Gender, Autonomy, and Contraceptive Use Among Young People

职业目标：这是加州大学旧金山分校公共卫生社会科学家Ushma Upadhyay博士和公共卫生硕士Ushma Upadhyay在人口研究领域的K01职业发展奖的申请书。她的初步研究重点是避孕措施的使用和意外怀孕，包括制定第一项生殖自主措施，评估妇女决定和控制与避孕措施使用、怀孕和生育有关的事项的能力。在短期内，她的目标是在这项工作的基础上再接再厉，调查基于性别的权力对年轻人避孕措施使用的影响。从长远来看，她渴望进行研究，得出以证据为基础的干预措施，帮助年轻人控制自己的生育能力。她将从K01奖中获得的知识和经验将为她竞争NICHD R01资金做好准备，以设计一项随机干预试验，以测试基于性别的权力干预对青少年避孕药使用和意外怀孕的影响。环境：加州大学旧金山分校(UCSF)为初级教师提供慷慨的支持。加州大学旧金山分校的研究人员在寻求生殖健康方面的创新想法方面有着悠久的历史。作为一个机构，它一直明确支持关于避孕用法和意外怀孕的研究。研究职业发展计划的关键要素：Upadhyay博士在流行病学和人口统计学方法方面拥有丰富的背景，具有分析大型数据集的丰富经验。这一职业发展奖将使她能够解决她在针对其职业目标的培训中的几个剩余差距，并获得关于基于性别的权力和避孕用具的初步数据收集研究的应用经验。她的培训目标是在青少年社会性别理论、定性研究、先进的定量方法以及将证据转化为干预措施方面获得经验和专业知识。为了实现这些目标，Upadhyay博士组建了一支独特的跨学科培训和指导团队。其中包括主要导师Tina Raine-Bennett，医学博士，公共卫生硕士，曾在加州大学旧金山分校担任临床科学家，现任Kaiser Permanente妇女健康研究所研究主任，专门研究青少年意外怀孕和种族差异，以及共同导师Shari Dworkin，博士，MS，加州大学社会和行为科学系的医学社会学家和基于性别的权力专家。她的团队还包括另外三名互补顾问：加州大学旧金山分校产科、妇科和生殖科学系人口学家戴安娜·福斯特博士，研究意外怀孕后果的人口统计学家；加州大学旧金山分校艾滋病预防研究中心定量方法学家Torsten B.Neilands博士，擅长潜变量(结构方程)建模；以及克莱尔·布林迪斯教授。 儿科学和健康政策，其研究重点是青少年和儿童健康政策，青少年怀孕和怀孕预防，以及青少年健康和冒险行为。Upadhyay博士的培训将包括有组织的阅读清单和导师辅导、课程作业、自我指导学习、会议报告和出席，以及研讨会。研究项目简介：意外怀孕是一个重要的公共卫生问题；美国一半的怀孕都是意外怀孕。向成年期过渡是意外怀孕的一个特别脆弱的时期；15至24岁的妇女风险最高。意外怀孕的主要原因之一是缺乏持续的避孕措施。这项研究的总体目标是进行指导性研究，在15至24岁的年轻人中检查权力、性别规范、阳刚之气和避孕用具使用之间的路径。我的主要假设是，坚持性别规范和传统的男性规范会导致避孕措施的不一致和不使用。这项研究将通过三个具体目标来评估这一假设。目的1是探讨关系权力、性别规范和男子气概在影响青少年避孕用具使用方面的作用。这一目标包括对青少年和年轻女性、男性和夫妇进行定性的深入采访。目标2是调整和验证衡量关系权力、性别规范和男子气概的现有工具，使其适合青少年和年轻人。这一目标包括修改我自己的生殖自主量表、性别关系量表和关系中的男性意识量表，以供青少年和年轻男女使用。目标3是通过在一家青少年计划生育诊所进行的一项为期3个月的试验性前瞻性研究，确定关系权力、性别规范和男性气概如何影响青少年和年轻人的避孕用具使用。使用混合方法从多个学科的角度审视基于性别的权力，我预计将在三个领域做出重要贡献：1)关于性别与权力和避孕使用的理论，2)青少年基于性别的权力的衡量，以及3)减少意外怀孕的潜在干预措施。最终，这项有指导的研究将为我成功提交R01申请做好准备，以测试青少年避孕药使用干预和青少年生殖健康的性别和权力相关决定因素的研究生涯。

DESCRIPTION (provided by applicant): Career Goals: This is an application for a K01 Career Development Award in Population Research for Ushma Upadhyay, PhD, MPH, a Public Health Social Scientist at the University of California, San Francisco. Her preliminary research focuses on contraceptive use and unintended pregnancy, and includes the development of the first measure of reproductive autonomy, assessing a woman's power to decide about and control matters related to contraceptive use, pregnancy and childbearing. In the short term, she aims to build on this work, investigating the effect of gender-based power on contraceptive use among young people. In the long term, she aspires to conduct research that results in evidence-based interventions that help young people to control their fertility. The knowledge and experience she will gain from the K01 award will prepare her to compete for NICHD R01 funding to design a randomized intervention trial to test the effects of a gender-based power intervention on contraceptive use and unintended pregnancy among adolescents and young people. Environment: The University of California, San Francisco (UCSF) provides generous support for junior faculty. UCSF researchers have a long history of pursuing innovative ideas in reproductive health. As an institution, it has been unequivocally supportive of research on contraceptive use and unintended pregnancy. Key Elements of Research Career Development Plan: Dr. Upadhyay has a rich background in epidemiologic and demographic methods, with substantial experience analyzing large datasets. This career development award will enable her to address several remaining gaps in her training specific to her career goals, and to gain applied experience planning and executing a primary data collection study on gender-based power and contraceptive use. Her training goals are to gain experience and expertise in sociological theories of gender among adolescents, qualitative research, advanced quantitative methods, and translating evidence into intervention. To achieve these goals, Dr. Upadhyay has assembled a unique interdisciplinary training and mentoring team. It includes a Primary Mentor, Tina Raine-Bennett, MD, MPH, a clinician scientist formerly at UCSF who is now Research Director of the Women's Health Research Institute at Kaiser Permanente specializing in adolescent unintended pregnancy and racial disparities, and co-mentor Shari Dworkin, PhD, MS, a medical sociologist in UCSF's Department of Social and Behavioral Sciences and an expert on gender- based power. Her team includes three additional, complementary advisors: Diana Foster, PhD, a demographer in UCSF's Department of Obstetrics, Gynecology, and Reproductive Sciences, who studies the consequences of unintended pregnancy; Torsten B. Neilands, PhD, a quantitative methodologist at UCSF's Center for AIDS Prevention Studies with expertise in latent variable (structural equation) modeling; and Claire Brindis, DrPH, Professor of Pediatrics and Health Policy whose research focuses on adolescent and child health policy, adolescent pregnancy and pregnancy prevention, and adolescent health and risk-taking behaviors. Dr. Upadhyay's training will include a combination of structured reading lists and tutorials with mentors, coursework, self-directed learning, conference presentations and attendance, and seminars. Description of the Research Project: Unintended pregnancy is an important public health problem; half of all pregnancies in the United States are unintended. The transition to adulthood is a particularly vulnerable period for unintended pregnancy; women ages 15 to 24 are at highest risk. One of the main reasons for unintended pregnancy is lack of consistent contraceptive use. The overall objective of this study is to conduct mentored research that examines the pathways between power, gender norms, and masculinities and contraceptive use among young people ages 15 to 24. My main hypothesis is that adherence to gender norms and traditional norms of masculinity lead to inconsistent and non-use of contraceptives. This research will assess this hypothesis through three specific aims. Aim 1 is to explore the role that relationship power, gender norms, and masculinities have in influencing adolescent and young people's contraceptive use. This aim involves qualitative in-depth interviews with adolescent and young women, men, and couples. Aim 2 is to adapt and validate existing instruments that measure relationship power, gender norms, and masculinities so that they are appropriate for adolescents and young people. This aim involves adapting my own Reproductive Autonomy Scale, the Gender Relations Scale, and the Masculinity Ideology in Relationships Scale for use among adolescents and young men and women. Aim 3 is to determine how relationship power, gender norms, and masculinities impact adolescent and young people's contraceptive use through a 3-month pilot prospective study at an adolescent family planning clinic. Examining gender-based power from the perspectives of multiple disciplines using mixed-methods, I expect to make important contributions in three areas: 1) theory on gender and power and contraceptive use, 2) measurement of gender-based power among adolescents, and 3) potential interventions that reduce unintended pregnancy. Ultimately, this mentored research will prepare me for the successful submission of an R01 application to test an adolescent contraceptive use intervention and a research career in gender and power-related determinants of adolescent reproductive health.