Improving Menstrual Health Among Women and Girls Using Community Engaged Intervention Development in Nepal

项目摘要/摘要 尽管月经是一个自然的生理过程，但它往往与健康和安全有关。 挑战，特别是在资源匮乏的环境中。在尼泊尔，90%的妇女和女孩至少有一次月经 限制。最极端的是Chhaupadi，这是一种社会宗教传统，在这种传统中，妇女在 月经，使他们暴露在有害的健康后果中。缺乏关于有效的证据。 解决Chhaupadi问题的方法仍然很普遍。研究：这项社区参与的研究旨在 严格审查现有的干预证据，以及共同设计和试点具有文化相关性的Chhaupadi 旨在最终改善尼泊尔妇女健康的干预措施。研究目标如下：目标1--开展 现实主义综合，以阐明迄今为止Chhaupadi干预成功或失败的机制，包括 关键线人面谈(KIIS)(n=35)。目标2--与妇女(n=30)共同设计Chhaupadi干预方案 使用参与式、以人为本的设计活动的地区。干预措施将通过社区加以完善 会议(n=6)和KIIS(n=25)。目标3-在两个匹配的社区(干预和 对照组，n=45)。将进行采用标准化措施的调查和重点小组讨论(n=6)，以 评估健康态度和行为的可行性、可接受性和变化，预计将受到 干预。候选人：Sara Baumann博士是匹兹堡大学商学院的助理教授 公共卫生，行为和社区卫生科学系，曾在 社区参与的研究和尼泊尔妇女的生殖健康。培训：将实现四个培训目标 支持鲍曼博士成为一名独立调查员的轨迹：1)获得现实主义技能 综合以确定潜在的原因机制和干预成功或失败的原因；2)开发 干预措施制定和评估以及实施科学方面的专门知识；3)掌握新技能 适用于低收入和中等收入国家(LMIC)的临床试验设计；以及4)在 领导力、导师、助学金写作和学习管理。导师/环境：鲍曼博士将成为 由一支由国际和多学科专家组成的卓越团队提供支持，包括多样化的指导 在尼泊尔的团队、顾问委员会、顾问和合作组织。她的导师团队有专业知识 在基本内容和方法领域，如干预开发、评估、临床试验和 统计分析。她的全面职业发展计划包括实质性的指导，说教 在匹兹堡大学(美国)和特里布万大学(尼泊尔)进行培训和体验式学习。通过 成功完成这些严格的职业发展和研究计划，鲍曼博士将完全 准备转型为成功的独立全球卫生研究人员和干预主义者，利用 改善低收入中等收入国家妇女生殖健康的社区参与办法。

PROJECT SUMMARY/ABSTRACT Despite being a natural physiological process, menstruation is often associated with health and safety challenges, especially in low-resource settings. In Nepal, 90% of women and girls follow at least one menstrual restriction. The most extreme is chhaupadi, a social-religious tradition in which women live in isolation during menstruation, exposing them to harmful health consequences. There is a dearth of evidence regarding effective approaches to address chhaupadi, which remains widespread. Research: This community-engaged study aims to rigorously review extant intervention evidence, as well as co-design and pilot a culturally relevant chhaupadi intervention to ultimately improve women’s health in Nepal. The study aims are as follows: Aim 1 - Conduct a Realist Synthesis to elucidate the mechanisms of success or failure of chhaupadi interventions to date, including key-informant interviews (KIIs) (n=35). Aim 2 - Co-design a chhaupadi intervention with women (n=30) in three districts using participatory, human-centered design activities. The intervention will be refined via community meetings (n=6) and KIIs (n=25). Aim 3 - Pilot test the intervention in two matched communities (intervention and control, n=45). Surveys with standardized measures and focus group discussions (n=6) will be conducted to assess feasibility, acceptability, and changes in health attitudes and behaviors expected to be impacted by the intervention. Candidate: Dr. Sara Baumann is an Assistant Professor at the University of Pittsburgh School of Public Health, Department of Behavioral and Community Health Sciences with extensive previous training in community-engaged research and women’s reproductive health in Nepal. Training: Four training goals will support Dr. Baumann’s trajectory toward becoming an independent investigator: 1) Acquire skills in Realist Synthesis to identify underlying causal mechanisms and reasons for intervention success or failure; 2) develop expertise in intervention development and assessment, as well as implementation science; 3) attain new skills in clinical trial design applicable to low- and middle-income countries (LMICs); and 4) gain essential skills in leadership, mentorship, grant writing, and study management. Mentors/Environment: Dr. Baumann will be supported by an exceptional team of international and multidisciplinary experts including a diverse mentorship team, advisory board, consultants, and collaborating organizations in Nepal. Her mentorship team has expertise in essential content and methodological areas such as intervention development, evaluation, clinical trials, and statistical analyses. Her comprehensive career development plan includes substantial mentorship, didactic training, and experiential learning at the University of Pittsburgh (US) and Tribhuvan University (Nepal). By successfully completing these rigorous career development and research plans, Dr. Baumann will be fully prepared to transition into a successful independent global health researcher and interventionist who harnesses community-engaged approaches to improve women’s reproductive health in LMICs.