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

描述（由申请人提供）：年轻的非洲裔美国妇女承担着不成比例的意外怀孕和性传播疾病的负担。双重保护战略可同时预防意外怀孕和性传播疾病。以前努力发展诊所为基础的干预措施，以促进双重保护，取得了有限的成功。由于对年轻妇女保护自己的战略缺乏了解，个人、伙伴和提供者之间的相互作用对年轻妇女的双重保护做法产生影响，以及提供者围绕双重保护的做法，这些努力受到了阻碍。拟议的干预措施旨在建立双重保护使用的动机，一个多层次的（自我，同伴，护理团队，合作伙伴等）围绕双重保护用途的支持文化，社会规范转向对双重保护用途的期望，承认双重保护用途的影响和挑战以及针对这些挑战的管理建议。研究方法：这是一项随机对照试验，测试基于组的教育和临床护理，以鼓励年轻的非洲裔美国妇女使用双重保护。我们将招募年龄在15- 19岁的非洲裔美国女性，她们正在格雷迪纪念青少年服务诊所接受生殖健康护理。同意入组的年轻女性将被随机分为两组。将以门诊日为随机化单位。随机分配至对照组的受试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体的临床护理。随机分配至干预组的受试者将接受相同的临床护理，但是，受试者将作为一组进入诊所。这些参与者将获得 根据需要提供个人临床护理以及基于群体的教育，重点是双重保护，方法如下：利用互动式多媒体平台，重点介绍双重保护战略，并选择一项战略，（双重保护的重要性，关系，性决策，伴侣沟通）一个一致的护理团队（护理、健康教育者、医疗保健提供者）根据需要为参加小组会议的个人提供支持和护理通过Facebook进行代祷沟通这项干预将从招募到最终随访持续18个月。我们将测试以下假设：H1：参与这种多组分干预的参与者将经历比对照组参与者更低的生物学结局（意外怀孕，衣原体和/或淋病）发生率。H2：参与这种多成分干预的参与者将报告比对照组的参与者更高的采用和坚持已被证明的双重保护策略。

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.