A multimedia, group-based clinical care and support model to increase dual protec

描述(由申请人提供)：年轻的非裔美国女性背负着不成比例的意外怀孕和性传播疾病的负担。双重保护战略同时提供意外怀孕和性传播疾病的预防。以前开发以临床为基础的干预措施以促进双重保护的努力收效甚微。由于对青年妇女用于保护自己的战略认识不足，个人、伴侣和提供者对青年妇女双重保护做法的影响相互影响，以及提供者围绕双重保护的做法，这些努力一直受到阻碍。建议的干预旨在建立双重保护使用、多层次(自我、同伴、护理团队、合作伙伴等)的动机。关于双重保护使用的支持文化，社会规范转向对双重保护使用的期望，承认双重保护使用的影响和挑战，以及针对这些挑战提出管理建议。方法：这是一项随机对照试验，以小组为基础的教育和临床护理，以鼓励年轻的非裔美国女性使用双重保护。我们将招募15-19岁的非洲裔美国女性到格雷迪纪念青少年服务诊所进行生殖健康护理。同意参加的年轻女性将被随机分为两组。将以门诊日为随机单位。那些被随机分配到对照组的患者将在格雷迪纪念青少年服务诊所接受符合标准护理方案的基于个人的临床护理。那些被随机分配到干预组的患者将接受相同的临床护理，然而，参与者将作为一个小组前往诊所就诊。这些参与者将获得 根据需要进行个人临床护理以及以团体为基础的教育，重点是双重保护，方法如下：使用侧重于双重保护策略的交互式多媒体平台，并选择五个以团体为基础的教育课程，重点关注与双重保护使用相关的问题(双重保护的重要性、关系、性决策、伴侣沟通)始终如一的护理团队(护士、健康教育者、医疗保健提供者)根据需要通过Facebook为参加团体会议的个人提供支持和护理通过Facebook进行调解沟通这种干预措施从招募到最后的后续行动将持续18个月。我们将检验以下假设：H1：这种多成分干预的参与者将体验到比对照组参与者更低的生物学结果(意外怀孕、衣原体和/或淋病)的发生率。H2：这项多组分干预的参与者将报告比对照组参与者更多地采用和遵守经过验证的双重保护策略。

DESCRIPTION (provided by applicant): Young African American women carry a disproportionate burden of both unintended pregnancy and STDs. Dual protection strategies offer concurrent prevention of both unintended pregnancy and STDs. Previous efforts to develop clinic-based interventions to promote dual protection have met with limited success. Efforts have been hampered by a poor understanding of the strategies young women employ to protect themselves, the interplay among individual, partner and provider influences on young women's dual protection practices, and provider practices around dual protection. The proposed intervention seeks to build motivation for dual protection use, a multi-layered (self, peers, care team, partners, etc.) culture of support around dual protection use, a social norms shift towards expectation of dual protection use, and an acknowledgement of the influences and challenges of dual protection use as well as management suggestions for these challenges. Methods: This is a randomized controlled trial testing group-based educational and clinical care to encourage dual protection use among young African American women. We will recruit African American females aged 15- 19 who are attending the Grady Memorial Teen Services Clinic for reproductive health care. Young women who consent to enrollment will be randomized to one of two groups. Clinic day will be the unit of randomization. Those randomized to the control arm will receive individual-based clinical care consistent with standard care protocols at the Grady Memorial Teen Services Clinic. Those randomized to the intervention arm will receive the same clinical care, however, participants will access clinic as a group. These participants will receive individual clinical care as needed as well as group-based education with a focus on dual protection with the following approaches: Use of an interactive multimedia platform focused on dual protection strategies and selection of a strategy of Five group based educational sessions focusing on issues relevant to dual protection use (Importance of dual protection, Relationships, Sexual decision-making, Partner communication) A consistent care team (Nursing, Health Educator, Healthcare Provider) providing support and care to individuals attending the group sessions as needed Intercession communication via Facebook This intervention will span 18 months from recruitment to final follow-up. We will test the following hypotheses: H1: Participants in this multi-component intervention will experience lower incidence of biologic outcomes (unintended pregnancy, Chlamydia and/or gonorrhea) than participants in the control group. H2: Participants in this multi-component intervention will report higher adoption and adherence to proven dual protection strategies than participants in the control group.