Utilizing pediatric primary care connections to advance reproductive health

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PROJECT ABSTRACT/SUMMARY In the US, nearly half of all pregnancies are unintended. Unintended pregnancies are associated with risks to maternal and child health including late prenatal care, premature delivery, developmental delay, and family instability. Governmental agencies and professional maternal and child health organizations support access to contraceptive use and family planning services as essential for women’s health. However, some communities face structural barriers to contraceptive access. The Latinx immigrant community in the US is growing and over half of all US-born Latinx children live with at least one immigrant parent. Latinx immigrants have a limited path to legal status in the US, limiting preventive health care access. With the growing number of US-born children living in immigrant families and the limited options for Latinas to access contraceptive care, the pediatric setting is an unexplored venue for interventions that increase contraceptive access for Latina immigrants. However, to be effective, contraceptive access interventions must be person-centered and acknowledge the historical burdens of structural racism on contraceptive access for communities of color. In this K23 application, Dr Caballero, a research-trained pediatrician, proposes a rigorous training and research plan that will facilitate her long-term career goal: to strengthen child and family health by developing and implementing person-centered interventions to improve contraceptive access equity for immigrants. She proposes to: 1) develop expertise in qualitative methods and analysis to inform implementation-focused outcomes; 2) develop skills in human factors engineering principles and implementation science; 3) learn and apply family planning demography principles to intervention design and analysis; and 4) develop a deeper understanding of contraceptive and reproductive oppression in the US and how to apply health equity principles to advance equitable sexual and reproductive health interventions. She also proposes innovative mentored research to develop and pilot a contraceptive screening and care coordination intervention (Conecta/Conect) in a pediatric primary care setting that serves a large proportion of immigrant families. Conecta will be stakeholder-informed and rooted in human factors engineering approaches to health care redesign. This study will provide preliminary data to support a future larger trial of Conecta. Dr. Caballero’s research will occur in a supportive, collaborative environment at Johns Hopkins School of Medicine, under the guidance of an experienced and dedicated multidisciplinary mentoring team. This team is committed to supporting Dr. Caballero in achieving her research and training goals and her long-term goal of becoming a highly productive independent clinician-investigator and leader in pediatric-focused interventions to improve contraceptive access equity that uniquely address the needs of immigrant families.