Gathering, Learning & Initiating: Setting the Stage for Community-engagement in Women's Health in SW Alaska

摘要：与美国一样，阿拉斯加的孕产妇死亡率(2014-2018年间增长了63%) 阿拉斯加西南部农村地区与物质使用障碍(SUD)相关的不成比例的高水平 社区。为了解决患有SUD的妇女与孕产妇保健服务之间的潜在联系， 研究和预防性护理干预设计必须适合当地社区。发展中的 适合当地的研究和干预战略需要让当地社区和卫生部门参与进来 作为当地利益攸关方的护理机构--特别是涉及敏感和未探索的跨部门问题 人口。该项目的目标1建议为西南地区的孕产妇健康研究奠定基础。 阿拉斯加通过邀请感兴趣的当地妇女和卫生机构为未来在这些领域的研究做准备 通过设立妇女和产妇保健社区咨询委员会(妇产科社区咨询委员会)， 使用经过调整的基于NIH的CAB工具包(Kubinek&Robles，2016)作为指南。此工具包是资源的一部分 用于将社区之声整合到研究学习包中，由NIH-Based Southern汇编 加州临床与翻译科学研究所，概述了如何开发和维护 社区咨询委员会(CAB)，负责研究整合社区观点的研究。趁有机会 强调必须考虑如何使CAB成为一个支持性的环境，以确保平等 参与--为“确定成员，将他们纳入研究过程”列出的战略， 随着时间的推移保持参与度，会议便利化并不一定考虑到 阿拉斯加乡村的偏远或旅行困难，观察自给自足或商业捕鱼的重要性 季节，或要导航的不同部落和区域机构的层次。这些策略的使用， 然后，适当地调整，以提高社区的兴趣和参与的机会；以及 建议使用较小的本地出租车，而不是较大的出租车。Project使用已存在的与 地区AHEC(地区健康教育中心)办事处在该地区进行介绍和 WMH CAB成员对每个社区的推荐；以及焦点小组或讨论圈 将举行会议，讨论如何最好地处理妇女和妇女问题的研究 他们社区中的孕产妇健康问题。本项目的目标2集中在开发和实施 举办工作坊，培训一批本地本科生，以便在 设计的研究始于随后的赠款资助。包括当地的AHEC研究生(S) 在这个阶段帮助推动社区会议；研究和干预设计；以及进行 为当地与会者举办工作坊活动，使他们成为未来研究的采访者。出租车从五(5)辆起 阿拉斯加西南部社区，在AHEC区域办事处的服务区，将负责提供 对研究和干预设计以及研讨会组件的投入。

Summary: As in the US, Alaska’s increased maternal mortality (63% between 2014-2018) has been associated with substance use disorders (SUD) at disproportionately higher levels in rural southwest Alaska communities. To address the underlying connections between women with SUD and maternal health services, research and preventative care intervention designs must be tailored to the local community. Development of locally appropriate research and intervention strategies requires engaging the local communities and health care agencies as local stakeholders—particularly with sensitive and unexplored issues of intersectional populations. Aim 1 of this project proposes to lay the groundwork for a maternal health study in southwest Alaska by engaging interested local women and health agencies to prepare for future research in these communities through the creation of a Women’s and Maternal Health Community Advisory Board (WMH CAB), using an adapted NIH-based CAB toolkit (Kubicek & Robles, 2016) as a guide. This toolkit, part of a Resource for Integrating Community Voices into Research Study package, compiled by the NIH-based Southern California Clinical & Translational Science Institute, provides an overview of how to develop and maintain a community advisory board (CAB) for research studies to integrate community perspectives. While there is emphasis on the importance of considering ways to make the CAB a supportive environment to ensure equal participation— the strategies listed for ‘identifying members, integrating them into the research process, maintaining engagement over time, and meeting facilitation’ did not necessarily take into account the remoteness or difficulty of travel in rural Alaska, the importance of observing subsistence or commercial fishing seasons, or the layers of different tribal and regional agencies to be navigated. The use of these strategies, then, are appropriately adjusted to improve the chances of community interest and involvement; and five smaller local-based CABs proposed, instead of one larger one. Project uses already-existing ties with the regional AHEC (Area Health Education Centers) offices in the area for making the introductions and recommendations of WMH CAB members for each respective communities; and focus group or talking circle meetings will take place to engage in addressing how best to approach research on the Women’s and Maternal health issues in their community. Aim 2 of this project is focused on the development and executions of workshops to train a pool of local undergraduates for placement as local interviewers when the resulting designed research begins with subsequent grant funding. Local-based AHEC graduate student(s) are included in this phase to help facilitate the community meetings; research and intervention design; and to conduct workshop activities for the local attendees to become interviewers for the future studies. CABs from five (5) southwest Alaska communities, in the service areas of AHEC regional offices, will be tasked with providing input on research and intervention designs and workshop components.