Reducing reproductive health disparities among Latinx youth living in rural communities

项目摘要/摘要 少女怀孕(TP)在很大程度上是无意的，可能会导致不利的健康、教育和经济 对母亲和孩子都有影响。尽管美国的TP率在过去几十年里有所下降， 差距依然存在。美国拉丁裔青少年的出生率是全国平均水平的1.5倍 农村地区的白人青少年比农村白人青少年高出两倍多。在农村定居的拉丁裔移民 这些地区是美国农村地区规模最大、增长最快的少数民族群体。最佳实践 在这些独特的社区中实施循证TP预防计划在很大程度上仍然是未知的。 因此，迫切需要制定和评估一套专门针对以下问题的响应干预措施 这些脆弱的青少年。转基因实施科学框架已被用来处理其他 拉美裔农村社区之间的健康差距。基于我们之前的工作，论证了TP的必要性 为满足这一独特人口的需求而量身定做的预防干预措施，我们将利用这一框架建立 在CuíDate(关爱)上，一种以证据为基础的、文化响应的干预措施已被证明 减少城市拉丁裔青年的性危险行为。巴拉尔医生是一名青少年内科医生， 本次职业发展奖候选人，致力于以患者为中心的临床研究生涯 有针对性地采取干预措施，减少生殖健康差距。她的五年职业发展计划 包括结构化的指导和正式的教学，以通过收购 在行为改变理论、青少年行为研究的临床试验和社区方面的专业知识 从事研究。拟议的研究通过提供实践经验来补充其他培训活动 在干预、共同开发和可行性试验中。在确定了以下关键因素之后， 为农村拉美裔青少年开发可接受的TP预防干预措施，巴拉尔博士将使用 创新框架，共同开发最适合社区独特需求和背景的干预措施。 巴拉尔博士将进行一项单臂可行性试验，以评估联合创建的 干预。拟议的调查将通过以下方式提高对TP预防差异的科学知识 在新兴的拉丁裔移民群体中解决TP的交叉性和背景 扎根于农村社区。她将全面纳入社区和利益相关者的指导 成为一种共同创建的新颖干预措施，最适合这些独特的新移民的当地需求 人口。研究结果将为开发更大的混合功效实施研究提供参考， 在K23获奖期内提交的R01支持。这一培训和研究计划是一致的 以国家卫生研究院和国家少数民族健康与健康研究所为使命 差距。

Project Summary/Abstract Teenage pregnancy (TP) is largely unintended and can lead to adverse health, educational, and economic outcomes for both the mother and the child. Although TP rates have declined in the U.S. over several decades, disparities persist. Birth rates among Latinx teens in the U.S. are 1.5 times higher than the national average and more than 2 times higher in rural areas compared to rural White teens. Latinx immigrants settling in rural areas represent the largest and fastest growing minority group in rural America. Best practices for implementing evidence-based TP prevention programs in these unique communities remain largely unknown. Thus, a critical need exists to develop and evaluate a set of responsive interventions tailored specifically to these vulnerable teens. The transcreation implementation science framework has been used to address other health disparities among Latinx rural communities. Based on our previous work demonstrating the need for TP prevention interventions tailored to meet needs in this unique population, we will use this framework to build upon Cuídate (Take Care), an evidence-based, culturally responsive intervention that has been shown to decrease sexual risk behaviors among urban Latinx youth. Dr. Barral, an adolescent medicine physician and candidate for this career development award, is committed to a patient-oriented clinical research career targeting interventions to reduce reproductive health disparities. Her five-year career development plan includes structured mentoring and formal didactics to address critical gaps in her training through acquisition of expertise in theories of behavior change, clinical trials for adolescent behavioral research, and community engaged research. The proposed study complements other training activities by enabling hands-on experience in intervention co-development and feasibility trial. Following identification of key factors needed for the development of an acceptable TP prevention intervention for rural Latinx teens, Dr Barral will use the transcreation framework to co-develop an intervention that best fits the community’s unique needs and context. Dr. Barral will conduct a one arm feasibility trail to evaluate acceptability and practicality of the co-created intervention. The proposed investigation will improve scientific knowledge in disparities in TP prevention by addressing the intersectionality and context of TP occurring among emerging immigrant Latinx populations embedded in rural communities. She will comprehensively incorporate community and stakeholder guidance into a co-created and novel intervention that optimally fits local needs of these unique new immigrant populations. Study findings will inform the development of a larger hybrid efficacy implementation study, supported by an R01 submission during the K23 award period. This training and research plan are consistent with the mission of the National Institutes of Health and the National Institute on Minority Health and Health Disparities.