Impact of Social Factors on the Effectiveness of a Preconceptional PTB Program

候选人：Vijaya K.Hogan，P.H.博士，M.P.H.是北卡罗来纳大学妇产科临床副教授和兼职助理教授。她的研究重点是早产和种族差异的原因。职业发展计划：应聘者将参加正式的课程作业、研讨会和有指导的研究，以学习与健康决定因素有关的基本理论、知识和技能以及社会科学方法，学习先进的定量分析技术和研究的伦理行为。近期目标：整合社会科学和流行病学方法，以了解社会暴露对脆弱人群的影响。长期目标：通过发展和应用这一综合知识来设计、实施和评估有效的多水平(行为、社会和临床)随机控制干预措施，以降低全国早产率和差异。具体目标：1.确定和验证对妇女参与预先提供的早产预防干预措施产生不利影响的特定社会因素；2.估计这些关键因素的不同经历在多大程度上解释了在接受结构化的、预先提供的干预措施方面的差异。研究方法：利用现有行为/临床随机对照研究中有关早产分娩干预措施的数据并对受试者进行跟踪，我们将使用Anderson行为模型进行定量分析，以确定在这一人群中解释早产护理利用的决定因素。然后，我们将使用人种学技术来确定社会暴露、个人行为和获得怀孕前护理之间的更具体路径。指导：指导将由一位著名的社会学家(穆兰-哈里斯)提供；并得到包括人类学家、社会学家、人口学家和流行病学家在内的咨询小组的支持。相关性：这项研究将确定继续对卫生保健参与和结果产生影响的特定社会暴露，即使消除了所有影响保健的系统性障碍。我们将开发一种可复制的经验方法来衡量非洲裔美国女性独特经历的相关慢性应激暴露的变化，从而更好地理解这些因素影响循证护理有效性的机制。

DESCRIPTION (provided by applicant): Candidate: Vijaya K. Hogan, Dr. P.H., M.P.H. is a Clinical Associate Professor in Maternal and Child Health and Adjunct Assistant Professor in Ob/GYN at the University of N. Carolina. Her research focuses on causes of preterm birth and ethnic disparities. Career Development Plan: The candidate will participate in formal coursework, workshops and mentored research to learn essential theory, knowledge and skills and social science methods relating to determinants of health, in advanced quantitative analytic techniques and in ethical conduct of research. Immediate Objective: to integrate social science and epidemiologic methods to understand effects of social exposures on vulnerable populations. Long-term objective: To reduce national rates of preterm birth and disparities by developing and applying this integrated knowledge to the design, implementation and evaluation of effective multi-level (behavioral, social and clinical) randomized controlled interventions. Specific Aims: 1 .Identify and validate specific social factors that adversely impact on women's participation in preconceptionally delivered preterm birth prevention interventions; 2. Estimate the extent that differential experience of these key factors explains variation in receipt of structured, preconceptionally delivered interventions. Research Methods: Using data and following up on subjects from an existing behavioral/clinical RCT on preconceptionally delivered preterm birth reduction interventions, we will conduct a quantitative analysis using the Anderson Behavioral Model to identify the determinants that explain utilization of preconceptional care in this population. We will then use ethnographic techniques to identify more specific pathways between the social exposures, individual behaviors and access to preconceptional care. Mentorship: Mentorship will be provided by a prominent sociologist (Mullan-Harris); with support from an Advisory group that includes anthropologist, sociologist, demographer, and epidemiologist. Relevance: This research will identify the specific social exposures that continue to exert an influence on health care participation and outcomes, even when all systemic barriers to care are removed. We will develop a replicable and empirical method for measuring the variation in relevant chronic stressful exposures uniquely experienced by African American women with a better understanding of the mechanisms through which these factors influence the effectiveness of evidence-based care.