Sexual Health Empowerment for Jail-Involved Women's Health Literacy and Prevention

监狱妇女健康素养和预防的性健康赋权

• 批准号: 10524082
• 负责人: Megha Ramaswamy
• 金额: $ 18.4万
• 依托单位: UNIVERSITY OF KANSAS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-04-23 至 2024-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10524082
• 关键词: Address; Age; Behavior; Belief; Breast Cancer Detection; Car Phone; Cervical; Cervical Cancer Screening; Communications Media; Communities; Discharge Plannings; Drug usage; Effectiveness; Electronic Mail; Evidence based intervention; Face; Facebook; Fibrinogen; General Population; Health; Health Educators; Health Promotion; Health behavior; Health education; Human; Imprisonment; Internet; Intervention; Interview; Jail; Justice; Knowledge; Lead; Left; Literacy Programs; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Mental Health; Modality; Modeling; Modification; Multimedia; Nature; Outcome; Pamphlets; Participant; Perception; Prevention; Prevention program; Preventive; Prisons; Productivity; Publications; Randomized; Randomized Controlled Trials; Recording of previous events; Reduce health disparities; Research; Risk; Risk Factors; Risk Reduction; Role; STI prevention; Screening for cancer; Self Efficacy; Sexual Health; Sexually Transmitted Diseases; Surveys; Testing; Text; Text Messaging; Time; Touch sensation; Trauma; Vulnerable Populations; Woman; Women' s Health; Work; arm; base; behavior change; birth control; cancer health disparity; cancer risk; cervical cancer prevention; effectiveness evaluation; effectiveness outcome; effectiveness testing; experience; falls; follow-up; health disparity; health empowerment; health literacy; high risk population; implementation facilitators; improved; intervention delivery; literacy; malignant breast neoplasm; pilot test; post intervention; pregnant; recruit; screening; social media; standard of care; unintended pregnancy; uptake; women of color

ABSTRACT Over the last 35 years, there has been a 700% increase in the number of women in prisons and jails. These women, mostly women of color, have pervasive trauma histories, mental health problems, and drug use, all of which compromise their ability to engage in preventive health behaviors. For the last eight years, our research team has studied women leaving jail and why they are 4-5 times more likely to develop cervical cancer, a disparity that has remained unchanged for over 50 years. The original objective of the Sexual Health Empowerment (SHE) for Cervical Health Literacy and Prevention program (R01 CA181047) was to assess the effectiveness of a jail-based intervention to increase cervical health literacy and screening. SHE increased jailed women’s cervical health literacy and rates of cancer screening after the women left jail. While delivering SHE, we observed: 1) the cross-cutting nature of women’s health risk factors, i.e. the risks that jailed women faced for cervical cancer also could lead to other women’s health problems; and 2) opportunity for taking an evidence-based intervention, with a rich theoretical framing, to expand to other women’s health issues faced by this group, around, not only cervical cancer prevention, but also breast cancer, unintended pregnancy, and STI prevention. While following women after release from jail (85% follow-up rate after 3 years), we also identified strategies for reaching this high-risk population through electronic communication. SHE participants were high users of mobile phones (88%), text (76%), Web (79%), and Facebook (70%). This renewal application presents an opportunity to holistically address health disparities experienced by women leaving jail and test new modalities for intervention delivery given their use of electronic communication and social media. In our first aim, we will assess the feasibility and pilot effectiveness of ‘SHE-Women’, an electronic women’s health literacy intervention, with women leaving jail. The second aim uses an RCT to test the effectiveness of SHE-Women with women leaving jail on increasing women’s health literacy, screening, and risk reduction practices (for cervical, breast cancer, unintended pregnancy, and STIs) against a standard of care. Our third aim will be to understand the role and impact of human interaction in electronic interventions by tracking participants and interviewing key stakeholders. Knowledge gained from this study will lead to an understanding of: 1) how a comprehensive women’s health literacy intervention can narrow health disparities among justice-involved women and 2) the role of human interaction in successful electronic interventions, thereby creating a sustainable model for dissemination of health promotion interventions.

摘要 在过去35年中，监狱和看守所中的妇女人数增加了700%。 这些妇女，大多数是有色人种，有普遍的创伤史，心理健康问题和吸毒， 所有这些都损害了他们从事预防性健康行为的能力。在过去的八年里，我们 一个研究小组研究了离开监狱的女性，以及为什么她们患宫颈癌的可能性是其他女性的4-5倍。 癌症，这一差距50多年来一直没有改变。性健康的最初目标 宫颈健康知识和预防计划（R 01 CA 181047）的授权（SHE）是为了评估 以监狱为基础的干预措施的有效性，以增加宫颈健康知识和筛查。SHE增加 被监禁妇女的宫颈健康知识和妇女出狱后的癌症筛查率。 在提供SHE时，我们观察到：1）妇女健康风险因素的交叉性质，即 因子宫颈癌而入狱的妇女也可能导致其他妇女的健康问题;以及2） 有机会采取以证据为基础的干预措施，具有丰富的理论框架，扩展到其他 这个群体所面临的女性健康问题，围绕着，不仅是宫颈癌的预防，还有乳腺癌， 意外怀孕和性传播感染预防。在跟踪妇女出狱后的情况时（跟踪率为85%）， 3年后），我们还确定了通过电子手段接触这些高危人群的策略， 通信SHE参与者是移动的电话（88%）、文本（76%）、网络（79%）和 Facebook（70%）。这一更新申请提供了一个全面解决健康差距的机会 并测试新的干预提供模式，因为她们使用电子 沟通和社交媒体。 在我们的第一个目标中，我们将评估“SHE-Women”的可行性和试点效果， 妇女健康知识普及干预，妇女出狱。第二个目标是使用随机对照试验来测试 SHE-Women与出狱妇女在提高妇女健康素养、筛查和 降低风险的做法（宫颈癌、乳腺癌、意外怀孕和性传播感染）， 在乎我们的第三个目标将是了解电子干预中人类互动的作用和影响， 跟踪参与者并采访关键利益相关者。从这项研究中获得的知识将导致 了解：1）全面的妇女健康知识普及干预如何缩小健康差距 2）人际互动在成功的电子干预中的作用， 从而为宣传健康促进干预措施创造了一个可持续的模式。