Gathering, Learning & Initiating: Setting the Stage for Community-engagement in Women's Health in SW Alaska

摘要：与美国一样，阿拉斯加的孕产妇死亡率（2014-2018年间为63%）一直在上升， 与阿拉斯加西南部农村的物质使用障碍（SUD）相关， 社区.为了解决患有SUD的妇女与孕产妇保健服务之间的潜在联系， 研究和预防性护理干预措施的设计必须适合当地社区。发展 适合当地的研究和干预战略需要当地社区和卫生部门的参与 护理机构作为当地的利益相关者，特别是在敏感和未探索的交叉问题上， 人口。该项目的目标1建议为西南地区的孕产妇健康研究奠定基础 阿拉斯加州，让感兴趣的当地妇女和卫生机构为未来的研究做准备， 通过建立妇女和产妇保健社区咨询委员会， 使用基于NIH的CAB工具包（Kubicek & Robles，2016）作为指南。此工具包是资源的一部分， 将社区之声纳入研究包，由美国国立卫生研究院的南方 加州临床和转化科学研究所，提供了一个概述，如何开发和维护一个 社区咨询委员会（CAB）的研究，以整合社区的观点。虽然 强调必须考虑如何使CAB成为一个支持性环境，以确保平等 参与-列出的战略“确定成员，将他们纳入研究过程， 随着时间的推移保持接触，会议便利化“并不一定考虑到 阿拉斯加农村的偏远或旅行困难，观察生计或商业捕鱼的重要性 季节，或不同部落和地区机构的层次导航。这些策略的运用， 然后，进行适当调整，以提高社区的兴趣和参与的机会; 提出了一个较小的基于本地的CAB，而不是一个较大的CAB。项目使用与 区域AHEC（区域健康教育中心）办公室在该地区进行介绍， WMH CAB成员对每个社区的建议;以及焦点小组或谈话圈 将举行会议，讨论如何以最佳方式研究妇女问题， 社区的产妇健康问题。本项目的目标2是专注于开发和执行 举办工作坊，培训一批本地本科生，以便在完成面试后， 设计的研究从随后的赠款资金开始。包括当地的AHEC研究生 在这一阶段，帮助促进社区会议;研究和干预设计;并进行 工作坊活动，让本地参与者成为未来研究的访问者。从五个CAB（5） 阿拉斯加西南部社区，在AHEC区域办事处的服务领域，将负责提供 对研究和干预设计以及讲习班组成部分的投入。

Summary: As in the US, Alaska’s increased maternal mortality (63% between 2014-2018) has been associated with substance use disorders (SUD) at disproportionately higher levels in rural southwest Alaska communities. To address the underlying connections between women with SUD and maternal health services, research and preventative care intervention designs must be tailored to the local community. Development of locally appropriate research and intervention strategies requires engaging the local communities and health care agencies as local stakeholders—particularly with sensitive and unexplored issues of intersectional populations. Aim 1 of this project proposes to lay the groundwork for a maternal health study in southwest Alaska by engaging interested local women and health agencies to prepare for future research in these communities through the creation of a Women’s and Maternal Health Community Advisory Board (WMH CAB), using an adapted NIH-based CAB toolkit (Kubicek & Robles, 2016) as a guide. This toolkit, part of a Resource for Integrating Community Voices into Research Study package, compiled by the NIH-based Southern California Clinical & Translational Science Institute, provides an overview of how to develop and maintain a community advisory board (CAB) for research studies to integrate community perspectives. While there is emphasis on the importance of considering ways to make the CAB a supportive environment to ensure equal participation— the strategies listed for ‘identifying members, integrating them into the research process, maintaining engagement over time, and meeting facilitation’ did not necessarily take into account the remoteness or difficulty of travel in rural Alaska, the importance of observing subsistence or commercial fishing seasons, or the layers of different tribal and regional agencies to be navigated. The use of these strategies, then, are appropriately adjusted to improve the chances of community interest and involvement; and five smaller local-based CABs proposed, instead of one larger one. Project uses already-existing ties with the regional AHEC (Area Health Education Centers) offices in the area for making the introductions and recommendations of WMH CAB members for each respective communities; and focus group or talking circle meetings will take place to engage in addressing how best to approach research on the Women’s and Maternal health issues in their community. Aim 2 of this project is focused on the development and executions of workshops to train a pool of local undergraduates for placement as local interviewers when the resulting designed research begins with subsequent grant funding. Local-based AHEC graduate student(s) are included in this phase to help facilitate the community meetings; research and intervention design; and to conduct workshop activities for the local attendees to become interviewers for the future studies. CABs from five (5) southwest Alaska communities, in the service areas of AHEC regional offices, will be tasked with providing input on research and intervention designs and workshop components.