Impact of Social Factors on the Effectiveness of a Preconceptional PTB Program

简介（由申请人提供）：候选人：Vijaya K. Hogan, p.h.博士，M.P.H.是北卡罗莱纳大学妇幼保健临床副教授和妇产科兼职助理教授。她的研究重点是早产的原因和种族差异。职业发展计划：候选人将参加正式课程、研讨会和指导研究，学习与健康决定因素有关的基本理论、知识和技能以及社会科学方法，学习先进的定量分析技术和道德研究行为。近期目标：整合社会科学和流行病学方法，了解社会暴露对弱势群体的影响。长期目标：通过发展和应用这些综合知识来设计、实施和评估有效的多层次（行为、社会和临床）随机对照干预措施，降低全国早产率和差异。具体目标：1；查明并确认对妇女参与孕前早产预防干预有不利影响的具体社会因素；2. 估计这些关键因素的不同经验在多大程度上解释了在接受有组织的、先入为主的干预措施方面的差异。研究方法：利用现有的行为/临床随机对照试验中有关孕前分娩减少早产干预的数据和随访，我们将使用安德森行为模型进行定量分析，以确定孕前护理在该人群中使用的决定因素。然后，我们将使用人种学技术来确定社会暴露，个人行为和获得孕前护理之间更具体的途径。指导：由著名社会学家（Mullan-Harris）提供指导；在包括人类学家、社会学家、人口学家和流行病学家在内的咨询小组的支持下。相关性：本研究将确定特定的社会暴露继续对医疗保健的参与和结果产生影响，即使所有系统性的障碍都被消除。我们将开发一种可复制的经验方法来测量非裔美国妇女独特经历的相关慢性压力暴露的变化，并更好地了解这些因素影响循证护理有效性的机制。

DESCRIPTION (provided by applicant): Candidate: Vijaya K. Hogan, Dr. P.H., M.P.H. is a Clinical Associate Professor in Maternal and Child Health and Adjunct Assistant Professor in Ob/GYN at the University of N. Carolina. Her research focuses on causes of preterm birth and ethnic disparities. Career Development Plan: The candidate will participate in formal coursework, workshops and mentored research to learn essential theory, knowledge and skills and social science methods relating to determinants of health, in advanced quantitative analytic techniques and in ethical conduct of research. Immediate Objective: to integrate social science and epidemiologic methods to understand effects of social exposures on vulnerable populations. Long-term objective: To reduce national rates of preterm birth and disparities by developing and applying this integrated knowledge to the design, implementation and evaluation of effective multi-level (behavioral, social and clinical) randomized controlled interventions. Specific Aims: 1 .Identify and validate specific social factors that adversely impact on women's participation in preconceptionally delivered preterm birth prevention interventions; 2. Estimate the extent that differential experience of these key factors explains variation in receipt of structured, preconceptionally delivered interventions. Research Methods: Using data and following up on subjects from an existing behavioral/clinical RCT on preconceptionally delivered preterm birth reduction interventions, we will conduct a quantitative analysis using the Anderson Behavioral Model to identify the determinants that explain utilization of preconceptional care in this population. We will then use ethnographic techniques to identify more specific pathways between the social exposures, individual behaviors and access to preconceptional care. Mentorship: Mentorship will be provided by a prominent sociologist (Mullan-Harris); with support from an Advisory group that includes anthropologist, sociologist, demographer, and epidemiologist. Relevance: This research will identify the specific social exposures that continue to exert an influence on health care participation and outcomes, even when all systemic barriers to care are removed. We will develop a replicable and empirical method for measuring the variation in relevant chronic stressful exposures uniquely experienced by African American women with a better understanding of the mechanisms through which these factors influence the effectiveness of evidence-based care.