Trends in Associations between Maternal Methamphetamine Use and Congenital Syphilis in Los Angeles County, 2011 through 2020

项目摘要/摘要 博士前个人国家研究服务奖(F31)的目的是为候选人提供 具有指导和研究经验，将促进候选人作为独立候选人的发展 研究人员，特别强调时空趋势和纵向分析以及多层次 梅毒确诊人群中母婴健康的建模。培训的目标是 发展知识和技能以：1)使用最先进的方法获得研究经验，使用大型 纵向监测数据集，并将研究成果作为第一作者发表；2)推进 流行病学培训侧重于药物滥用和性行为的流行病学知识 传播感染并获得调解和纵向分析的统计技能；以及3)获得 成功的学术生涯和专业发展，包括道德操守、研究传播 研究结果，以及发展协作科学关系。培训活动将包括说教 课程作业和具体的研讨会，定向阅读和与导师的一对一教程，以及指导 以负责任的态度进行研究。候选人将接受培训委员会的指导 由全国知名的药物使用、妇幼保健、性健康领域的专家组成 加州大学洛杉矶分校的传播疾病(STDS)和纵向数据分析。这个 拟议研究的具体目的是：1)测量甲基苯丙胺的时空趋势 育龄妇女(15-44岁)、孕妇和先天性心脏病的使用率 2011至2020年间洛杉矶县被诊断为梅毒的母亲梅毒(CS)病例2 确定产前护理就诊、孕期梅毒治疗和分娩的时间趋势 在被诊断为梅毒的孕妇中，患有CS的婴儿因使用冰毒而有所不同；以及3)使用联用 研究冰毒使用、高危性行为、无家可归和社会脆弱性的理论 并测试这些因素的共同出现与无产前护理和CS事件之间的关联 被诊断为梅毒的孕妇。研究目标将通过进行空间- 时间趋势分析和高级统计，如结构方程建模和盘腿面板 模特儿。定量数据将来自性病监测系统，样本量将由 育龄妇女(N=6,014)及婴儿出生时感染梅毒(N=426)数目 2011年至2020年在洛杉矶县。拟议研究的结果将使 提出F32或K01提案的候选人，以试点测试理论驱动的混合方法干预 解决在性传播疾病和生殖机会方面使用冰毒的妇女所面临的多种风险 健康。

PROJECT SUMMARY/ABSTRACT The purpose of the Predoctoral Individual National Research Service Award (F31) is to provide the candidate with mentoring and research experiences that will promote candidate’s development as an independent researcher, with particular emphasis in spatial-temporal trend and longitudinal analysis as well as multi-level modeling in maternal and child health among populations diagnosed with syphilis. Objectives of the training are to develop knowledge and skills to: 1) gain research experience using state-of-the-art methods using a large longitudinal surveillance dataset and publish the research findings as the first author; 2) advance epidemiological training focused on knowledge of the epidemiology of substance abuse and sexually transmitted infections and gain statistical skills for mediation and longitudinal analyses; and 3) obtain Skills for a successful academic career and professional development, including ethics, the dissemination of research findings, and the development of collaborative scientific relationships. Training activities will include didactic coursework and specific workshops, directed readings and one-on-one tutorials with mentors, and instruction in the responsible conduct of research. The candidate will receive mentorship from a Training Committee comprised of nationally renowned experts in the fields of substance use, maternal and child health, sexually transmitted diseases (STDs), and longitudinal data analysis at the University of California, Los Angeles. The specific aims of the proposed research are to: 1) measure spatial-temporal trends in methamphetamine (meth) use incidence rates among women of reproductive age (15-44 years old), pregnant women, and congenital syphilis (CS) case mothers who are diagnosed with syphilis in Los Angeles County between 2011 and 2020; 2) determine whether temporal trends in prenatal care visits, syphilis treatment during pregnancy, and delivery of infants with CS among pregnant women diagnosed with syphilis differ by meth use; and 3) apply syndemic theory to examine meth use, high-risk sexual behaviors, homelessness, and social vulnerabilities that co-occur and test how the co-occurrence of these factors are associated with no prenatal care and CS incidents among pregnant women diagnosed with syphilis. The research aims will be accomplished by conducting spatial- temporal trend analysis and advanced statistics such as structural equation modeling and cross-legged panel modeling. Quantitative data will come from STD surveillance system and sample size will be determined by the number of women at reproductive age diagnosed with syphilis (N=6,014) and infants born with syphilis (N=426) in Los Angeles County between 2011 and 2020. Findings from the proposed research will position the candidate to propose a F32 or K01 proposal to pilot test a theoretically-driven, mixed methods intervention that addresses the multiplicity of risks among meth using women in the context of STDs and access to reproductive health.