Factors influencing vasectomy use

描述(由申请者提供)：拟议的为期四年的K01人口研究科学家发展奖支持Kari White博士成为一名独立的社会科学家和公共卫生研究员，负责研究卫生服务提供模式和政策对获得和使用高效避孕措施的影响，目的是减少意外怀孕的差异。这与NICHD的任务有关，并表明对确保妇女和男子获得安全、有效和可接受的避孕方法的相关研究的兴趣。怀特博士在生育率人口学和使用定性和定量研究方法方面接受了扎实的培训，以研究避孕措施的使用。她的职业发展计划有三个主要目标：1)发展从个人角度评估卫生服务和政策的方法方面的专门知识；2)深入了解避孕方法和了解如何提供避孕服务；3)掌握高级统计技能和熟练使用新的数据来源来分析政策和健康结果。这些目标将通过正式的课程作业、赞助商的指导、专家顾问的指导研究、临床观察和会议来实现。她将把自己目前的知识和技能与通过职业发展活动获得的知识和技能结合起来，对导致美国低收入男性输精管结扎术使用不足的个人、提供者和卫生系统层面的因素进行研究。更多地使用输精管结扎术有可能减少意外怀孕中基于收入的差异，但对于为什么这种方法在低收入男性中使用如此少的研究一直有限。为了全面考察影响输精管结扎需求(个人层面)和供应(提供者和医疗系统层面)的因素，该研究项目旨在：1)评估不想要更多孩子的低收入男性对输精管结扎的知识、态度和兴趣；2)在公共资助的计划生育组织和健康中心的提供者中，找出向低收入男性提供输精管结扎服务的障碍；以及3)评估扩大针对低收入男性的医疗补助计划生育覆盖范围是否增加了输精管结扎的使用，并确定通过该计划接受输精管结扎手术的男性的特征。总而言之，这一职业发展奖将为怀特博士提供有组织的指导、先进的多学科培训以及进行原创性研究的经验，这些将有助于她过渡到领导避孕研究的独立调查员。这些研究将使她对了解意外怀孕的关键决定因素之一做出重大贡献，并可用于为临床实践和卫生政策提供信息。

DESCRIPTION (provided by applicant): The proposed four-year K01 Population Research Scientist Development Award supports the development of Dr. Kari White as an independent social scientist and public health researcher conducting studies of the impact of health service delivery models and policies on access to and use of highly effective contraception, with the aim of reducing disparities in unintended pregnancy. This is relevant to the NICHD mission and stated interest in research relevant to ensuring that women and men have access to safe, effective and acceptable contraceptive methods. Dr. White brings her solid training in the demography of fertility and use of qualitative and quantitative research methods to the study of contraceptive use. Her career development plan has three main goals: 1) develop expertise in methods to evaluate health services and policy from the individual perspective; 2) gain in-depth knowledge of contraceptive methods and exposure to how contraceptive services are provided; and 3) acquire advanced statistical skills and proficiency working with new data sources to analyze policies and health outcomes. These goals will be met through formal coursework, mentoring from sponsors, directed study with expert advisors, clinical observation, and conferences. She will integrate her current knowledge and skill set with those gained through the career development activities by conducting a study of the individual-, provider- and health systems-level factors contributing to the underutilization of vasectomy among low-income men in the United States. Greater use of vasectomy has the potential to reduce income-based disparities in unintended pregnancy, but there has been limited study of why this method is so little used among low-income men. To comprehensively examine the factors shaping both the demand (individual-level) and supply (provider- and health systems-level) of vasectomy, the research project aims to: 1) assess knowledge, attitudes and interest in vasectomy among low-income men who do not want more children; 2) identify barriers to providing vasectomy services to low-income men among providers at publicly funded family planning organizations and health centers; and 3) evaluate whether expanded Medicaid family planning coverage for low-income men increases vasectomy use and identify the characteristics of men getting vasectomies through the program. In sum, this career development award will provide Dr. White the structured mentoring, advanced multi-disciplinary training, and experience conducting original research that will facilitate her transition to an independent investigator leading studies on contraception. These studies will allow her to make significant contributions to understanding one of the key determinants of unintended pregnancy and that can be used to inform clinical practice and health policy.