Comprehensive Reintegration Assistance for Women with Obstetric Fistula

为患有产科瘘的妇女提供全面的重返社会援助

• 批准号: 9013324
• 负责人: Alison M El Ayadi
• 金额: $ 15.74万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-04-15 至 2018-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9013324
• 关键词: Address; Affect; Africa South of the Sahara; Applications Grants; Award; Birth; Birth trauma; Bladder; Camping; Caring; Cephalopelvic Disproportions; Cervical spinal cord injury; Communities; Consult; Counseling; Data; Data Sources; Development; Discipline of obstetrics; Economics; Effectiveness of Interventions; Emergency Situation; Ensure; Epidemiologic Studies; Evaluation; Evidence based intervention; Evidence based practice; Extravasation; Face; Family; Feces; Fistula; Foundations; Future; Gait abnormality; Genital system; Goals; Gray unit of radiation dose; Head; Health; Health Services Accessibility; Health education; Healthcare; Household; Infection; Infertility; Intervention; Ischemia; Knowledge; Length; Literature; Maternal Health; Maternal Mortality; Measurement; Measures; Medical; Mental Depression; Mental Health; Mentors; Mentorship; Methodology; Methods; Morbidity - disease rate; Necrosis; Nerve; Obstructed labor; Operative Surgical Procedures; Outcome; Pain; Pathway interactions; Phase; Physical Rehabilitation; Physically Handicapped; Pregnancy; Prevention; Prevention approach; Process; Protocols documentation; Psyche structure; Publishing; Quality of life; Randomized; Recovery; Religion and Spirituality; Reporting; Research; Research Activity; Research Methodology; Research Personnel; Research Training; Role; Sampling; Scientist; Services; Severities; Site; Surgical Injuries; Testing; Time; Tissues; Training; Training Activity; Translating; Trauma; Uganda; Urine; Vagina; Woman; Women' s Health; Work; base; cohort; community living; community reintegration; design; disability; empowerment; evidence base; experience; fetal; follow-up; food preparation; health disparity; hip bone; improved; innovation; intervention program; longitudinal analysis; maternal morbidity; meetings; multi-component intervention; physical conditioning; programs; psychologic; psychosocial; public health relevance; rectal; repaired; skills; social; standard of care; success; systematic review; theories; therapy development

 DESCRIPTION (provided by applicant): The goal of this Pathway to Independence Award (K99/R00) is to facilitate my transition to becoming an independent scientist carrying out innovative epidemiologic research on the structural, social, and interpersonal factors influencing maternal health disparities, and translate this research into tangible approaches for the prevention and treatment of maternal morbidity and mortality. The research activities proposed target obstetric fistula, an under-researched traumatic birth injury that affects an estimated 2-3 million women globally [1]. OF has broad physical and psychosocial ramifications, and women with OF are severely stigmatized and marginalized. Despite clinically successful surgery, physical disabilities and poor mental health may persist, making reintegration to family and community difficult for women. The post-surgical reintegration focus of my work is timely, as access to surgery has increased without parallel development of evidence-based reintegration programming. To address this gap, the training and research activities planned during the mentored phase of this award (K99) will build upon my capabilities to equip me with the necessary knowledge and skills in: 1) social-psychological health theories and methodologies; 2) mixed-methods research; 3) advanced quantitative methods for the analysis of longitudinal data; and 4) intervention development. Each of these activities will be instrumental to my successful advancement to the independent phase (R00) of this application, the aims of which are: 1) To conduct a systematic review of the published and grey literature on reintegration programming for OF and analogous conditions; 2) To design a post-surgical reintegration intervention for women and their households to improve women's psychosocial and physical recovery through iterative work with key stakeholders; and 3) To pilot the intervention developed in Aim 2 using a cohort- controlled design and measure the feasibility, acceptability and preliminary impact on post-surgical reintegration success. My mentorship and consulting team is uniquely poised to assist me in achieving my training and research goals, and ensure my transition to success as an independent investigator. This preparatory research, intervention development and pilot testing will lay the groundwork for an R01 which will expand this trial both in size and length of follow-up time in order to evaluate the effectiveness of the intervention on women's post-surgical reintegration, physical and mental disabilities, and economic status.

 描述（由适用提供）：这一获得独立奖的目标（K99/R00）的目的是促进我过渡到成为一名独立科学家，进行创新的关于结构，社会和人际关系因素的创新流行病学研究，影响孕产妇健康差异，并影响预防和治疗孕妇介绍性和孕妇介绍性和孕妇介绍性和治疗的有形方法。研究活动提出了目标产科瘘，这是一种研究不足的创伤性出生损伤，影响了全球估计的2-300万妇女[1]。具有广泛的身体和社会心理后果，并且具有严重污名化和边缘化的妇女。尽管手术在临床上成功，但身体疾病和心理健康状况不佳可能会持续存在，使妇女的家庭和社区重新融合。我的工作后手术后的重新整合重点是及时的，因为手术的机会增加而没有并行开发基于证据的重新整合计划。为了解决这一差距，在该奖项的修订阶段（K99）计划的培训和研究活动将基于我的能力，使我拥有所需的知识和技能：1）社会心理健康理论和方法； 2）混合方法研究； 3）用于分析纵向数据的高级定量方法； 4）干预开发。这些活动中的每一个都将对我成功地发展到本应用程序的独立阶段（R00），其目的是：1）对已发表和灰色的文献进行系统的审查，以实现OF和类似条件的重新整合编程； 2）通过与主要利益相关者的迭代工作，为妇女及其家庭设计后手术后的再整合干预措施，以改善妇女的社会心理和身体恢复； 3）使用队列控制设计中的AIM 2中开发的干预措施，并衡量对手术后重新整合成功的可行性，可接受性和初步影响。我的心态和咨询团队唯一中毒，可以帮助我实现培训和研究目标，并确保我向独立研究者的成功过渡。这项制备研究，干预开发和试点测试将为R01奠定基础，这将扩大该试验的大小和随访时间长度，以评估干预措施对妇女后手术后的重新综合，身心残障以及经济状况的有效性。