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

项目总结 迄今为止的研究表明，青少年和青少年的性健康和生殖健康(SRH)护理需求 成年人(Aya)的残疾没有得到很好的满足，尽管这一人群很可能是性行为 像他们的同龄人一样活跃，没有残疾。然而，对SRH和与SRH相关的医疗保健接受情况的研究 在阿亚残疾人中，这一比例仍然有限。几乎没有证据告诉我们对生殖的理解 按残疾类型分列的年轻女性和男性残疾人士的医疗保健需求，没有关于 生殖保健服务在这一多样化人群中的广泛使用情况。此外，几乎没有 提供资源，帮助残疾人克服SRH护理和获得所需服务的障碍。这是混合的- 方法研究将在过渡期间检查SRH和医疗保健利用以及与SRH相关的未满足需求 美国残疾青少年和青壮年的总体年龄和残疾类型。我们会 从全国调查数据、对残疾人士Aya的采访和对 残疾的阿雅的父母。我们的分析将解决三个基本问题，这将建立一个 为开发和试点测试量身定做的干预措施奠定基础，以改善SRH护理和结果 残障人士，15-26岁：1)在生殖保健服务利用方面存在哪些差距 性别和残疾类型；2)对残疾Aya进行SRH护理的障碍是什么？这些障碍是怎样的 性别和残疾类型相似或不同；以及3)哪些SRH信息和资源将得到加强 Aya残疾人的知识、参与护理和与提供者的沟通？以此为基础 基金会，我们将与Aya合作，制定一项干预措施，以解决已确定的 障碍和未得到满足的需求。我们的项目直接解决了国家确定的未满足的SRH护理需求 卫生研究所，包括(1)调查残疾人生殖保健方面的障碍，以及 (2)编写供残障人士使用的生殖健康教育材料。这个项目是建立在 研究小组先前对青少年和残疾妇女生殖健康的研究，经验 为发育障碍人士开发健康教育课程和性健康资源， 为从青春期到青春期的残疾人提供护理的临床专业知识 成人期。该项目的预期结果是一个创新的、可访问的多媒体教育工具包，以 提高SRH知识和激活与供应商的沟通。我们的试点测试将提供初步的 证明工具包对我们的目标人群的实用性，为未来的疗效测试奠定了基础 在临床试验中。该项目将开辟新的领域，为SRH健康和 医疗保健成果，并将开发一个创新的SRH教育工具包，以解决障碍和 残障人士之间的差距。

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.