Preventing IPV and Reproductive Coercion Among Underserved Adolescents

 描述(由申请人提供)：拟议的以患者为导向的研究职业发展奖(K23)旨在为候选人提供培训和研究经验，以促进她作为独立临床医生和研究员的发展，特别是在墨西哥医疗服务不足的女性青少年中基于医疗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)。这项培训将为她提供机会发展以下方面的知识和技能：1)生殖胁迫(RC)流行病学、评估和预防；2)获得理论、开发、实施和适应以临床为基础的行为干预措施的理论、开发、实施和适应方面的知识；3)获得纵向数据多水平建模的技能，以评估基于临床的行为干预措施的有效性。培训活动将包括授课课程和具体的研讨会，定向阅读和与导师的一对一辅导，以及负责任的研究行为指导。候选人将接受一个培训委员会的指导，该委员会由基于性别的暴力、生殖胁迫、青少年健康、基于医疗保健的筛查以及RC和流行病学研究的简要干预领域的全球知名专家组成。目前的K23研究项目源于西尔弗曼博士和米勒的ARCES(Addressing Reductive Componence In Healthcare Setting)干预的现有研究基础设施，具体目的是对ARCHS的青少年(16-20岁)亚样本进行二次数据分析，并进行流行病学研究，以估计ARCES干预对16-20岁(n=1311)美国女性青少年RC的患病率及其相关性；2)对ARCHS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中的RC的影响；3)开展定性研究，以找出阻碍和调整ARCHS干预措施以提高提华纳(墨西哥)城市卫生诊所女青少年生殖自主性的障碍；4)在提华纳城市卫生诊所实施适应性ARCHS干预措施，初步测试其可行性，并估计未来大规模随机对照试验(RCT)所需的效果大小。虽然这项工作的具体初始目标是一种适合墨西哥青少年保健的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低收入和中等收入国家扩大此类计划的实施。

 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.