Addressing Sexual and Reproductive Health Care Disparities and Barriers among Adolescents and Young Adults with Disabilities

项目概要 迄今为止的研究表明，青少年的性与生殖健康 (SRH) 护理需求 残疾成年人（AYA）并没有得到很好的满足，尽管事实上这个人群很可能有性行为 与没有残疾的同龄人一样活跃。然而，对性健康和生殖健康的研究以及与性健康和生殖健康相关的医疗保健的接受情况 残疾 AYA 的人数仍然有限。缺乏证据让我们了解生殖 按残疾类型划分的残疾年轻女性和男性的医疗保健需求，目前还没有关于 不同人群中生殖保健服务的利用情况。此外，还有少数 帮助残疾 AYA 克服 SRH 护理障碍并获得所需服务的资源。这种混合—— 方法研究将审查转型期性健康和生殖健康和医疗保健利用以及与性健康和生殖健康相关的未满足需求 美国残疾青少年和年轻人的总体年龄和残疾类型。我们会 对来自全国调查数据、对残疾 AYA 的访谈以及对 残疾 AYA 的父母。我们的分析将解决三个基本问题，这将建立一个 制定和试点测试定制干预措施的基础，以改善性健康和生殖健康护理和结果 15-26 岁的残疾 AYA：1) 不同群体在利用生殖保健服务方面存在哪些差异 性别和残疾类型； 2) 残疾 AYA 获得 SRH 护理的障碍是什么？这些障碍如何 性别和残疾类型相似或不同？； 3) SRH 信息和资源将增强哪些能力 残疾 AYA 的知识、参与护理以及与提供者的沟通？在此基础上 基金会，我们将与 AYA 残疾人合作制定干预措施，以解决已确定的问题 障碍和未满足的需求。我们的项目直接解决国家卫生健康委员会确定的性健康和生殖健康护理方面未满足的需求 卫生研究院，包括 (1) 调查残疾 AYA 生殖保健的障碍，以及 (2) 编写供残疾 AYA 使用的生殖健康教育材料。该项目建立在 研究小组之前对残疾青少年和妇女生殖健康的研究、经验 为发育障碍人士制定健康教育课程和性健康资源， 以及为从青春期过渡到残障人士提供护理的临床专业知识 成年期。该项目的预期成果是一个创新的、易于使用的多媒体教育工具包 提高性与生殖健康知识、激活以及提供者的沟通。我们的试点测试将提供初步的 该工具包对我们的目标人群的实用性的证据，为未来的功效测试奠定了基础 在临床试验中。该项目将通过提供有关性健康和生殖健康的证据基础来开辟新天地 医疗保健成果，并将开发创新的性健康和生殖健康教育工具包，以解决障碍和 残疾 AYA 之间的差异。

PROJECT SUMMARY Studies to date suggest that the sexual and reproductive health (SRH) care needs of adolescents and young adults (AYA) with disabilities are not well met, despite the fact that this population is as likely to be sexually active as their peers without disabilities. However, research on SRH and receipt of SRH-related health care among AYA with disabilities remains limited. Scant evidence informs our understanding of the reproductive healthcare needs of both young women and men with disabilities by disability type and there is no research on reproductive healthcare service utilization across the breadth of this diverse population. Further, there are few resources to help AYA with disabilities navigate barriers to SRH care and obtain needed services. This mixed- methods study will examine SRH and healthcare utilization and SRH-related unmet needs among transition age adolescents and young adults with disabilities overall and by disability type in the United States. We will triangulate information from national survey data, interviews with AYA with disabilities, and interviews with parents of AYA with disabilities. Our analyses will address three fundamental questions that will establish a foundation for development and pilot testing of a tailored intervention to improve SRH care and outcomes for AYA with disabilities, ages 15-26: 1) What disparities exist in reproductive health care service utilization by gender and type of disability; 2) What are the barriers to SRH care for AYA with disabilities and how are these similar or different by gender and disability type?; and 3) What SRH information and resources would enhance knowledge, participation in care, and communication with providers for AYA with disabilities? Building on this foundation, we will collaborate with AYA with disabilities to develop an intervention to address the identified barriers and unmet needs. Our project directly addresses unmet needs for SRH care identified by the National Institutes of Health, including (1) investigating barriers to reproductive health care for AYA with disabilities, and (2) developing reproductive health education materials for use by AYA with disabilities. This project builds on the research team’s prior research on reproductive health of teens and women with disabilities, experience in developing health education curricula and sexual health resources for people with developmental disabilities, and clinical expertise in provision of care to people with disabilities transitioning from adolescence to adulthood. The expected outcome of this project is an innovative, accessible, multi-media educational toolkit to improve SRH knowledge and activation and provider communication. Our pilot testing will provide initial evidence on the utility of the toolkit for our target population, establishing a foundation for future efficacy testing in a clinical trial. This project will break new ground by providing a foundation of evidence on SRH health and healthcare outcomes, and will develop an innovative SRH educational toolkit to address barriers and disparities among AYA with disabilities.