Gender, Autonomy, and Contraceptive Use Among Young People

年轻人的性别、自主性和避孕药具的使用

• 批准号: 8925702
• 负责人: Ushma Desai Upadhyay
• 金额: $ 14.43万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-15 至 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8925702
• 关键词: AIDS prevention; Acute; Address; Adherence; Adolescent; Adult; Age; Area; Behavior; Behavioral; Belief; Birth; California; Child health care; Clinic; Cognitive; Cohort Studies; Contraceptive Agents; Contraceptive Usage; Contraceptive methods; Couples; Data; Data Collection; Data Set; Decision Making; Demographer; Development; Development Plans; Discipline; Discipline of obstetrics; Doctor of Philosophy; Elements; Environment; Epidemiology; Equation; Ethnic Origin; Evidence based intervention; Faculty; Family Planning; Fathers; Female; Fertility; Fostering; Funding; Gender; Gender Relations; Goals; Gynecology; Health; Health Policy; Healthy People 2020; Institution; Intervention; Intervention Trial; Interview; Investigation; K-Series Research Career Programs; Knowledge; Lead; Learning; Measurement; Measures; Medical; Men' s Role; Mentored Research Scientist Development Award; Mentors; Mentorship; Methods; Modeling; National Institute of Child Health and Human Development; Outcome; Participant; Pathway interactions; Pediatrics; Population Research; Pregnancy; Pregnancy Rate; Pregnancy in Adolescence; Prospective Studies; Public Health; Qualitative Research; Race; Randomized; Reading; Recording of previous events; Recruitment Activity; Reproductive Health; Research; Research Institute; Research Personnel; Research Project Grants; Risk-Taking; Role; San Francisco; Science; Scientist; Solutions; Structure; Testing; Time; Training; Translating; United States; Universities; Woman; Women' s Health; Work; aged; base; behavioral/social science; career; career development; child bearing; condoms; design; experience; follow-up; high risk; improved; innovation; instrument; male; man; men; novel; pregnancy prevention; prevent; professor; public health relevance; racial disparity; reproductive; reproductive health of adolescents; social; sociologist; symposium; theories; unintended pregnancy; young man; young woman

DESCRIPTION (provided by applicant): Career Goals: This is an application for a K01 Career Development Award in Population Research for Ushma Upadhyay, PhD, MPH, a Public Health Social Scientist at the University of California, San Francisco. Her preliminary research focuses on contraceptive use and unintended pregnancy, and includes the development of the first measure of reproductive autonomy, assessing a woman's power to decide about and control matters related to contraceptive use, pregnancy and childbearing. In the short term, she aims to build on this work, investigating the effect of gender-based power on contraceptive use among young people. In the long term, she aspires to conduct research that results in evidence-based interventions that help young people to control their fertility. The knowledge and experience she will gain from the K01 award will prepare her to compete for NICHD R01 funding to design a randomized intervention trial to test the effects of a gender-based power intervention on contraceptive use and unintended pregnancy among adolescents and young people. Environment: The University of California, San Francisco (UCSF) provides generous support for junior faculty. UCSF researchers have a long history of pursuing innovative ideas in reproductive health. As an institution, it has been unequivocally supportive of research on contraceptive use and unintended pregnancy. Key Elements of Research Career Development Plan: Dr. Upadhyay has a rich background in epidemiologic and demographic methods, with substantial experience analyzing large datasets. This career development award will enable her to address several remaining gaps in her training specific to her career goals, and to gain applied experience planning and executing a primary data collection study on gender-based power and contraceptive use. Her training goals are to gain experience and expertise in sociological theories of gender among adolescents, qualitative research, advanced quantitative methods, and translating evidence into intervention. To achieve these goals, Dr. Upadhyay has assembled a unique interdisciplinary training and mentoring team. It includes a Primary Mentor, Tina Raine-Bennett, MD, MPH, a clinician scientist formerly at UCSF who is now Research Director of the Women's Health Research Institute at Kaiser Permanente specializing in adolescent unintended pregnancy and racial disparities, and co-mentor Shari Dworkin, PhD, MS, a medical sociologist in UCSF's Department of Social and Behavioral Sciences and an expert on gender- based power. Her team includes three additional, complementary advisors: Diana Foster, PhD, a demographer in UCSF's Department of Obstetrics, Gynecology, and Reproductive Sciences, who studies the consequences of unintended pregnancy; Torsten B. Neilands, PhD, a quantitative methodologist at UCSF's Center for AIDS Prevention Studies with expertise in latent variable (structural equation) modeling; and Claire Brindis, DrPH, Professor of Pediatrics and Health Policy whose research focuses on adolescent and child health policy, adolescent pregnancy and pregnancy prevention, and adolescent health and risk-taking behaviors. Dr. Upadhyay's training will include a combination of structured reading lists and tutorials with mentors, coursework, self-directed learning, conference presentations and attendance, and seminars. Description of the Research Project: Unintended pregnancy is an important public health problem; half of all pregnancies in the United States are unintended. The transition to adulthood is a particularly vulnerable period for unintended pregnancy; women ages 15 to 24 are at highest risk. One of the main reasons for unintended pregnancy is lack of consistent contraceptive use. The overall objective of this study is to conduct mentored research that examines the pathways between power, gender norms, and masculinities and contraceptive use among young people ages 15 to 24. My main hypothesis is that adherence to gender norms and traditional norms of masculinity lead to inconsistent and non-use of contraceptives. This research will assess this hypothesis through three specific aims. Aim 1 is to explore the role that relationship power, gender norms, and masculinities have in influencing adolescent and young people's contraceptive use. This aim involves qualitative in-depth interviews with adolescent and young women, men, and couples. Aim 2 is to adapt and validate existing instruments that measure relationship power, gender norms, and masculinities so that they are appropriate for adolescents and young people. This aim involves adapting my own Reproductive Autonomy Scale, the Gender Relations Scale, and the Masculinity Ideology in Relationships Scale for use among adolescents and young men and women. Aim 3 is to determine how relationship power, gender norms, and masculinities impact adolescent and young people's contraceptive use through a 3-month pilot prospective study at an adolescent family planning clinic. Examining gender-based power from the perspectives of multiple disciplines using mixed-methods, I expect to make important contributions in three areas: 1) theory on gender and power and contraceptive use, 2) measurement of gender-based power among adolescents, and 3) potential interventions that reduce unintended pregnancy. Ultimately, this mentored research will prepare me for the successful submission of an R01 application to test an adolescent contraceptive use intervention and a research career in gender and power-related determinants of adolescent reproductive health.

描述（由申请人提供）：职业目标：这是Ushma Upadhyay，博士，公共卫生社会科学家在加州大学，旧金山弗朗西斯科的人口研究K 01职业发展奖的申请。她的初步研究重点是避孕药具的使用和意外怀孕，包括制定生育自主权的第一项措施，评估妇女决定和控制与避孕药具使用、怀孕和生育有关的事项的权力。在短期内，她的目标是在这项工作的基础上，调查基于性别的权力对年轻人使用避孕药具的影响。从长远来看，她渴望进行研究，从而得出基于证据的干预措施，帮助年轻人控制生育。她将从K 01奖获得的知识和经验将为她竞争NICHD R 01资金做好准备，以设计一项随机干预试验，以测试基于性别的权力干预对青少年和年轻人避孕药具使用和意外怀孕的影响。环境：加州大学旧金山分校（UCSF）为初级教师提供慷慨的支持。弗朗西斯科。加州大学旧金山分校的研究人员在生殖健康方面追求创新理念的历史悠久。作为一个机构，它一直明确支持关于避孕药具使用和意外怀孕的研究。研究职业发展计划的关键要素：Upadhyay博士在流行病学和人口统计学方法方面具有丰富的背景，在分析大型数据集方面具有丰富的经验。这一职业发展奖将使她能够解决她的培训，具体到她的职业目标，并获得应用经验规划和执行基于性别的权力和避孕药具的使用的初步数据收集研究中存在的几个差距。她的培训目标是获得青少年性别社会学理论，定性研究，先进的定量方法的经验和专业知识，并将证据转化为干预措施。为了实现这些目标，Upadhyay博士组建了一支独特的跨学科培训和指导团队。它包括一个主要的导师，蒂娜Raine-Bennett，医学博士，公共卫生硕士，临床医生科学家以前在加州大学旧金山分校谁现在是研究主任妇女健康研究所在凯撒永久专门从事青少年意外怀孕和种族差异，和共同导师沙里Dworkin，博士，MS，医学社会学家在加州大学旧金山分校的社会和行为科学系和基于性别的权力专家。她的团队包括三个额外的，互补的顾问：戴安娜福斯特，博士，在加州大学旧金山分校的妇产科和生殖科学系的人口统计学家，谁研究意外怀孕的后果;托尔斯滕B。Neilands博士，加州大学旧金山分校艾滋病预防研究中心的定量方法学家，具有潜在变量（结构方程）建模方面的专业知识; Claire Brindis博士， 儿科和卫生政策，其研究重点是青少年和儿童健康政策，青少年怀孕和预防怀孕，青少年健康和冒险行为。Upadhyay博士的培训将包括结构化的阅读清单和导师辅导，课程，自我指导学习，会议演示和出席，以及研讨会的组合。意外怀孕是一个重要的公共卫生问题;在美国，一半的怀孕是意外的。向成年过渡是意外怀孕的特别脆弱时期; 15至24岁的妇女风险最高。意外怀孕的主要原因之一是缺乏持续的避孕措施。这项研究的总体目标是进行指导研究，探讨权力之间的途径，性别规范，男性和避孕药具的使用年龄在15至24岁的年轻人。我的主要假设是，遵守性别规范和传统的男性规范导致避孕药具的不一致和不使用。本研究将通过三个具体目标来评估这一假设。目的1是探讨关系权力，性别规范和男性在影响青少年和年轻人的避孕药具使用的作用。这一目标涉及对青少年和青年妇女、男子和夫妇进行定性深入访谈。目标2是调整和验证现有的衡量关系权力、性别规范和男子气概的工具，使其适合青少年和年轻人。这一目标包括调整我自己的生殖自主量表，性别关系量表和关系中的男性意识形态量表，以供青少年和年轻男女使用。目标3是通过在青少年计划生育诊所进行为期3个月的试点前瞻性研究，确定关系权力、性别规范和男性气质如何影响青少年和年轻人的避孕药具使用。从多学科的角度，使用混合的方法来研究基于性别的权力，我希望在三个领域做出重要贡献：1）关于性别和权力以及避孕药具使用的理论，2）青少年基于性别的权力的测量，3）减少意外怀孕的潜在干预措施。最终，这项指导研究将为我成功提交R 01申请做好准备，以测试青少年避孕药具使用干预措施以及青少年生殖健康的性别和权力相关决定因素的研究生涯。