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

项目总结/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，这将促进候选人作为独立的发展 研究人员，特别强调时空趋势和纵向分析以及多层次 在被诊断患有梅毒的人群中建立孕产妇和儿童健康模型。培训的目标是 发展知识和技能，以：1）获得研究经验，使用国家的最先进的方法，使用大型 纵向监测数据集，并作为第一作者发表研究结果; 2）推进 流行病学培训侧重于药物滥用和性行为流行病学知识， 传播感染，并获得调解和纵向分析的统计技能;以及3）获得以下技能 成功的学术生涯和专业发展，包括道德，研究的传播 研究结果，以及合作科学关系的发展。培训活动将包括教学 课程作业和具体的研讨会，指导阅读和一对一辅导与导师，和指导 负责任地进行研究。候选人将接受培训委员会的指导 由药物使用、孕产妇和儿童健康、性健康和生殖健康等领域的全国知名专家组成， 传播疾病（STD），以及加州大学洛杉矶分校的纵向数据分析。的 拟议研究的具体目标是：1）衡量甲基苯丙胺（冰毒）的时空趋势 育龄妇女（15-44岁）、孕妇和先天性 2011年至2020年期间洛杉矶县被诊断患有梅毒的梅毒（CS）病例母亲; 2） 确定产前检查、怀孕期间的梅毒治疗和分娩的时间趋势， 诊断为梅毒的孕妇中患有CS的婴儿因使用冰毒而不同;以及3） 一个理论来研究冰毒的使用，高风险的性行为，无家可归，以及共同发生的社会脆弱性 并测试这些因素的共同出现如何与产前护理和CS事件之间的关系。 被诊断为梅毒的孕妇。研究目标将通过开展空间- 时间趋势分析和高级统计，如结构方程模型和交叉腿面板 建模定量数据将来自性病监测系统，样本量将由 诊断为梅毒的育龄妇女人数（N= 6 014）和出生时感染梅毒的婴儿人数（N=426） 在洛杉矶县的一次枪击案拟议研究的结果将定位于 候选人提出F32或K 01提案，以试点测试理论驱动的混合方法干预措施， 解决了使用冰毒的妇女在性传播疾病和获得生殖健康方面的多重风险， 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.