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

项目总结/摘要 尽管月经是一个自然的生理过程，但它通常与健康和安全有关。 挑战，特别是在低资源环境中。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，妇女在怀孕期间过着与世隔绝的生活。 月经，使他们暴露于有害的健康后果。缺乏证据表明， 解决chhaupadi问题的办法，这一问题仍然很普遍。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文化相关的chhaupadi 这是一项旨在最终改善尼泊尔妇女健康的干预措施。研究的目的如下：目的1 -开展 现实主义的综合，以阐明迄今为止chhaupadi干预的成功或失败的机制，包括 关键知情人访谈（KIIs）（n=35）。目标2 -在三个国家与妇女（n=30）共同设计chhaupadi干预措施 社区使用参与式的、以人为本的设计活动。干预措施将通过社区 会议（n=6）和KII（n=25）。目标3 -在两个相匹配的社区（干预和 对照组（n=45）。将进行标准化测量调查和焦点小组讨论（n=6）， 评估可行性，可接受性，以及预期受影响的健康态度和行为的变化 干预候选人：Sara Baumann博士是匹兹堡大学医学院的助理教授。 公共卫生，行为和社区卫生科学系，曾接受过以下方面的广泛培训： 社区参与的研究和尼泊尔妇女生殖健康。培训：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）获得现实主义的技能 综合以确定潜在的因果机制和干预成功或失败的原因; 2）制定 干预措施制定和评估以及实施科学方面的专门知识; 3）获得新技能 适用于低收入和中等收入国家（LMIC）临床试验设计;以及4）获得以下方面的基本技能 领导力、指导、拨款写作和学习管理。导师/环境：鲍曼博士将 由国际和多学科专家组成的卓越团队提供支持，包括多元化的导师 小组、咨询委员会、顾问和尼泊尔的合作组织。她的导师团队拥有 在基本内容和方法领域，如干预开发，评估，临床试验， 统计分析。她全面的职业发展计划包括大量的指导，说教， 在匹兹堡大学（美国）和特里布万大学（尼泊尔）接受培训和体验式学习。通过 成功地完成这些严格的职业发展和研究计划，鲍曼博士将完全 准备过渡到一个成功的独立的全球卫生研究员和干预谁利用 * 采取社区参与的办法，改善中低收入国家妇女的生殖健康。

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.