Developing and Testing a Smart Phone Based Contraceptive Use Educational Intervention for African Immigrant Women with Low Literacy

为识字率低的非洲移民妇女开发和测试基于智能手机的避孕药具使用教育干预

• 批准号: 10667872
• 负责人: Kafuli Agbemenu
• 金额: $ 24.85万
• 依托单位: STATE UNIVERSITY OF NEW YORK AT BUFFALO
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-19 至 2025-10-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10667872
• 关键词: Access to Information; Address; Adverse effects; African; Age; Belief; Birth; Birth Intervals; COVID-19 pandemic; Cause of Death; Cellular Phone; Centers for Disease Control and Prevention (U.S.); Child; Communities; Contraceptive Agents; Contraceptive Usage; Contraceptive methods; Data; Development; Education; Educational Intervention; Educational Status; Environment; Family; Family Planning; Family Planning Education; Family member; Fertility; Fright; Future; Goals; Health; Health Personnel; Healthcare; Healthcare Systems; Hormonal; Immigrant; Immigrant community; Incidence; Infant Mortality; Intervention; Knowledge; Language; Length; Low Birth Weight Infant; Low income; Maternal Mortality; Maternal and Child Health; Measures; Methods; Misinformation; Modality; Modification; Mothers; Neonatal Mortality; Online Systems; Outcome; Participant; Persons; Population; Population Control; Pregnancy; Pregnancy Rate; Premature Birth; Prenatal care; Preparation; Process; Proliferating; Reaction; Refugees; Reporting; Reproductive Health; Research; Resources; Sampling; Science; Self Efficacy; Services; System; Target Populations; Testing; Text; Time; Underserved Population; United States; Voice; Vulnerable Populations; Woman; Work; Writing; birth control; black women; career; child bearing; cost; design; empowerment; evidence base; experience; health care availability; health disparity; hormonal contraception; human centered design; implementation trial; improved; information gathering; innovation; literacy; low socioeconomic status; marginalization; marginalized population; obstetrical complication; pregnancy prevention; programs; racial minority; recruit; reproductive; smartphone application; social; social culture; sociocultural determinant; unintended pregnancy; uptake; usability; video chat; women of color

Project Summary/Abstract Maternal mortality continues to be the second leading cause of death for women of reproductive age around the world. Maternal mortality is contributed to by unplanned, or mistimed pregnancies, that is, pregnancies that occur at a time the mother is not prepared for, or too soon after a previous birth. Unplanned pregnancies are associated with low birth weight, delayed access to prenatal care, and other health concerns for women and babies. Unplanned pregnancy occurs disproportionately among low-income women, women of color, and immigrant women. Rates of unplanned pregnancy can be reduced through the use of family planning, which include natural methods, and use of contraceptives, whether hormonal or otherwise. Contraception use allows women to decide whether, and when to have children. In addition, planning, postponing and spacing births, allows women to achieve educational and career goals. Family planning access is influenced by factors such as access to health care, fear of adverse effects, proliferation of misinformation about family planning methods, and fear of a partner or family member’s reaction to use. These concerns are amplified in vulnerable and underserved populations, such as in immigrant communities, where social ties, and connections with the larger healthcare system may not be as strong. In the U.S., a particularly marginalized group is that of African immigrant women (including African refugee women), a steadily increasing population, who have been reported to have overall poorer reproductive health outcomes due to decreased access to health care, language barriers, low socioeconomic status, and potentially lower education levels. Therefore, the objective of this R21 application is to address important gaps in the healthcare environment by providing salient and meaningful contraceptive information for African refugee women who may not speak English, and have low literacy levels. The specific aims are to: 1) adapt an existing web-based family planning intervention into a culturally congruent family planning smartphone-based intervention, and 2) assess the feasibility, acceptability, and preliminary efficacy of the developed smart-phone based intervention. This intervention will be designed to increase access to information by providing self-paced, science-based education. Findings from the feasibility and usability study will allow the research team to gather information on the processes, resources, and scientific feasibility of the approach. This preliminary assessment will provide formative data that will inform the development of a well-designed future R01 implementation trial. It is also anticipated that this intervention could be trialed in in a larger sample of the population. The use of a cellphone application is an innovative method that allows for self-paced, yet wide spread dissemination of the intervention.

项目总结/摘要 孕产妇死亡率仍然是育龄妇女死亡的第二大原因， 世界产妇死亡率是由计划外怀孕或时机不当造成的，即 发生在母亲没有准备好的时候，或者在前一次分娩后太快。计划外怀孕 与出生体重低、产前护理延迟和妇女的其他健康问题有关， 婴儿计划外怀孕发生在低收入妇女，有色人种妇女， 移民妇女。计划生育可以降低意外怀孕率， 包括自然方法和使用避孕药具，无论是激素或其他避孕药具。避孕措施的使用 女性决定是否以及何时要孩子。此外，计划生育、推迟生育和间隔生育， 使妇女能够实现教育和职业目标。 获得计划生育的机会受到诸如获得保健、担心不利影响、 关于计划生育方法的错误信息扩散，以及对伴侣或家庭成员的恐惧 使用的反应。这些问题在弱势和得不到充分服务的人口中，如移民中， 社区，那里的社会联系和与更大的医疗保健系统的联系可能不那么强。在 美国，一个特别边缘化的群体是非洲移民妇女（包括非洲难民妇女）， 人口稳步增长，据报告，这些人的生殖健康结果总体较差 由于获得医疗保健的机会减少，语言障碍，社会经济地位低下， 教育水平。因此，本R21应用程序的目标是解决 为非洲难民提供突出和有意义避孕信息， 妇女可能不会说英语，识字水平低。 具体目标是：（1）将现有的基于网络的计划生育干预措施调整为文化上一致的 计划生育智能手机为基础的干预，2）评估可行性，可接受性，和初步 开发的基于智能手机的干预措施的有效性。 这项干预措施的目的是通过提供自定进度的、以科学为基础的 教育可行性和可用性研究的结果将使研究小组能够收集以下信息： 方法的过程、资源和科学可行性。这一初步评估将提供 形成性数据，将为设计良好的未来R 01实施试验的开发提供信息。也是 预计这种干预措施可以在更大的人群样本中进行试验。使用手机 应用程序是一种创新的方法，允许自定进度，但广泛传播的 干预