning her fellowship in 2012, Dr. Callegari's research has reflected her commitment to addressing the reproductive health care needs of women Veterans. The proposed Career Development Award (CDA-2) will provide Dr. Callegari with the in-depth training and skills she needs to succeed as an independent health services researcher designing and testing interventions to improve reproductive health care for women Veterans. CAREER DEVELOPMENT PLAN. Dr. Callegari's proposed CDA-2 will employ innovative strategies, including reproductive planning and shared decision making, to address gaps in reproductive health services for women Veterans. Compared to civilians, women Veterans have higher rates of chronic medical and mental health illness. These comorbidities, in combination with low rates of documented contraception among women Veterans, result in increased risks of unplanned pregnancy and poor pregnancy outcomes. Reproductive planning discussions promote proactive planning for pregnancy and contraceptive use, yet rarely occur in practice. One novel approach to guide reproductive planning discussions is use of a decision aid based on shared decision making principles. Decision aids improve decision quality by aligning patients' health care decisions with their values and preferences. While decision aids have been used effectively for other reproductive health decisions, no decision aid has been developed for reproductive planning. This CDA-2 proposes to design and test a reproductive planning decision aid intervention in VA primary care to improve reproductive planning decision quality and use of contraception. Specifically, this CDA-2 aims to: 1) determine reproductive planning decision needs among women Veterans and VA primary care physicians using qualitative methods; 2) develop, refine, and pilot test a reproductive planning decision aid; and 3) conduct a two-site randomized controlled trial (RCT) to test the effect of the decision aid on decision quality (decisional conflict, knowledge, decision self-efficacy and decision satisfaction) and contraceptive outcomes, compared to reproductive planning information only. Barriers and facilitators to implementation will also be investigated to facilitate downstream implementation if the intervention is found to be effective. The experience Dr. Callegari will gain in conducting the proposed research will be supplemented with structured training in qualitative methods, decision science and decision aid development, RCT design, and implementation science. Dr. Callegari will conduct her research under the guidance and supervision of her mentorship and consultant team, which includes experts in health services interventions (Karin Nelson, MD, MSHS), shared decision making and decision aides (David Arterburn, MD, MPH and Suzanne Brodney, PhD), reproductive health and qualitative methods (Sonya Borrero, MD, MS and Alison Hamilton, PhD, MPH), RCT designs (Gayle Reiber, PhD and Eleanor Bimla Schwarz, MD, MS), implementation science (Alison Hamilton, PhD, MPH), and reproductive health policy (Laurie Zephyrin, MD, MPH, MBA). IMPACT. This CDA-2 will enable Dr. Callegari to collaborate with leaders in VA women's health research and shared decision making to design and test a patient centered intervention that improves reproductive decisions and the quality of reproductive health care services. The research proposed, in combination with the mentorship and training plan, will facilitate Dr. Callegari's successful transition to an independent VA health services researcher with a career dedicated to advancing the health of women Veterans.