Utilizing pediatric primary care connections to advance reproductive health

利用儿科初级保健联系促进生殖健康

• 批准号: 10738847
• 负责人: Tania Maria Caballero
• 金额: $ 17.39万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-18 至 2028-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10738847
• 关键词: Academy; Address; Adoption; American; Award; Caring; Child; Child Health; Childhood; Clinic; Clinical Trials; Color; Communities; Contraceptive Agents; Contraceptive Usage; Control Groups; Data; Dedications; Demography; Developmental Delay Disorders; Effectiveness; Eligibility Determination; Emergency Care; Engineering; Equity; Face; Family; Family Planning; Family health status; Focus Groups; Future; Goals; Health; Healthcare; Human; Hybrids; Immigrant; Immigrant community; Immigrant family; Individual; Insurance; Intervention; Interview; Justice; Lactation; Latina; Latina Population; Latinx; Leadership; Learning; Legal Status; Limited English Proficiency; Maps; Maternal Health; Maternal and Child Health; Measures; Medical; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Methodology; Methods; Mothers; Needs Assessment; Outcome; Parents; Pediatrics; Persons; Postpartum Depression; Postpartum Period; Pregnancy; Pregnancy Rate; Premature Birth; Prenatal care; Preventive healthcare; Primary Care; Process; Productivity; Protocols documentation; Provider; Qualitative Methods; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Recommendation; Reproductive Health; Research; Research Methodology; Research Personnel; Research Training; Risk; Structural Racism; Structure; Surveys; Testing; Training; Uninsured; Visit; Woman; Women' s Health; acceptability and feasibility; bilingualism; care coordination; care costs; career; cohort; collaborative environment; design; effectiveness measure; experience; health care availability; health equity; health organization; implementation evaluation; implementation facilitators; implementation framework; implementation outcomes; implementation science; implementation/effectiveness; improved; innovation; medical schools; multidisciplinary; novel; pediatrician; person centered; prevent; primary care setting; programs; reproductive; reproductive health intervention; screening; sexual health intervention; skills; social; social health determinants; therapy design; unintended pregnancy; uptake

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.

项目摘要/总结 在美国，近一半的怀孕是意外的。意外怀孕与以下风险有关： 妇幼保健，包括产前晚期护理、早产、发育迟缓和家庭 不稳定政府机构和专业妇幼保健组织支持获得 避孕药具的使用和计划生育服务对妇女健康至关重要。然而，一些社区 在获得避孕药具方面面临结构性障碍。美国的拉丁裔移民社区正在增长， 在美国出生的拉丁裔儿童中，有一半与至少一位移民父母生活在一起。拉丁裔移民的道路有限 在美国的法律的地位，限制了预防性医疗保健的获得。随着美国出生的孩子越来越多， 生活在移民家庭中，拉丁裔获得避孕护理的选择有限，儿科环境 是一个未经探索的干预场所，增加拉丁美洲移民的避孕药具获得。但要 为了有效，避孕措施必须以人为本，并承认历史 结构性种族主义对有色人种社区获得避孕药具的负担。在这个K23应用程序中， 卡瓦列罗是一位受过研究训练的儿科医生，她提出了一项严格的培训和研究计划， 长期职业目标：通过发展和实施以人为本的 采取干预措施，改善移民获得避孕药具的公平性。她建议：1）发展专业知识， 定性方法和分析，以告知以实施为重点的成果; 2）发展人类技能 因素工程原理与实施科学; 3）学习和应用计划生育人口学 干预设计和分析的原则; 4）加深对避孕和 美国的生殖压迫，以及如何应用健康公平原则来促进公平的性和 生殖健康干预措施。她还提出了创新的指导研究，以开发和试点 在儿科初级保健环境中进行避孕筛查和护理协调干预（Conecta/Conect） 为很大一部分移民家庭服务。Conecta将以人为本， 因素工程方法来重新设计医疗保健。这项研究将提供初步数据，以支持 未来更大规模的Conecta试验卡瓦列罗博士的研究将在一个支持性的、协作性的环境中进行， 约翰霍普金斯医学院，在一个经验丰富，专门的多学科的指导下， 指导团队。该团队致力于支持Caballero博士实现她的研究和培训 她的长期目标是成为一名高效的独立临床研究者和领导者， 以儿科为重点的干预措施，以改善获得避孕药具的公平性， 移民家庭。