Comprehensive Reintegration Assistance for Women with Obstetric Fistula

为患有产科瘘的妇女提供全面的重返社会援助

• 批准号: 9924584
• 负责人: Alison M El Ayadi
• 金额: $ 22.14万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-05-25 至 2023-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9924584
• 关键词: Address; Affect; Africa South of the Sahara; Applications Grants; Award; Birth; Birth trauma; Bladder; Caring; Cephalopelvic Disproportions; Cervical spinal cord injury; Clinical; Communities; Consult; Counseling; Data; Development; Economics; Effectiveness of Interventions; Emergency Situation; Ensure; Evaluation; Evidence based intervention; Evidence based practice; Extravasation; Face; Family; Feces; Fistula; Foundations; Future; Gait abnormality; Genital system; Goals; Head; Health; Health education; Household; Infection; Injury; Intervention; Ischemia; Knowledge; Length; Literature; Maternal Health; Maternal Mortality; Measurement; Measures; Medical; Mental Depression; Mental Health; Mentors; Mentorship; Methodology; Methods; Morbidity - disease rate; Necrosis; Nerve; Obstructed labor; Operative Surgical Procedures; Pain; Pathway interactions; Phase; Physical Rehabilitation; Pregnancy; Prevention; Prevention approach; Process; Protocols documentation; Psyche structure; Publishing; Quality of life; Randomized; Recovery; Religion and Spirituality; Reporting; Research; Research Activity; Research Methodology; Research Personnel; Role; Sampling; Scientist; Service provision; Severities; Site; Stigmatization; Structure; Testing; Time; Tissues; Training; Training Activity; Translating; Trauma; Uganda; Urine; Vagina; Woman; Women' s Health; Work; base; cohort; community reintegration; design; disability; effectiveness evaluation; empowerment; epidemiology study; evidence base; experience; fetal; follow-up; food preparation; health care availability; health disparity; hip bone; improved; innovation; longitudinal analysis; maternal morbidity; meetings; multi-component intervention; multiple data sources; obstetric care; obstetric fistula; physical conditioning; physically handicapped; psychologic; psychosocial; public health relevance; rectal; repaired; secondary infertility; skills; social; standard of care; success; surgery outcome; systematic review; theories; therapy development

 DESCRIPTION (provided by applicant): The goal of this Pathway to Independence Award (K99/R00) is to facilitate my transition to becoming an independent scientist carrying out innovative epidemiologic research on the structural, social, and interpersonal factors influencing maternal health disparities, and translate this research into tangible approaches for the prevention and treatment of maternal morbidity and mortality. The research activities proposed target obstetric fistula, an under-researched traumatic birth injury that affects an estimated 2-3 million women globally [1]. OF has broad physical and psychosocial ramifications, and women with OF are severely stigmatized and marginalized. Despite clinically successful surgery, physical disabilities and poor mental health may persist, making reintegration to family and community difficult for women. The post-surgical reintegration focus of my work is timely, as access to surgery has increased without parallel development of evidence-based reintegration programming. To address this gap, the training and research activities planned during the mentored phase of this award (K99) will build upon my capabilities to equip me with the necessary knowledge and skills in: 1) social-psychological health theories and methodologies; 2) mixed-methods research; 3) advanced quantitative methods for the analysis of longitudinal data; and 4) intervention development. Each of these activities will be instrumental to my successful advancement to the independent phase (R00) of this application, the aims of which are: 1) To conduct a systematic review of the published and grey literature on reintegration programming for OF and analogous conditions; 2) To design a post-surgical reintegration intervention for women and their households to improve women's psychosocial and physical recovery through iterative work with key stakeholders; and 3) To pilot the intervention developed in Aim 2 using a cohort- controlled design and measure the feasibility, acceptability and preliminary impact on post-surgical reintegration success. My mentorship and consulting team is uniquely poised to assist me in achieving my training and research goals, and ensure my transition to success as an independent investigator. This preparatory research, intervention development and pilot testing will lay the groundwork for an R01 which will expand this trial both in size and length of follow-up time in order to evaluate the effectiveness of the intervention on women's post-surgical reintegration, physical and mental disabilities, and economic status.

 描述（由申请人提供）：独立之路奖 (K99/R00) 的目标是帮助我转变为一名独立科学家，对影响孕产妇健康差异的结构、社会和人际因素进行创新的流行病学研究，并将这项研究转化为预防和治疗孕产妇发病率和死亡率的切实方法。这些研究活动的目标是产科瘘管病，这是一种尚未充分研究的创伤性产伤，估计影响全球 2-300 万妇女[1]。 OF 具有广泛的身体和心理社会影响，患有 OF 的女性受到严重侮辱和边缘化。尽管手术在临床上取得了成功，但身体残疾和心理健康状况不佳可能仍然存在，使妇女难以重新融入家庭和社区。我的工作重点是术后重返社会，这是及时的，因为接受手术的机会增加了，但没有并行制定基于证据的重返社会规划。为了弥补这一差距，该奖项（K99）指导阶段计划的培训和研究活动将建立在我的能力基础上，使我具备以下方面必要的知识和技能：1）社会心理健康理论和方法； 2）混合方法研究； 3）先进的纵向数据分析定量方法； 4）干预措施的发展。这些活动中的每一项都将有助于我成功进入本申请的独立阶段 (R00)，其目的是： 1) 对 OF 和类似情况的重返社会规划的已发表文献和灰色文献进行系统回顾； 2) 与主要利益相关者反复合作，为妇女及其家庭设计手术后重返社会干预措施，以改善妇女的心理和身体康复； 3) 使用队列对照设计来试行目标 2 中制定的干预措施，并衡量可行性、可接受性以及对术后重新融入成功的初步影响。我的指导和咨询团队非常愿意帮助我实现培训和研究目标，并确保我成功过渡为一名独立调查员。这项准备性研究、干预措施开发和试点测试将为 R01 奠定基础，R01 将扩大该试验的规模和随访时间，以评估干预措施对妇女术后重返社会、身体和精神残疾以及经济状况的有效性。

项目成果

Validation of an adapted instrument to measure female genital fistula-related stigma.

• DOI: 10.1080/17441692.2020.1813786
• 发表时间: 2021-07
• 期刊: Global public health
• 影响因子: 3.3
• 作者: El Ayadi AM;Barageine JK;Neilands TB;Ryan N;Nalubwama H;Korn A;Turan JM
• 通讯作者: Turan JM

Women's sexual activity and experiences following female genital fistula surgery.

女性生殖器瘘管手术后女性的性活动和经历。

• DOI: 10.1093/jsxmed/qdad010
• 发表时间: 2023
• 期刊: The journal of sexual medicine
• 作者: ElAyadi,AlisonM;Nalubwama,Hadija;Miller,Suellen;Mitchell,Ashley;Korn,AbnerP;Chen,ChiChiungGrace;Byamugisha,Josaphat;Painter,Caitlyn;Obore,Susan;Barageine,JustusK
• 通讯作者: Barageine,JustusK

Rehabilitation and reintegration programming adjunct to female genital fistula surgery: a scoping review protocol.

女性生殖器瘘手术的康复和重返社会规划辅助：范围界定审查方案。

• DOI: 10.1136/bmjopen-2018-027991
• 发表时间: 2019
• 期刊: BMJ open
• 影响因子: 2.9
• 作者: ElAyadi,AlisonM;Painter,CaitlynE;Delamou,Alexandre;Barr-Walker,Jill;Obore,Susan;Byamugisha,Josaphat;Korn,Abner;Barageine,JustusK
• 通讯作者: Barageine,JustusK

The social, economic, emotional, and physical experiences of caregivers for women with female genital fistula in Uganda: A qualitative study.

乌干达女性生殖器瘘管病女性护理人员的社会、经济、情感和身体经历：一项定性研究。

• DOI: 10.1080/17441692.2023.2242458
• 发表时间: 2023
• 期刊: Global public health
• 影响因子: 3.3
• 作者: ElAyadi,AlisonM;Mitchell,Ashley;Nalubwama,Hadija;Miller,Suellen;Semere,Wagahta;Barageine,JustusK;Korn,AbnerP;Obore,Susan;Lucas,Ruby;Byamugisha,Josaphat
• 通讯作者: Byamugisha,Josaphat

Contraceptive preferences and adoption following female genital fistula surgery in Uganda: a mixed-methods study.

• DOI: 10.1186/s12978-023-01663-3
• 发表时间: 2023-08-19
• 期刊: REPRODUCTIVE HEALTH
• 影响因子: 3.4
• 作者: El Ayadi, Alison M.;Nalubwama, Hadija;Painter, Caitlyn;Kakaire, Othman;Miller, Suellen;Barageine, Justus;Byamugisha, Josaphat;Obore, Susan;Korn, Abner;Harper, Cynthia C.
• 通讯作者: Harper, Cynthia C.