Developing and Testing a Smart Phone Based Contraceptive Use Educational Intervention for African Immigrant Women with Low Literacy

项目摘要/摘要 孕产妇死亡率仍然是育龄妇女死亡的第二大原因。 整个世界。孕产妇死亡是由计划外怀孕或不合时怀孕造成的，即 发生在母亲没有做好准备的时候，或者发生在上一次出生后太快。计划外怀孕是 与低出生体重、延迟获得产前护理以及妇女和 宝贝们。意外怀孕在低收入妇女、有色人种妇女和 移民妇女。计划外妊娠率可以通过计划生育来降低，这是 包括自然方法，以及避孕药的使用，无论是荷尔蒙还是其他。避孕措施的使用允许 妇女决定是否以及何时生育。此外，计划、推迟和间隔生育， 使妇女能够实现教育和职业目标。 计划生育的可及性受到以下因素的影响：获得医疗保健的机会、对不良影响的恐惧、 关于计划生育方法的错误信息泛滥，以及对伴侣或家庭成员的恐惧 对使用的反应。这些担忧在弱势和服务不足的人群中被放大，例如在移民中。 社区，那里的社会联系，以及与更大的医疗体系的联系可能没有那么强大。在 在美国，一个特别边缘化的群体是非洲移民妇女(包括非洲难民妇女)， 稳步增长的人口，据报道，他们的生殖健康结果总体较差 由于获得医疗保健的机会减少，语言障碍，社会经济地位低，可能更低 受教育程度。因此，此R21应用程序的目标是解决 通过为非洲难民提供显著和有意义的避孕信息，创造医疗保健环境 女性可能不会说英语，而且识字水平较低。 具体目标是：1)将现有的基于网络的计划生育干预措施转变为文化契合 以智能手机为基础的计划生育干预，以及2)评估可行性、可接受性和初步 所开发的基于智能手机的干预效果。 这种干预旨在通过提供自定进度的、以科学为基础的 教育。可行性和可用性研究的结果将使研究小组能够收集关于 该方法的过程、资源和科学可行性。这项初步评估将提供 形成的数据将为开发设计良好的未来R01实施试验提供信息。它也是 预计这一干预措施可以在更大的人口样本中进行试验。手机的使用 应用程序是一种创新的方法，允许自定进度但广泛传播 干预。

Project Summary/Abstract Maternal mortality continues to be the second leading cause of death for women of reproductive age around the world. Maternal mortality is contributed to by unplanned, or mistimed pregnancies, that is, pregnancies that occur at a time the mother is not prepared for, or too soon after a previous birth. Unplanned pregnancies are associated with low birth weight, delayed access to prenatal care, and other health concerns for women and babies. Unplanned pregnancy occurs disproportionately among low-income women, women of color, and immigrant women. Rates of unplanned pregnancy can be reduced through the use of family planning, which include natural methods, and use of contraceptives, whether hormonal or otherwise. Contraception use allows women to decide whether, and when to have children. In addition, planning, postponing and spacing births, allows women to achieve educational and career goals. Family planning access is influenced by factors such as access to health care, fear of adverse effects, proliferation of misinformation about family planning methods, and fear of a partner or family member’s reaction to use. These concerns are amplified in vulnerable and underserved populations, such as in immigrant communities, where social ties, and connections with the larger healthcare system may not be as strong. In the U.S., a particularly marginalized group is that of African immigrant women (including African refugee women), a steadily increasing population, who have been reported to have overall poorer reproductive health outcomes due to decreased access to health care, language barriers, low socioeconomic status, and potentially lower education levels. Therefore, the objective of this R21 application is to address important gaps in the healthcare environment by providing salient and meaningful contraceptive information for African refugee women who may not speak English, and have low literacy levels. The specific aims are to: 1) adapt an existing web-based family planning intervention into a culturally congruent family planning smartphone-based intervention, and 2) assess the feasibility, acceptability, and preliminary efficacy of the developed smart-phone based intervention. This intervention will be designed to increase access to information by providing self-paced, science-based education. Findings from the feasibility and usability study will allow the research team to gather information on the processes, resources, and scientific feasibility of the approach. This preliminary assessment will provide formative data that will inform the development of a well-designed future R01 implementation trial. It is also anticipated that this intervention could be trialed in in a larger sample of the population. The use of a cellphone application is an innovative method that allows for self-paced, yet wide spread dissemination of the intervention.