Preventing IPV and Reproductive Coercion Among Underserved Adolescents

 描述（申请人提供）：拟议的指导以病人为导向的研究职业发展奖（K23）是为候选人提供培训和研究经验，这将促进她作为一个独立的临床研究人员的发展，特别强调在基于保健的干预研究领域，解决基于性别的暴力，特别是生殖胁迫（RC），在墨西哥医疗服务不足的女青少年。本次培训将为她提供发展知识和技能的机会：1）生殖胁迫（RC）流行病学，评估和预防; 2）获得理论知识，开发，实施和适应理论驱动的基于临床的行为干预措施，以减少RC; 3）获得纵向数据的多层次建模技能，以评估基于临床的行为干预措施的有效性。培训活动将包括教学课程和具体讲习班、指导阅读和与导师一对一辅导，以及指导负责任地开展研究。候选人将接受培训委员会的指导，该委员会由性别暴力、生殖胁迫、青少年健康、基于保健的筛查以及RC和流行病学研究的简要干预措施等领域的全球知名专家组成。目前的K23研究项目来自西尔弗曼博士和米勒博士的ARCHES现有的研究基础设施（解决保健机构中的生殖胁迫问题）干预，具体目标是对青少年次级样本进行二级数据分析（16-20岁）和1）进行流行病学研究，以估计美国16-20岁女性青少年中RC的患病率和相关性。（2）对ARCHES青少年样本进行多水平纵向数据分析，以评估干预对这一群体生殖自主性的影响;（3）进行定性研究，以确定ARCHES干预的障碍，并调整ARCHES干预措施，以提高蒂亚戈州（墨西哥）城市卫生诊所女性青少年的生殖自主性;（4）在天津市城市卫生所实施适应性ARCHES干预，初步检验其可行性，并估计未来大规模随机对照试验（RCT）所需的效应量。虽然这项工作的具体初始目标是为墨西哥的青少年保健提供一个基于诊所的干预模式，但候选人的长期目标是在整个拉丁美洲和其他中低收入国家扩大实施此类方案。

 DESCRIPTION (provided by applicant): The proposed Mentored Patient-Oriented Research Career Development Award (K23) is to provide the candidate with training and research experiences that will promote her development as an independent clinician-researcher, with particular emphasis in the field of healthcare-based intervention research addressing gender-based violence, specifically reproductive coercion (RC), among medically underserved female adolescents in Mexico. This training will provide her with the opportunity to develop knowledge and skills in: 1) reproductive coercion (RC) epidemiology, assessment and prevention; 2) acquire knowledge in the theory, development, implementation, and adaptation of theoretically driven clinic-based behavioral interventions to reduce RC; 3) Acquire skills in multilevel modeling of longitudinal data to assess the efficacy of clinic-based behavioral interventions. Training activities will include didactic coursework and specific workshops, directed readings and one-on-one tutorials with mentors, and instruction in the responsible conduct of research. The candidate will receive mentorship from a Training Committee comprised of globally renowned experts in the fields of gender-based violence, reproductive coercion, adolescent health, healthcare-based screening and brief interventions for RC and epidemiology research. The present K23 research project emerges from the existing research infrastructure of Drs. Silverman and Miller's ARCHES (Addressing Reproductive Coercion in Healthcare Settings) intervention, specific aims are to conduct secondary data analysis of the sub-sample of adolescents (16-20 years old) from ARCHES and 1) Conduct epidemiologic research to estimate the prevalence and correlates of RC among US female adolescents ages 16-20 (n=1311) from the ARCHES intervention; 2) Conduct multilevel longitudinal data analyses of the ARCHES adolescent sample to evaluate the effect of the intervention on RC among this group; 3) Conduct qualitative research to identify barriers to and adapt the ARCHES intervention to improve the reproductive autonomy of female adolescents in urban health clinics in Tijuana (Mexico); 4) Implement the adapted ARCHES intervention for female adolescents in urban health clinics in Tijuana, pilot test its feasibility and estimate effect sizes needed for future lrge-scale randomized controlled trial (RCT). While the specified initial goal of this work is a clinic-based intervention model adapted for adolescent health care in Mexico, the candidates' longer-term goal is to expand implementation of such programs throughout Latin America and in other low and middle-income countries.