Developing a Primary Care Intervention to Support Reproductive Decision-Making among Black and Latina Women of Reproductive Age with Type 2 Diabetes

制定初级保健干预措施以支持患有 2 型糖尿病的育龄黑人和拉丁裔女性的生殖决策

• 批准号: 10192132
• 负责人: Cassondra Marshall
• 金额: $ 13.76万
• 依托单位: UNIVERSITY OF CALIFORNIA BERKELEY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-08 至 2026-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10192132
• 关键词: Address; Adult; Affect; Age; Area; California; Caring; Chronic; Climate; Clinical; Clinical Services; Competence; Congenital Abnormality; Consolidated Framework for Implementation Research; Contraceptive Agents; Counseling; Decision Making; Development; Diabetes Mellitus; Educational workshop; Environment; Equilibrium; Family Planning Center; Funding; Goals; Guidelines; Health; Health Personnel; Health Services; Health Services Research; Health system; Healthcare; Infant Health; Infant Mortality; Insulin-Dependent Diabetes Mellitus; Intervention; Interview; K-Series Research Career Programs; Latina; Maternal Health; Maternal Mortality; Medical; Mentored Research Scientist Development Award; Mentors; Methods; Minority; Multiple Pregnancy; Neighborhood Health Center; Neonatal Mortality; Non-Insulin-Dependent Diabetes Mellitus; Outcome; Patients; Population; Positioning Attribute; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnant Women; Premature Birth; Prevalence; Primary Health Care; Process; Provider; Reporting; Reproductive Health; Research; Research Activity; Research Infrastructure; Research Personnel; Risk; Science; Structure; Surveys; Testing; Training; Training Activity; Training Support; Training and Infrastructure; Translations; United States; United States Public Health Service; Woman; acceptability and feasibility; adverse outcome; adverse pregnancy outcome; aged; apprenticeship; care preference; care providers; care systems; career development; child bearing; design; early pregnancy; effectiveness implementation study; effectiveness implementation trial; ethnic minority population; evidence base; experience; field survey; glycemic control; health equity; healthy pregnancy; high risk; implementation science; implementation strategy; improved; informant; interest; maternal morbidity; maternal risk; neonatal morbidity; organizational readiness; patient oriented; person centered; post-doctoral training; preference; prepregnancy; prevent; primary care setting; racial and ethnic; racial and ethnic disparities; racism; reproductive; reproductive health intervention; reproductive outcome; stillbirth; support tools; usability; young woman

Project Summary/Abstract Candidate: The goal of this K01 Award is to support the training and research of Dr. Cassondra Marshall, who's long-term goal is to advance reproductive and maternal health equity through the translation of evidence into practice using tailored interventions that address the needs of racial/ethnic minority women with chronic medical conditions. Her research has examined young women's contraceptive decision-making and has explored the ways in which health care providers and systems can deliver patient-centered contraceptive care. Research Plan: Women with diabetes prior to pregnancy have elevated rates of maternal and neonatal morbidity and mortality. Type 2 diabetes is increasingly prevalent among women during their childbearing years, disproportionately impacting Black and Latina women. To prevent maternal and infant health complications, there is an urgent need for enhanced efforts to improve reproductive health outcomes among reproductive-aged women with type 2 diabetes, particularly racial/ethnic minorities. However, there are currently no evidence-based strategies to implement clinical guidelines for improving reproductive outcomes among adult women with type 2 diabetes. Patient decision support tools in primary care represent a promising implementation strategy. The research aims are: Aim 1: Elucidate reproductive decision-making processes and reproductive health care preferences among Black and Latina women of reproductive age with type 2 diabetes, using person-centered and structural competency frameworks. Aim 2: Adapt an existing patient decision support intervention to support reproductive decision-making and reproductive health counseling delivery in primary care to meet the needs of Black and Latina reproductive-aged women with type 2 diabetes. Aim 3: Assess acceptability and feasibility of the adapted intervention among patients and providers and examine the implementation context for the intervention. Career Development and Training Plan: The candidate's training plan capitalizes on an interdisciplinary mentoring team with expertise in person-centered family planning care, diabetes care, implementation science, and organizational research in primary care. Through coursework, workshops, apprenticeships, and mentored research experiences, Dr. Marshall will receive training in Person- Centered and Structurally Competent Reproductive Health Interventions, Advanced Mixed Methods, Implementation Science and Stakeholder Engagement, and Designing and Implementing Trials in the Primary Care Setting. UC Berkeley and close partners UCSF and Kaiser Permanente Northern California provide an excellent research infrastructure and training environment for Dr. Marshall. Summary: The training and research proposed in this application position Dr. Marshall to be competitive for R01 funding to support a multisite effectiveness-implementation trial of the adapted intervention and facilitate her transition to independence as a researcher.

项目总结/摘要 候选人：这个K 01奖的目标是支持Cassondra马歇尔博士的培训和研究， 世卫组织的长期目标是通过转化证据来促进生殖和孕产妇健康公平 采用量身定制的干预措施，满足少数种族/族裔妇女的需要， 医疗条件。她的研究调查了年轻女性的避孕决策， 探讨了卫生保健提供者和系统提供以病人为中心的避孕保健的方式。 研究计划：妊娠前患有糖尿病的妇女的孕产妇和新生儿死亡率升高 发病率和死亡率。2型糖尿病在育龄妇女中越来越普遍 这对黑人和拉丁裔女性的影响尤为严重。预防母婴健康 由于存在各种并发症，迫切需要加强努力，改善妇女的生殖健康成果， 2型糖尿病育龄妇女，特别是少数民族。但有 目前没有循证战略来实施改善生殖结果的临床指南 2型糖尿病患者中的比例初级保健中的患者决策支持工具代表了一种有前途的 实施战略本研究的目的是：目的1：阐明生殖决策过程， 2型糖尿病育龄黑人和拉丁裔妇女的生殖保健偏好， 使用以人为本和结构化的能力框架。目标2：调整现有患者决策 * 采取支助性干预措施，以支助生殖决策和提供生殖健康咨询， 初级保健，以满足患有2型糖尿病的黑人和拉丁裔育龄妇女的需求。目标三： 评估患者和提供者对适应性干预的可接受性和可行性， 干预的实施背景。职业发展和培训计划：候选人的培训 该计划利用了一个具有以人为本的计划生育护理专门知识的跨学科指导小组， 糖尿病护理、实施科学和初级保健的组织研究。通过课程， 研讨会，学徒，并指导研究经验，马歇尔博士将接受培训的人， 以中心为中心且结构合理的生殖健康干预措施，先进的混合方法， 实施科学和利益相关者参与，以及设计和实施小学试验 护理设置。加州大学伯克利分校和密切的合作伙伴UCSF和凯撒永久北方加州提供了一个 为马歇尔博士提供了良好的研究基础设施和培训环境。摘要：培训和 在本申请中提出的研究立场马歇尔博士是有竞争力的R 01资金，以支持一个 适应性干预的多中心有效性实施试验，并促进她过渡到 作为研究者的独立性。