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

项目摘要/摘要 候选人：这个K01奖的目标是支持卡桑德拉·马歇尔博士的培训和研究， 世卫组织的长期目标是通过证据翻译促进生殖和孕产妇健康公平 使用量身定做的干预措施，解决患有慢性病的种族/少数民族妇女的需求 医疗条件。她的研究考察了年轻女性的避孕决策，并 探索卫生保健提供者和系统能够提供以患者为中心的避孕护理的方式。 研究计划：怀孕前患有糖尿病的妇女产妇和新生儿的发病率较高 发病率和死亡率。2型糖尿病在育龄妇女中的发病率越来越高 多年来，对黑人和拉丁裔女性的影响不成比例。预防母婴健康 并发症，迫切需要加强努力，以改善以下人群的生殖健康结果 患有2型糖尿病的育龄妇女，特别是少数民族。然而，有一些 目前还没有循证战略来实施改善生殖结局的临床指南 在患有2型糖尿病的成年女性中。初级保健中的患者决策支持工具代表着一种很有前途的 实施战略。研究的目的是：目标1：阐明生殖决策过程和 患有2型糖尿病的育龄黑人和拉丁裔妇女的生殖保健偏好， 使用以人为中心和结构性能力框架。目标2：调整现有患者的决定 支持干预措施，以支持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3： 评估适应性干预在患者和提供者中的可接受性和可行性，并检查 干预的实施环境。职业发展和培训计划：应聘者的培训 Plans利用了一支跨学科的指导团队，他们在以个人为中心的计划生育护理方面拥有专业知识， 初级保健中的糖尿病护理、实施科学和组织研究。通过课程作业， 研讨会、学徒期和指导研究经验，马歇尔博士将接受面对面的培训- 集中的、结构上称职的生殖健康干预、高级混合方法、 实施科学和利益相关者参与，以及设计和实施小学试验 护理环境。加州大学伯克利分校及其亲密合作伙伴UCSF和Kaiser Permanente North California提供 为马歇尔博士提供了优良的研究基础设施和培训环境。总结：培训和 在这项申请中建议的研究马歇尔博士在R01资金方面具有竞争力，以支持 多点有效性--实施适应性干预试验，并促进她过渡到 作为研究人员的独立性。

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.