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

项目摘要 迄今为止的研究表明，青少年和青年的性健康和生殖健康护理需求 成年人（AYA）残疾人没有得到很好的满足，尽管事实上，这一人群很可能是性行为， 像没有残疾的同龄人一样活跃。然而，关于性健康和生殖健康的研究以及接受与性健康和生殖健康有关的保健的情况并不多见。 残疾人的数量仍然有限。我们对生殖系统的理解缺乏证据 按残疾类型分列的残疾青年男女的医疗保健需求， 生殖保健服务的利用率在这一多样化的人口的广度。此外，很少有 资源，以帮助残疾AYA克服性健康和生殖健康护理的障碍，并获得所需的服务。这种混合- 方法研究将检查性健康和生殖健康和医疗保健利用和性健康和生殖健康相关的未满足的需求， 年龄段的青少年和年轻的成年人残疾的整体和残疾类型在美国。我们将 从全国调查数据、与残疾人AYA的访谈以及与 AYA残疾人的父母。我们的分析将解决三个基本问题，这些问题将建立一个 为制定和试点测试量身定制的干预措施奠定基础，以改善性健康和生殖健康护理， 15-26岁的AYA残疾人：1）在生殖保健服务利用方面存在哪些差异， 性别和残疾类型; 2）对残疾AYA的性健康和生殖健康护理有哪些障碍，这些障碍是如何形成的 性别和残疾类型相似或不同？以及3）哪些性健康和生殖健康信息和资源将加强 知识，参与护理，并与残疾AYA提供者沟通？在此基础上 基金会，我们将与残疾人AYA合作，制定一项干预措施，以解决已确定的 障碍和未满足的需求。我们的项目直接解决了国家卫生部确定的性健康和生殖健康护理方面未得到满足的需求。 卫生研究所，包括（1）调查残疾AYA生殖保健的障碍，以及 (2)编制生殖健康教育材料，供AYA残疾人使用。该项目建立在 研究小组先前对残疾青少年和妇女生殖健康的研究， 为发育障碍者制定健康教育课程和性健康资源， 和临床专业知识，为从青春期过渡到 成年该项目的预期成果是一个创新的、可获得的多媒体教育工具包， 改善性健康和生殖健康知识和激活以及提供者沟通。我们的试点测试将提供初步的 该工具包对我们目标人群的实用性证据，为未来的疗效测试奠定基础 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， 卫生保健成果，并将开发一个创新性的性健康和生殖健康教育工具包，以解决障碍， AYA与残疾人之间的差异。

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.