SELF-CARE TO PREVENT BIRTH-RELATED UI IN DIVERSE WOMEN: FOCUS GROUP

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 盆底肌肉训练(PFMT)可将育龄妇女患产后尿失禁(UI)的风险降低39-59%。PFMT被推荐用于妊娠/产后尿失禁的预防，但只有20%-47%的人报告使用了它。PFMT是一种非侵入性的自我护理做法，非常适合育龄妇女。 我们在老年女性中进行的随机对照试验(RCT)测试了一系列自我护理策略--PFMT(盆底肌肉的重复自愿收缩和放松)、膀胱训练(BT)(一种排尿时间间隔渐进的排尿计划)和诀窍手法(故意收缩盆底以避免尿失禁)对预防尿失禁的有效性。这些自我护理实践已经证明了尿失禁治疗的有效性，但我们的RCT是第一个证明它们联合起来预防尿失禁的能力。课后三个月和一年后，对PFMT的依从率分别为82%和68%。依从性通过自我效能感、并发BT和常规方法进行预测。我们相信，这些战略之间存在协同效应。采取综合策略的班级可能会加强育龄妇女进行PFMT的实践。 尽管非裔美国人(AA)和西班牙裔妇女患尿失禁的风险较低，但她们有尿失禁症状的心理困扰超过了高加索妇女(AA妇女高1.26倍，西班牙裔妇女高5.7倍)。以前的预防尿失禁的试验包括主要是高加索妇女，这引起了人们对非裔美国人和西班牙裔美国人预防性卫生服务率低的健康差距的担忧。在有色人种女性中，增加的痛苦和缺乏尿失禁自我护理有效性的证据，需要在未来的随机对照试验中测试产前膀胱健康等级(BH等级)的有效性。NIH早些时候的一份申请很受欢迎，但建议与目标样本的成员讨论BH班级的文化适宜性、渗漏指数问卷以及招募/保留策略。拟议的试点将通过以下具体目标产生证据： 目标1：开发适合文化的方式，向再生障碍性贫血和西班牙裔育龄妇女提供BH课程。 目标2：确保BH班使用的渗漏指数问卷和印刷材料达到适合我们目标人群的五年级阅读水平。 目标3：为密歇根州东南部的再生障碍性贫血和西班牙裔育龄妇女确定文化上合适的招聘和留住战略。 为了实现这些目标，我们将与AA和西班牙裔妇女开展焦点小组。结果将为未来的NIH拨款申请提供依据。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Pelvic floor muscle training (PFMT) reduces childbearing women's risk of birth-related urinary incontinence (UI) by 39-59%. PFMT is recommended for UI prevention in pregnancy/postpartum but only 20-47% report its use. PFMT is a non-invasive self-care practice well-suited for childbearing women. Our randomized controlled trial (RCT) with older women tested the effectiveness for UI prevention of an intensive class presenting an array of self-care strategies - PFMT, (repetitive voluntary contraction and relaxation of pelvic floor muscles); bladder training (BT) (a program of scheduled voiding with progressive voiding intervals); and the Knack maneuver (intentional contraction of the pelvic floor to avoid UI). These self-care practices have demonstrated efficacy in UI treatment but our RCT was the first to demonstrate their combined capacity for UI prevention. Adherence to PFMT was 82% at three months and 68% one year post-class. Adherence was predicted by self-efficacy, concurrent BT, and routine approach to PFMT. We believe synergy exists across the strategies. The class with combined strategies will likely enhance childbearing women's practice of PFMT. Although the risk of UI is lower among African American (AA) and Hispanic women, their psychological distress with UI symptoms exceeds that of Caucasian women (1.26 times higher in AA women, 5.7 times higher in Hispanic women). Previous trials of PFMT to prevent UI included predominantly Caucasian women raising a health disparities concern of low rates for preventive health services among African Americans and Hispanics. Increased distress plus lack of evidence for UI self-care efficacy in women of color, warrant testing the effectiveness of an antenatal bladder health class (BH Class) in a future RCT. An earlier NIH application was well received but recommended that cultural appropriateness of the BH Class, the Leakage Index questionnaire, and recruitment/retention strategies be discussed with members of the target sample. The pilot proposed will generate that evidence through the following specific aims: Aim 1: Develop culturally appropriate ways to present the BH class to AA and Hispanic childbearing women. Aim 2: Assure that the Leakage Index questionnaire and the print materials used in the BH Class are at a 5th grade reading level, which is appropriate for our target population. Aim 3: Identify culturally appropriate recruitment and retention strategies for AA and Hispanic childbearing women in Southeast Michigan. To accomplish these aims, we will conduct focus groups with AA and Hispanic women. Results will inform a future NIH grant application.'